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The Effects of Circumcision on Newborn Boys

Thursday, June 10th, 2010

If you are planning a hospital birth for your son, you should expect hospital staff to approach you at some point in the first day or two after your son is born to ask about circumcision. There are many long-term reasons to leave your son intact,1 but you may not have considered the more immediate benefits to you and your new baby.

No American medical association recommends infant circumcision as a routine procedure. The reason that American medical associations (and the vast majority of medical associations worldwide) do not recommend routine infant circumcision is because it is not medically necessary.2  And as Lamaze’s Healthy Birth Practice Paper #6 details, “experts agree that unless a medical reason exists, healthy mothers and babies shouldn’t be separated after birth or during the early days following birth.”3 Consequently, unless there is a medical reason to circumcise your newborn son, it is inadvisable to agree to this unnecessary medical procedure.

circumcision restraint
Immediate Consequences of Routine (Medically Unnecessary) Infant Circumcision

1. Circumcision Causes Pain and Stress: An infant’s foreskin has more than 240 feet of nerves, 20,000 nerve endings, and 3 feet of veins, arteries, and capillaries – circumcision removes all of them, causing the infant tremendous pain.4 Research has conclusively demonstrated “that circumcision has significant physiologic impact on newborns, mainly due [to] pain.”5 Serum cortisol (a hormone released in response to stress) concentrations increase during and after circumcision,6 and “[h]eart rate, respiratory rate and blood pressure increase, and oxygen saturation decreases, during and shortly after circumcision.7

After circumcision, the penis has a raw, open wound. The newborn’s surgically exposed glans is re-injured by abrasion and contaminants because it is encased in diapers (including the baby’s own feces and urine, which breaks down into ammonia). Disposable diapers themselves are also often irritants, because they are laden with chemicals, dyes, and fragrances that cause further pain.

2. Circumcision Interferes with Breastfeeding: Circumcision negatively affects breastfeeding, regardless of whether infants are given Acetaminophen (Tylenol) to help manage pain immediately after circumcision. Some circumcised males are unable to suckle at all after the procedure. Mothers who leave their sons intact have a better chance at establishing a healthy breastfeeding relationship.8

3. Circumcision Disrupts Sleep: After circumcision, babies’ normal sleep patterns are disrupted. Researchers believe this may be a mechanism to cope with the stress of the procedure.9 Infants who do not get enough sleep or enough quality sleep are at risk for additional significant stress.10

4. Circumcision Can Interrupt Normal Bonding and Causes Emotional Trauma: Lamaze recognizes that “[i]nterrupting, delaying, or limiting the time that a mother and her baby spend together may have a harmful effect on their relationship and on breastfeeding success.”11 The significant stress, disrupted sleep patterns, and breastfeeding problems experienced by circumcised babies all have the potential to interrupt the normal, healthy bonding with their caregivers. Bonding is interrupted because “the circumcision procedure frequently causes the newborn to withdraw from his environment[,]” including his mother.12

Moreover, circumcision causes emotional trauma to parents. Over 80% of parents regret their circumcision  decision in the first six months of their sons’ lives. 13

Protect Your Newborn: Leave Him Intact

Unless there is a medical reason to circumcise, you and your son can only benefit by deciding to keep him safe and close to your side after birth. The newborn period is so beautiful and fleeting. There is no reason to traumatize your baby or jeopardize your breastfeeding relationship by exposing your son to needless pain and stress.

If, after thoroughly researching, you feel that the decision to circumcise is one that you must make, please wait until after those fragile newborn days. Remember, you can always decide to circumcise, you can never decide to take it back.14

This post is part of the Lamaze Healthy Birth Blog Carnival. The topic of this month’s carnival is “keeping moms and babies together after birth.”

Photo credit: peaceful parenting (site) (Facebook fan page)

