Circumcision - Exploring Options
Understanding the Procedure and Your Options on Circumcision
Part 2 - Who Performs a Circumcision, How it is Performed and What Options You may Have
What are the reasons for performing a circumcision?
Most circumcisions are performed today due to personal choice, religious reasons, potential health benefits and traditional or cultural norms.
Who performs a circumcision?
Most of the time when a circumcision is performed, it is handled by the mother's obstetrician while she is still at the hospital. There are several other options, however, for circumcision.
An increasingly popular option is to have a pediatric urologist do a circumcision either at the hospital or at an office visit. One of the advantages with a urologist is that they are often more skilled on using options, such as nerve blocks, for pain relief (see below regarding pain medication options.)
If the family is interested, they may hire a moyel to perform the circumcision in their home. This can be an option for both Jewish and non-Jewish families. Occasionally the baby's pediatrician will also do circumcisions.
When is a circumcision performed?
In most cases, a circumcision is done within a few days after birth or up to about 8 days after birth. One advantage of waiting for at least 8 days is that the baby will begin to make its own Vitamin K, which is a necessary component for blood clotting. Exactly when the circumcision may be performed often largely depends on the care provider who is doing it (see above.)
Are there options for pain medication with a circumcision?
There are several options for pain relief including a ring block, a nerve block and a topical cream containing lidocaine. There some evidence that a pacifier dipped in a sugar solution may reduce pain. If the procedure is performed by a moyel, the baby is often given a few drops of wine prior to the circumcision. Be sure you explore all of the pain medication options with the care provider who is responsible for performing the circumcision prior to having it done.
How do parents help care for the infant following a circumcision?
If the mother is breastfeeding, offering the breast as soon as possible may help to soothe and comfort the infant after the circumcision. Be sure that you wash your hands prior to touching the newly circumcised penis. Check for bleeding at least every hour for the first 12 hours. If bleeding occurs, apply gentle pressure with a sterile gauze pad. Call your provider if bleeding does not stop.
Watch to see that the infant urinates after the circumcision. Change the diaper at least once every 4 hours, washing the penis gently with warm water. Apply petrolatum to the glans at each diaper change. Do not use soap until the circumcision has healed.
The penis will appear at first dark red and then is covered with a yellow-ish coating for 2-3 days. Redness, swelling or discharge are signs of infection so contact your care provider if this is apparent.
Making the Decision to Circumcise or Not to Circumcise Your Son
Even after you have learned about all of your options, you may still be wondering if circumcision is right for you and your son. Remember that this is a big decision and it should not be made without careful research. Whatever your plans are, it can be helpful to alert your medical team to your decision in your birth plan.
Don't be surprised if you discover that this issue causes emotional responses among your friends or family if you decide differently than they did. This is a topic that parents often feel quite passionate about so it does tend to bring up strong reactions. It is crucial to recognize that while there are many opinions about circumcision out there, no one knows best for you and your family but you!
Part 1 includes Risks, Benefits and Statistics of Circumcision.
What are your thoughts about circumcision? Share them with us.
