Circumcision

Neonatal circumcision is one of the most often executed surgeries in the United States. (1:130) In my clinical practice thus far, the question whether to circumcise male neonates or not is frequently asked in the postpartum period. Midwives play an important role in providing informed choice discussions for their clients, it is thus our role to present the research evidence available in order to help women make the right choice for them and their families. This paper aims to describe the different incentives of male circumcision and the benefits and risks involved.

Male circumcision involves the process of amputating the foreskin so that the glans of the penis is exposed. (2:602) Nontherapeutic male circumcision has been performed over many centuries and it is an integral part of some religions and cultures. The World Health Organization reports that 30% of males globally are circumcised, with 70% of these being Muslim. (3:1) The prophet Muhammad proclaimed that all followers must circumcise their sons on day seven postpartum. Although not all Muslims follow this exactly, males are circumcised within the first 10 years of age and it is one of the factors of the customs in Islam that allow for personal hygiene. (4:76) Judaism also values circumcision as an important part of the religion. As is described in the Old Testament it is one of the prerequisites to becoming a great nation that Abraham undergoes circumcision, and that every male be circumcised on the eight day of life. (4:76) Although Jesus Christ himself was circumcised, his disciple Paul proclaimed that this act is no longer necessary, thus circumcision is no longer a part of Christianity. (4:76) In addition to religious incentives for nontherapeutic circumcision, cultur...

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...nformed choice.

Since male circumcision is a surgery there are certain risks involved. There is a 2-10% occurrence rate of key complications that involve hemorrhage, sepsis, fistula, meatal stenosis, removal of excessive skin and penile loss (5:2239), of which parents should be made aware.

As midwives we can play an integral role in helping our clients make crucial decisions about their children’s lives. Although some parents may not hesitate with their decision to circumcise due to cultural or religious practices, it is our jobs as primary health care providers to present research evidence in a way to allow our clients to make informed choices. Along with presenting the scientific evidence outlined in this paper, being able to refer our client to competent health care providers that perform circumcisions is part of our critical role in the postpartum period.