  1. Please see What is Circumcision and Common Concerns, as well as the articles and research cited therein, for an explanation of the many reasons to leave your newborn son intact. ↩
  2. For official statements of many leading medical associations worldwide, please see this list compiled by NOCIRC. ↩
  3. Jeannette Crenshaw, “Healthy Birth Practice #6: Keep Mother and Baby Together,” (citing Academy of Breastfeeding Medicine Protocol Committee, 2007; American Academy of Family Physicians, 2007; American Academy of Pediatrics Expert Workgroup on Breastfeeding, 2005; International Lactation Consultant Association, 1999; UNICEF/WHO, 2004; WHO, 1998) ↩
  4. Paul Fleiss, MD, “The Case Against Circumcision” ↩
  5. Arie Alkalay, MD, “Analgesia for Non-Ritual Circumcision in Healthy Newborns” ↩
  6. Megan R. Gunner et al., “The Effects of Circumcision on Serum Cortisol and Behavior” ↩
  7. Analgesia for Non-Ritual Circumcision in Healthy Newborns; see also K.J.S. Anand et al., “Pain and Its Effects in the Human Neonate and Fetus” ↩
  8. Cynthia R. Howard, MD, “Acetaminophen Analgesia in Neonatal Circumcision: The Effect on Pain.” “Immediately” being 2 hours after the procedure. Acetaminophen is shown to have a positive effect on pain starting around 6 hours after the procedure. ↩
  9. Thomas F. Anders, MD and Robert J. Chalemian, MD, The Effects of Circumcision on Sleep-Wake States in Human Neonates; Robert N. Emde, MD, et al., “Stress and Neonatal Sleep” ↩
  10. Avi Sedah, “Stress, Trauma, and Sleep in Children” ↩
  11. Healthy Birth Practice #6: Keep Mother and Baby Together (citing (Enkin et al., 2000) ↩
  12. “Position Statement: The Effects of Circumcision on Breastfeeding” (citing Stress and Neonatal Sleep and Richard E. Marshall et al., “Circumcision: II. Effects Upon Mother-Infant Interaction“) ↩
  13. Paul Fleiss, MD, “What Your Doctor May Not Tell You About Circumcision” at xi ↩
  14. Of course, allowing your son to make his own informed decisions about his genitals is ideal. Every person should have the right to decide whether to keep his or her genitals whole. Wouldn’t you want to have the option? For more, see “Circumcision FAQ,” What if we want to have our son circumcised? ↩

Posted in Attachment Parenting, Breastfeeding, Circumcision, Diapering, Intactivism, Kids' Health, Parenting, Pregnancy & Birth | 101 Comments »

Big B, Little B, What Begins with B?

Friday, April 9th, 2010

I have never been blessed (or cursed, depending on your viewpoint) with large breasts. When I was growing up, I heard all of the euphemisms for being small-breasted:

Flat as a pancake
Mosquito bites
Flat as the Kansas plains
Smaller than anthills
Flat as a board
Titless wonder

It stung a little. I made up for being small-breasted by helping keep the Victoria’s Secret push-up bra line afloat.

Medium-sized breasts, even, eluded me until my third trimester of pregnancy. By the time my milk came in, Tom and I marveled over my melon-sized breasts, which were literally bigger than Kieran’s newborn head. For the first time in my life, I had breasts.

Funny thing was, I didn’t care as much as I thought I would. See, before breastfeeding, breasts had been sexualized in my eyes too. It always irked me that men were so focused on this particular part of the female anatomy, but I was guilty of the same thing.

And then I nourished my son. For over ten months, Kieran’s sole source of nutrition came from my body. To this day, my breasts provide him with comfort and nourishment. I have successfully made the mental switch from “breasts as sexual toys” to “breasts with a biological purpose.”

Thankfully, that mental transition came before my breasts started to deflate. Now that Kieran nurses more for comfort than calories, my milk supply has dropped. I am, once again, sporting small breasts.

But this time, it doesn’t matter to me. My breasts will always be beautiful – big as melons and bursting with breastmilk, or a little bit saggy but full of milky memories. Now whenever I think of my breasts, I hear the phrases:

Life-giving
Mama milk
The perfect food
Love
Nurturing
Trust
Miraculous
Nursies
Comforting
Awe inspiring
Bonding
Provision
Mother

How has your view of breasts evolved after pregnancy and breastfeeding (if applicable)?

What words or phrases would you add to my last list?

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This post is participating in the Body Image Carnival being hosted by Melodie at Breastfeeding Moms Unite! and MamanADroit who will be posting articles on themes pertaining to body image all week! Make sure you check out their blogs everyday between April 12-18 for links to other participants’ posts as well as product reviews, a giveaway, and some links to research, information and resources pertaining to body image.

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Posted in Breastfeeding, Breastfeeding Beyond Infancy, Lactivism, Parenting, Pregnancy & Birth | 19 Comments »

Healthy Birth Blog Carnival: Birthing On Our Backs

Tuesday, April 6th, 2010

This post is part of the Lamaze Healthy Birth Blog Carnival. The topic of this month’s carnival is “avoid giving birth on your back, and follow your body’s urges to push.”

A Tale of Two Labors

I recently had the great honor of helping coach my younger sister through her natural childbirth. I have no training as a doula or birth coach, but I have read extensively about natural childbirth and delivered my own son at a birth center (almost) drug-free.

