Maybe We Should've Circumcised Junior

By Edward Edelson
HealthScout Reporter

TUESDAY, Feb. 6 (HealthScout) -- A larger percentage of parents who do not have their newborn sons circumcised end up dissatisfied with that decision than parents whose boys undergo the procedure, a new study finds.

One reason for that unhappiness is a feeling that they did not get enough information from their doctors before making that decision.

"Parents of uncircumcised boys … were less likely to have been asked about circumcision, believed they did not receive adequate information about circumcision and felt less respected by their medical providers about their decision," says a report in the February issue of the journal Pediatrics.

"The most striking finding was the large percentage of people who feel they did not have an adequate discussion with their physician to get all the facts to make a decision," says study leader Dr. Robert Adler, associate chair of pediatrics at Childrens Hospital Los Angeles.

Circumcision, the surgical removal of the foreskin of the penis, is a common procedure in this country, taking place about 1.2 million times a year.

The study questioned 149 families in Los Angeles six to 36 months after the birth of a son. That small sample covers a wide range of ethnic and economic backgrounds, from families with incomes under $15,000 a year to those with incomes above $90,000; 34.9 percent were white, 28.9 percent black, 23.5 percent Latino and 4 percent Asian-American.

While Jewish tradition requires circumcision, only one in eight families said they based their decision on religion. Health reasons were the leading explanations.

Of the 149 boys, 81 were circumcised and 68 were not, with almost all done in the first eight weeks after birth. Twenty-seven percent of parents whose child was not circumcised said they were reconsidering that decision, while only 14 percent of parents whose boys underwent the procedure said they were having second thoughts.

Doctors need to talk

The American Academy of Pediatrics' (AAP) position, formulated by a task force in 1999, is that the medical benefits do not warrant routine circumcision. Nevertheless, Adler says, "Physicians have some obligation to discuss circumcision with the parents, to give them information and find out what is on their minds."

Dr. Alan Fleischman, senior vice president of the New York Academy of Medicine and a member of the task force, says, "One of the things the task force was quite specific about was the responsibility of health-care professionals who care for boys to communicate with parents on the issue."

The study's findings are not surprising, he says: "Almost always, these survey results show families saying they wish they had more information before making a decision."

Two-thirds of the families in the study said they had information from a physician, either an obstetrician or a gynecologist. Most others said their knowledge came from word of mouth or from the mass media.

Parents who decide not to circumcise a newborn baby face a number of barriers in reconsidering the decision, Adler says. Money is one, since the procedure can cost upwards of $3,000. They must also consider surgical risks and the pain that the child will undergo. The AAP recommends physicians give pain relief during circumcision.

The AAP task force said circumcision can reduce the risk of urinary tract infections, from one in 100 to one in 1000 in the first year of life. Some research has shown that circumcised men are less likely to acquire HIV and syphilis.