Your wait is finally over - you're the proud new parents of a baby boy. But if you haven't already thought about it, you need to make an important decision for your son before you take him home: whether to circumcise him.

For some families, the choice is simple because it's based on cultural or religious beliefs. But for others, the right option is not as clear-cut. Before you make a circumcision decision, you should talk to your child's doctor and consider some of the issues.

What Is Circumcision?
Boys are born with a hood of skin, called the foreskin, covering the head (glans) of the penis. In circumcision, the foreskin is surgically removed, exposing the end of the penis. Parents who choose circumcision often do so based on religious beliefs, concerns about hygiene, or cultural or social reasons, such as the wish to have their son look like other men in the family.

Approximately 65% of all newborn boys - about 1.2 million babies - are circumcised annually in the United States. According to the National Center for Health Statistics, there have been several notable trends in recent years. One is the closing of the gap between circumcision rates among white babies and black babies (in the past white babies were about 13% more likely to be circumcised than black babies). Another is a sharp difference in the rates of circumcision around the country - most notably, a 25% decrease in the West between 1980 and 1999. Researchers speculate that this might be due to an increase in the Asian and Latino populations in that region - two groups that are culturally less likely to opt for circumcision. Circumcision is much more widespread in the United States, Canada, and the Middle East than in Asia, South America, Central America, and most of Europe, where it's not common.

Circumcision is usually performed during the first 10 days of life, either in the hospital or, for some religious ritual circumcisions, at home. If you decide to have your son circumcised at the hospital, a doctor will perform the procedure before you bring your baby home. In preparation, your baby will be placed in a padded restraint chair and given local anesthesia. Then the doctor will slit the foreskin and insert a device under the foreskin to hold it away from, and protect, the glans. When the instrument has been in place for a few minutes, the doctor quickly cuts off the foreskin, removes the device, and covers the incision with an antibacterial ointment and gauze coated with petroleum jelly.

Pros and Cons of Circumcision
Although circumcision appears to have some medical benefits, it also carries potential risks - as does any surgical procedure. These risks are small, but you should be aware of both the possible advantages and the problems that can be associated with the procedure before you make your decision.

Complications of newborn circumcision are uncommon, occurring in between one in 200 and one in 500 cases. Of these, the most frequent are minor bleeding and local infection, both of which can be easily treated by your child's doctor. Even rarer are instances where either too little or too much skin is removed. The former requires a repeat circumcision, whereas the latter can take longer to heal or, occasionally, may lead to reconstructive penile surgery (this extreme measure is only necessary if a significant amount of skin is mistakenly cut, which happens very infrequently in the hands of an experienced circumciser).

Pain is another consideration. Although the procedure is painful, local anesthesia can greatly reduce your baby's discomfort. If you decide to circumcise your son, talk with your child's doctor about anesthesia options.

Some people also claim that circumcision either lessens or heightens the sensitivity of the tip of the penis, decreasing or increasing sexual pleasure later in life. But neither of these subjective findings has been proven to be true.

On the plus side, studies indicate that circumcised infants are less likely to contract a urinary tract infection (UTI) in the first year of life. About one out of every 1,000 circumcised boys has a UTI in the first year, whereas the rate is one in 100 for uncircumcised infants. Circumcised men may also be at lower risk for penile cancer, although the disease is rare in both circumcised and uncircumcised males. The procedure might offer an additional line of defense against sexually transmitted diseases (STDs), particularly HIV, but the results of studies in this area are conflicting and difficult to interpret. It's also easier to keep a circumcised penis clean, although uncircumcised boys can learn how to clean beneath the foreskin once the foreskin becomes retractable (usually some time before age 5). However, some uncircumcised boys do end up with infected foreskins as the result of poor hygiene.

- Read more of our articles on Circumcision

Reference Source 50
December 20, 2004

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