My sister’s labor was significantly shorter than mine: she entered active labor around 10:00p.m., felt the urge to push around 1:10a.m., and only needed to push a handful of times before her beautiful son joined us Earthside.

As fast as her labor and delivery were, it still pains me a little to think about what was done to her. When she felt the urge to push, she was standing up and leaning against the hospital bed. She pushed once and her water broke (the midwife wanted to break it earlier, thankfully the midwife did not force the issue). She pushed twice and felt the baby descending.

At that point, the birthing team came into the room and literally forced Shawna to get on the bed. Shawna resisted. She was uncomfortable on the bed, and when the nurses forced her to lie down, she began to cry from the pain and pressure – not from the fact that the baby’s head was crowning – but because she had felt more comfortable and in control in the position she chose for herself previously.

Two pushes later, she was done, but the scene replays in my thoughts frequently. My own labor was complicated by the fact that Kieran was sunny side up. His posterior position made him get “stuck” at my tailbone (which was broken in the process). I pushed for six hours* in a variety of positions and ended up giving birth on the birthing stool. (1)

Luckily I was at a birth center with a midwife who was as determined as I was to get Kieran out safely, and vaginally. If I had been at that hospital and forced to lie on my back, I would have ended up being subjected to a cesarean section.

The fact that it took work to get Kieran to descend should not have been an automatic ticket to the operating room.

Birthing on Our Backs (or “Supine in the Stirrups”)

Both anecdotal and scientific evidence make clear that birthing lying down is not ideal. To begin with, lying down or in a semi-reclined position decreases the space of the birth canal up to 30%. Opening up the birth canal not only helps the baby descend, but it reduces risk of harm to the laboring mother. (2)

Risks to the mother include dislocation or fracture of the coccyx, increased strain and tearing, a higher risk of harm to the pelvic floor, possible increased hypotension & pregnancy-induced hypertension, less effective contractions, ineffective pushing and a general slowing of labor, and an increased risk of cesarean section. (3)

Because of this ineffective method of pushing, there are also risks to the baby. Those risks include pressure on the baby’s neck, excessive bruising and head molding, a broken clavicle, compression of the umbilical cord, disruption to the baby’s oxygen supply, and an increased need for vacuum or forceps delivery due to poor positioning. (4)

I used my sister (Tammy) as a source of strength for lots of leaning and rocking during labor. Mom was always nearby to give a backrub or a reassuring pat.

The Benefits of Effective Pushing

Getting off your back for active labor and the pushing stage has incredible benefits, not the least of which is a shorter, more comfortable labor and delivery. Effective laboring allows for more effective contractions and an increased sense of power and involvement. It allows the baby a better oxygen and blood supply and the opportunity to descend into the optimal birthing position. (5)

If you are planning an unmedicated birth, familiarize yourself with labor and birthing positions that are safer and more comfortable than lying down. Use gravity to aid your baby’s descent and to empower yourself.

I know it enabled me to birth my posterior baby without an epidural, without a vacuum or forceps delivery, and without unnecessary surgery.

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*I should not have pushed for six hours – I did not feel the urge to push until about an hour before Kieran was born – but the midwife was worried about the amount of time that had already passed and asked me to try. I will save that story for another day.
(1) For descriptions and pictures of helpful labor positions, see “Positions for Labor,” available at http://www.lamaze.org/LinkClick.aspx?fileticket=SpYolBfPLnk%3d&tabid=792&mid=1751
(2) “Positioning for Prevention,” http://www.ubpn.org/index.php?option=com_content&view=article&id=67&Itemid=68
(3) Positioning for Prevention; see also “Episiotomy,” http://onyx-ii.com/birthsong/page.cfm?episiotomy
(4) Positioning for Prevention
(5) Positioning for Prevention; see also “Healthy Birth Practice #5: Avoid Giving Birth on the Back and Follow the Body’s Urges to Push,” http://www.lamaze.org/ChildbirthEducators/ResourcesforEducators/CarePracticePapers/NonsupinePositions/tabid/485/Default.aspx

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Posted in Pregnancy & Birth | 11 Comments »

Researching Circumcision, Part 3: Common Concerns

Monday, March 1st, 2010

This article is the third in a series I am writing to help expectant parents get a jump start on their research about circumcision. Part one discussed the foreskin and its normal, necessary functions. Part two provided information on the procedure itself (what it removes, how it is performed, and some of the consequences). Part three presents information on many of the common concerns parents have when considering circumcision (including an examination of the research on STD’s, cancer, and other health issues).

Intact v. Cut: Common Concerns

There is an abundance of misinformation floating around about circumcision. Some of this is due to outdated (and subsequently proven untrue) “scientific” articles, some to current studies that were not conducted using scientifically acceptable methods, some simply to old wives’ tales. Thankfully, there are several trustworthy sources available that can help parents sift through the misinformation to discover the truth about circumcision and its consequences. Following are facts and links to more resources on the topics that often concern parents about intact v. cut penises.

1. Circumcision does not prevent HIV/AIDS: “Transmission of HIV infection is caused by risky behaviors, such as multiple sex partners, failure to use condoms, and contaminated instruments or needles.” Recent studies, however, claim that circumcised men in Africa have a lower chance of contracting the AIDS virus than men who are intact. Aside from the fact that scientists and scholars have questioned the methods and results of those studies, there are several compelling reasons that the African research is inapplicable when discussion routine infant circumcision. (1)

First, other studies provide evidence that the exact opposite is true: circumcised men in Africa are actually more likely to contract the AIDS virus than are intact men. (2) Second, it makes no scientific sense to compare the behavior of adult men in Africa to the behavior of infants in the United States. The populations “have too little in common . . . .”

Third, “the US has the highest rate of medically unnecessary, nontherapeutic infant circumcision in the world – about 56 percent of male babies today undergo the procedure, . . . and yet the HIV infection rate in North America is twice the rate in Europe, where circumcision rates are low.” If circumcision prevented HIV, it should logically follow that the United States would have some of the lowest rates of AIDS, since men have traditionally been circumcised here. That is not the case. (3) Fourth, the average sexually active heterosexual American male has a 0.03% chance of becoming infected with HIV in his lifetime. If that heterosexual male was high risk? He still only has a 0.3% chance of contracting HIV in his lifetime. Circumcision has no effect on that number, but the use of condoms will drastically decrease the risk. (4)

“Circumcision cannot prevent the spread of HIV; circumcised men contract HIV, transmit HIV, and die from AIDS. ” Moreover, circumcision does nothing to prevent the transmission of HIV to a female partner. (5) Circumcision is not an HIV vaccine. To protect your children from HIV and other STDs, educate them about safe sex practices and teach them how to use condoms.

2. Circumcision does not prevent STDs: Again, the United States “has the highest rate of circumcision of any Western nation (by FAR the highest as our rates are about 50% and the next closest is Canada with a rate around 10%). We also have the HIGHEST rate of all STDs of any Western nation (including HIV). Developed nations where 98-99% of their boys/men remain intact have the lowest rates of STDs (including HIV). If circumcision ‘protected’ against diseases[,] . . . we would NOT see these figures to such an extreme and obvious degree.” (6)

To be more specific, here is a collection of scientific research on circumcision and STDs:

Cook et al. (1994) were unable to show a definite benefit for circumcision—finding a slight tendency for non-circumcised men to have more syphilis and gonorrhea, but less tendency to have genital warts. Donovan et al. (1994) reported no significant difference between non-circumcised and circumcised men. Van Howe (1999) found circumcised men may be slightly more likely to have urethritis and uncircumcised males may be more prone to genital ulcer disease (GUD). Dickson et al. (2008) found more STD in circumcised men but the difference was not statistically significant. The Fetus and Newborn Committee of the Canadian Paediatric Society found that “circumcision had no significant effect on the incidence of common STDs.” The AAP Task Force (1999) reported that “behavior factors appear to be far more important than circumcision status.” The medical evidence does not support the practice of neonatal circumcision to prevent STDs. (7)

3. Circumcision does not prevent cancer: “Circumcision is ineffective for the prevention of penile cancer.” Scientific research has shown that it makes no difference whether a man is circumcised or intact – his risk of getting penile cancer is virtually unchanged.

What about cervical cancer? Same story. “The risk factors for cervical cancer are infection with human papilloma virus (HPV) and smoking. Risk of infection with HPV is increased by early onset of sexual intercourse and multiple sex partners. There is no clear evidence that male circumcision decreases the risk of infection.” (8)

The American Cancer Society has actually written a letter to combat the myth that circumcision prevents cancer in either men or women. The American Cancer Society’s purpose in writing the letter was “to discourage the American Academy of Pediatrics from promoting routine circumcision as a preventive measure for penile or cervical cancer. The American Cancer Society does not consider routine circumcision to be a valid or effective measure to prevent such cancers.” (9)

Do you still need to be convinced? Think of it this way: “Men have a higher chance of getting BREAST CANCER (0.7% likelihood) than they do of getting penile cancer (0.09%).” (10)

Cutting off an infant’s foreskin to “prevent cancer” is ludicrous.

4. Circumcision does not prevent urinary tract infections (UTIs): UTIs are very rare in boys, whether they are intact or circumcised. “[I]n the first six years of life, the incidence of UTI in boys [is] 1.8 percent[;] in girls it [is] 6.6 percent. . . . When UTI does occur, it is easily treated medically. . . . The consensus of medical opinion is that circumcision is of little, if any, value in reducing UTI.” (11)

The most effective way to combat UTIs in boys and girls? Breastfeeding. Studies have shown that “breastfed infants have only 38% as many UTIs as non-breastfed infants.” (12) The following sticker is incredibly apropos:

Get this sticker and more FREE (or leave a donation) at http://www.tlctugger.com/prodStickers.htm

5. Intact penises are actually cleaner: I love Dr. Dean Edell’s response to this argument:

The most common myth is that it’s cleaner to be circumcised. It’s hard to imagine how this has persisted in an era of soap and running water. But certainly it’s understandable that people do get upset with moist places in the body.

A woman’s reproductive tract is certainly moist and contains lots of bacteria, yet no one would suggest circumcising females to make them cleaner. Intact boys and children have nothing to ‘clean’ and a post-puberty man can rinse his penis just as he would wash any other part of his body, and just as a woman washes her genitals. (13)

The intact penis has special properties to keep itself cleaner than a cut penis. Both the immunological properties and the design of the foreskin help keep the penis properly rinsed and moisturized, much like the eyelid does for the eye. (14)

6. Intact penises do not require special care: The number one rule in raising an intact son? Only clean what is seen.

As mentioned in the last article in this series, the foreskin is actually attached to the glans of the penis at birth, much like your fingernail is attached to the bed of your finger. Parents should NEVER retract an intact penis, the foreskin will separate naturally over the course of years. Remember, the glans is meant to be an internal organ – you do not need to expose, touch, or clean it.

Retracting an intact child before he is ready is painful and can cause bleeding and infections. Parents must be vigilant that no one – not babysitters, doctors, or other well-meaning but ignorant individuals – retract their child’s foreskin. (15)

7. Fathers and sons are not identical – their penises do not have to “match”: We differ from our children in many ways, there is no reason that an infant should be circumcised to “match” his father. Many enlightened circumcised men are raising intact sons.

You do not need to repeat the cycle of ignorance.

Similarly, there is no merit in the “locker room argument,” or the belief that children should “match” their peers. Circumcision rates are falling: in the United States, your intact son has just about as much of a chance as “looking like” the boy in the neighboring locker as he does “looking different” – nationwide, only 56% of our boys are cut. (16)

The decision to physically alter your child’s genitals should never be based on aesthetics. It should be an informed decision based on your child’s lifelong heath and well-being, and it should only be made if there is a valid medically necessary reason.

What Are the Benefits of Circumcision?

Are there benefits to circumcision? Its advocates would have you believe there are, and for some men circumcision might be preferable to staying intact.

Whether there are benefits of circumcision, and more importantly whether those benefits outweigh the risks, is a question that each man should be able to consider himself. Circumcision should be an option for a fully informed individual; it should not be a routine, medically unnecessary procedure performed on infants.

More Resources on Circumcision

Are You Fully Informed? (a comprehensive list of articles and websites devoted to circumcision; the author of “peaceful parenting” holds a PhD in Human Sexuality – she works to educate the public on and put an end to this unnecessary medical procedure)

Circumcision: A Response to Skeptics

The Intactivism Pages

National Organization of Circumcision Information Resource Centers

Third Year Medical Student Describes His First Circumcision Surgery

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On Code Name: Mama, I share information, resources, and my thoughts on natural parenting and life with a toddler. Please take a moment to subscribe to my RSS feed for free updates.

Please see the following sources and the citations within for more information:

(1) Fauntleroy, Gussie, “The Truth About Circumcision and HIV,” http://www.nocirc.org/2008-07_Mothering-Fauntleroy.pdf
(2) Okwemba, Arthur, “HIV Increases in Africa Where Most Men Circumcised,” http://www.drmomma.org/2009/09/hiv-increases-in-africa-where-most-men.html
(3) The Truth About Circumcision and HIV
(4) Coias, Jennifer, “The Nuts and Bolts of HIV in the USA and Why Circumcision Won’t Protect Men,” http://www.drmomma.org/2009/08/nuts-and-bolts-of-hiv-in-usa-and-why.html (The percentages given in the article are actually based on the risk of contracting HIV over a span of sixty years; I said “lifetime” for ease of discussion. Please read the article for clarity.)
(5) Preidt, Robert, “Circumcision Doesn’t Lessen HIV Transmission,” http://abcnews.go.com/Health/Healthday/story?id=8105119&page=1; The Truth About Circumcision and HIV
(6) “Circumcision: A Response to Skeptics,” http://www.drmomma.org/2009/07/circumcision-response-to-skeptics.html
(7) “Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 3: Alleged Medical Benefits of Circumcision,” http://www.doctorsopposingcircumcision.org/DOC/statement03.html#n18; see also “Circumcision and Sexually Transmitted Infections,” http://www.cirp.org/library/disease/STD/
(8) Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 3: Alleged Medical Benefits of Circumcision
(9) “Letter from the American Cancer Society,” http://www.fathermag.com/health/circ/acs/
(10) “A Dad’s View of Circumcision,” http://www.drmomma.org/2009/10/dads-view-of-circumcision.html
(11) Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 3: Alleged Medical Benefits of Circumcision
(12) “Position Statement: The Effects of Circumcision on Breastfeeding,” http://www.nocirc.org/statements/breastfeeding.php; see also “How the Foreskin Protects Against UTI,” http://www.drmomma.org/2009/12/how-foreskin-protects-against-uti.html
(13) Edell, Dean, M.D., “Dr. Dean Edell Statement on Circumcision,” http://www.drmomma.org/2010/02/dr-dean-edell-statement-on-circumcision.html
(14) “Functions of the Foreskin: Purposes of the Prepuce,” http://www.drmomma.org/2009/09/functions-of-foreskin-purposes-of.html
(15) “Raising Intact Sons,” http://www.drmomma.org/2009/11/raising-intact-sons.html; see also National Organization of Circumcision Information Resource Centers, “Answers to Your Questions About Your Young Son’s Intact Penis,” http://www.nocirc.org/publish/4pam.pdf
(16) “United States Circumcision Incidence,” http://www.cirp.org/library/statistics/USA/

Posted in Breastfeeding, Circumcision, Intactivism, Parenting, Pregnancy & Birth | 4 Comments »

Researching Circumcision, Part 2: What Is Circumcision?

Monday, February 22nd, 2010

This article is the second in a series I am writing to help expectant parents get a jump start on their research about circumcision. Please check back next Monday for the final article in this series. Part one discussed the foreskin and its normal, necessary functions. Part two is on the circumcision procedure: what it removes, how it is performed, and what the short- and long-term consequences are. Part three will present information on many of the common concerns parents have when considering circumcision (including an examination of the research on STD’s, cancer, and other health issues).

Please take a moment now to subscribe to my RSS feed for free updates so that you will not miss the remaining article in this series.

What is Circumcision?

Before parents choose circumcision, they should take the time to learn exactly what this procedure entails.*

What Circumcision Removes

Circumcision removes up to 80% of the penis’s skin. “Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings. The foreskin’s muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well.” (1)

How Circumcision Removes the Foreskin

The following description of circumcision is extremely difficult to read (and the clickable images are hard to view), but it is easier to read and see than it is to experience. Again, before parents choose to circumcise their baby, they must know exactly what is going to happen.

[L]et’s examine how a typical medical circumcision is performed. First the child, after 9 months in the fetal position, is tied down spreadeagled and straight-backed in a circumstraint, a plastic board molded to the outline of an infant’s body, which is equipped with velcro straps. Next he is covered with a sheet which has a hole through which his penis is threaded. Then his penis is thoroughly swabbed with sterilizing solution. Naturally, this frequently provokes an erection. Some physicians deliberately provoke erections in order to judge the “cutoff line” and to aid in the surgery itself. In any case, in the infant’s brand new, wide-open, pre-verbal consciousness, this is his first sexual experience: a torturous nightmare.

Because the foreskin of an infant is attached to the head of the penis by the same tissue that bonds a fingernail to a finger, it must be skinned away before it can be cut off. So the doctor forces a metal probe between the foreskin and the head and tears apart this flesh (called synechia) which bonds them together. Next, the doctor has several options for the actual amputation. One commonly used device for this step is called a gomco clamp. This essentially functions as a thumbscrew for the foreskin. . . . Surgical scissors are used to cut a slit along the length of the foreskin in order to insert the metal “bell” which serves as one jaw of the clamp. The foreskin is pulled over the bell and the other jaw of the clamp is attached. Then, by tightening a screw, the foreskin, one of the most densely innervated tissues of the body, is audibly crushed along two lines (inner and outer foreskin) around its circumference. (Since all the nerves of the foreskin pass through this crush line, the pain perception may be similar to that of putting virtually the entire erogenous surface of the penis in a vise.) The clamp is left on for a few minutes to promote blood clotting, then the foreskin is cut off at the crush line. Afterwards, the raw, bleeding, formerly internal organ is wrapped in bandages and a diaper, and then repeatedly burned with urine and its breakdown product, ammonia, and exposed to infectious fecal matter while healing. . . .

It wasn’t until 1978 that researchers even suggested using anesthetic during circumcision, and [as late as 1999, the AMA reported that] most medical circumcisions are performed without anesthesia . . . . This is in stark contrast to what is known about infant pain perception and its profound and lasting effects on the victim, as well as the plainly obvious reaction of the infant boy, who forcefully communicates his torment to anyone who will look and listen. Choking and breathing problems arise due to the continuous screaming. Surges in adrenaline and cortisol and large increases in heart rate, all established physiological indicators of torture, have been measured. Some babies appear to go into shock. Later, problems with sleep, mother-child bonding and breastfeeding, and increased sensitivity to stress and pain are all commonly seen after [circumcision (also referred to as male genital mutilation or "MGM")]. To all appearances, the infant is left in a state of post-traumatic stress. (2)

The Short-Term Consequences of Circumcision

Circumcision is “an extremely painful, distressing, traumatic, and exhausting experience for a newborn male infant.” Because it is so emotionally and physically stressful, it has documented negative effects. These include:

1. Circumcision affects sleep: “Circumcision disrupts the baby’s normal sleep patterns.” (3) “Routine circumcision, done without anesthesia in the newborn nursery was usually followed by prolonged non-rapid eye movement (NREM) sleep. . . . We consider its increase to be consistent with a theory of conservation-withdrawal in response to stressful stimulation.” (4)

2. Circumcision can affect bonding with caregivers: “Post-operatively, the circumcised infant is in pain and is in an exhausted, weakened, and debilitated condition.” Consequently, circumcised babies may withdraw, which interferes with the normal process of bonding with his mother, father, or other caregivers.

3. Circumcision interferes with the breastfeeding relationship: Because circumcised males are in such pain for an extended period after this stressful procedure, studies have shown that some babies are simply unable to suckle at their mother’s breast. Mothers who refuse to allow this procedure have a better chance at establishing a healthy breastfeeding relationship. (5)

4. Circumcision is painful: Circumcision leaves an open, raw wound for weeks. The newborn’s surgically exposed glans is re-injured by abrasion and contaminants because it is encased in diapers (including the baby’s own feces and urine, which breaks down into ammonia). Disposable diapers themselves are also often irritants, because they are laden with chemicals, dyes, and fragrances that cause further pain.

5. “Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500. These complications include uncontrollable bleeding and fatal infections.” (6)

The Long-Term Consequences of Circumcision

Aside from the immediate psychological and physical effects on the traumatized newborn, there are also long-term consequences.

1. Circumcision desensitizes: The foreskin’s rich nerve network of more than 20,000 nerve endings provides incredible sensitivity – even more than the glans itself. Circumcision amputates these nerve endings, which not only takes away that pleasure source, but the constantly exposed glans becomes even more desensitized with time and constant exposure to diapers and clothing. The glans actually keratinizes (much like the fibrous tissue found in hair or fingernails).

2. “Circumcision disables: The amputation of so much penile skin permanently immobilizes whatever skin remains, preventing it from gliding freely over the shaft and glans. This loss of mobility destroys the mechanism by which the glans is normally stimulated. When the circumcised penis becomes erect, the immobilized remaining skin is stretched, sometimes so tightly that not enough skin is left to cover the erect shaft.” Additionally, the surgically exposed glans is left without “the protection and emollients of the foreskin,” which makes it dry and “susceptible to cracking and bleeding.”

3. “Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft” and often tears pieces of the glans itself off. “Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection. The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely.”

4. “Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar.” This interruption of normal blood flow can ultimately obstruct the flow of urine.

5. “Circumcision harms the developing brain: [Scientific studies have demonstrated] that circumcision has long-lasting detrimental effects on the developing brain, adversely altering the brain’s perception centers. Circumcised boys have a lower pain threshold than girls or intact boys.” There is evidence “that circumcision can cause deeper and more disturbing levels of neurological damage, as well.”

6. “Circumcision is unhygienic and unhealthy: One of the most common myths about circumcision is that it makes the penis cleaner and easier to take care of. This is not true. Eyes without eyelids would not be cleaner; neither [is] a penis without its foreskin. The artificially externalized glans and meatus of the circumcised penis are constantly exposed to abrasion and dirt, making the circumcised penis, in fact, more unclean. The loss of the protective foreskin leaves the urinary tract vulnerable to invasion by bacterial and viral pathogens.
The circumcision wound is larger than most people imagine. It is not just the circular point of union between the outer and inner layers of the remaining skin. Before a baby is circumcised, his foreskin must be torn from his glans, literally skinning it alive. This creates a large open area of raw, bleeding flesh, covered at best with a layer of undeveloped proto-mucosa. Germs can easily enter the damaged tissue and bloodstream through the raw glans and, even more easily, through the incision itself.
Even after the wound has healed, the externalized glans and meatus are still forced into constant unnatural contact with urine, feces, chemically treated diapers, and other contaminants.”

7. Circumcision has other health consequences: As will be discussed in part three of this series, circumcision has other health consequences, and it “does not prevent acquisition or transmission of sexually transmitted diseases (STDs).” (7)

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There is no National or International Public Health Authority in the Western World Which Advocates for Routine Infant Circumcision (8)

If you or someone you know is considering circumcision for a newborn, please take time first to research. We owe it to our children to make thoughtful, ethical decisions for them. The links below lead to more information on this procedure.

10 Out of 10 Babies Agree (A “Scrubs” clip & related video; viewer discretion advised, but parents – please do not look away)

Babies Do Feel Pain

Birth as we Know it: Circumcision (Infant male circumcision video clip from the documentary film “Birth As We Know It” by Elena Tonetti-Vladimirova; viewer discretion advised)

Circumcision: A Photo Essay (this is tragic to look at, but parents who are considering this unnecessary medical procedure need to see what they would be subjecting their infants to)

Circumcision and the Old Testament

Circumcision: How Much Does it Hurt?

Cut v. Intact Outcome Statistics

The Day I Withdrew from Nursing School

The Effects of Circumcision on Breastfeeding

How Male Circumcision Impacts Your Love Life

Mothers’ Stories: I Regret Circumcising my Son

MRI Studies: The Brain is Permanently Altered from Circumcision

Penn & Teller on Circumcision (a series of videos by Penn & Teller on circumcision – I’m not sure how they managed to get a laugh out of me while I had tears streaming down my face, but they did)

Plastibell Infant Circumcision (an alternative to the Gomco Clamp described above)

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*Posts that describe circumcision may be particularly uncomfortable/painful to read if you are a parent of a circumcised boy. It is not my intention to make these parents feel judged, ostracized, or demonized. The sad fact is, circumcision has been the norm in our culture – parents have not been expected, nor do many even think about, seeking information on leaving their sons intact. If you are the parent of a circumcised boy and you regret the decision to circumcise, you can help bring about change for future generations. Speak out. Donate to organizations that spread the word about the benefits of staying intact. Forward this article on to expectant parents. Do not let ignorance result in more needless circumcisions. And thank you for reading this information with an open heart. It’s tough to have any parenting decision questioned, but reevaluating our decisions and beliefs is part of growing and maturing.
(1) Fleiss, Paul, M.D., “The Case Against Circumcision,” http://www.mothersagainstcirc.org/fleiss.html
(2) Winkel, Rich, “Male Circumcision in the USA: A Human Rights Primer,” http://www.math.missouri.edu/~rich/MGM/primer.html#fn73
(3) “Position Statement: The Effects of Circumcision on Breastfeeding,” http://www.nocirc.org/statements/breastfeeding.php
(4) “Circumcision vs Breastfeeding,” http://www.circumstitions.com/Docs/nursing.pdf
(5) Position Statement: The Effects of Circumcision on Breastfeeding
(6) The Case Against Circumcision; see also “Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 4: The Immediate Complications of Circumcision,” http://www.doctorsopposingcircumcision.org/DOC/statement04.html
(7) The Case Against Circumcision; see also Garcia, Francisco, “What Exactly is Circumcision and What is it Not?,” http://www.cirp.org/library/anatomy/garcia/; see also “Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 6: Long-Term Adverse Effects of Circumcision,” http://www.doctorsopposingcircumcision.org/DOC/statement06.html
(8) “The Medical Basis for Child Circumcision,” http://www.fathermag.com/health/circ/

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