In Bloom Doula Services

One of the most controversial topics in motherhood lately seems to be circumcision. I have hesitated to write about this for a long time. In fact, I have said before that it would be a topic (along with vaccinations) that I would never touch on. As a “mom blogger” I suppose that was a safe bet, but as a doula I feel an obligation to spread more information, which is what new parents want. Unbiased, accurate information. Many people would say, “well that is what doctors are for.” The problem is… doctors (pediatricians in particular) are biased. Doctors (in general) seem to be pro medical intervention of most kinds. I question EVERYTHING these days, and started doing so way before I even became a mom; about birth, about women’s reproductive health, about hospital policy. Why wouldn’t I question the medical care for my kids too?

You see, I tried to get good information about circumcision. The first thing I remember learning about it (aside from a Biblical standpoint) was in college, other than that I never really considered it very much. I thought every guy was circumcised and figured there were good reasons for it. As a college student, I began my journey of becoming a doula – I just didn’t know that is where I was headed yet. Instead, I majored in social work and applied to be apart of a group called Healthy Sexuality Peer Educators. I wanted to work with teen moms at the time, and wanted to get my hands on anything I could even remotely related to teens, pregnancy, birth, etc. As a peer educator I took 3 semesters of extensive sexual health education. I learned everything about anatomy, contraceptives, reproductive health, menstruation. Of course circumcision was a topic we covered, and according to my professor with a public health background, routine circumcision was a public health issue. It benefited boys in many ways: reduced penile cancer rates, it reduced the transmission of sexually transmitted infections, it reduced the risk of infections (UTIs, etc.) and having the procedure done as an infant was “low risk,” had a quicker healing time, and they wouldn’t even remember it.

I accepted this information and assumed that it made sense to have this procedure done for the benefit of boy’s health. Who wouldn’t want to do something preventive and helpful for their son’s future? Another side to the story was never presented. I didn’t even know there was a controversy surrounding this topic at the time.

Then I myself became pregnant, and with a boy. I met with my doula to discuss my birth plan and whether or not we wanted to circumcise our son was a question I was now faced with. Recalling all the information I had learned, my first thought was “yes, of course.” But now I was hearing some different information. An interference with breastfeeding, a risk of injury during the procedure. I had never even considered that something bad could happen, but the truth is that it could and that is something new parents need to know. I was suddenly terrified by something going wrong with this procedure. I couldn’t stand the thought.

Every man I knew and talked to said, without question it was something that needed to be done. I also thought, well who am I to make a decision about males that never concerned me? I decided that I would consult a pediatrician- surely they would know best. And all of my pregnancy apps said I should be interviewing pediatricians anyway, so I did.

I set up an interview with a pediatrician who I had a ton of questions for about breastfeeding, vaccines, and of course circumcision. The thing was in hind sight he was a very manipulative doctor with his answers. He knew I wanted to breastfeed, so he said he supported it, and he knew I wanted guidance about other choices, so he had very persuasive language, scare tactics even that he used to show he was very much in support of circumcision. I left almost feeling bullied into it. He claimed that there would be “very minor and rare” risks associated with the procedure, but equal or even greater risk if I chose not to get it done, and would then have to do so in the future and it would be a much harder recovery. I came to the conclusion that it must be for the best.

All the “crunchy, hippie, radical” moms with their strong language about “mutilation” to your son’s body seemed unfounded when I never heard anything bad about it from men around me. They all seemed to be supportive of the procedure. The majority of men had it right? It has been around for centuries…. right?

Despite all of this, I still felt something my gut that did not like this one bit. Not at all. In fact the thought of taking my day old infant away from me, to be strapped down on a table and have his genitals cut made me want to throw up. I was terrified that if something bad happened it would effect him for the rest of his life. As a mother, I want to protect him. I want him to function in every way that is happy and healthy. I was 100% against “female circumcision” or female genital mutilation. Why would it be ok to do that to my infant son? It just never felt right despite the pressure coming from every way that it was for the best.

Finding the right information was intimidating. Who was biased? Who was misinformed? Who could I trust to rely on when everything I heard contradicted each other?

Now I am expecting my third son.

I decided to watch the documentary American Circumcision (on Netflix). I don’t want to be another person throwing confusing information at new parents. I don’t want to participate in using scare tactics or use violent language – for or against. I just want to be transparent about what the information actual is. I think all parents make this decision with the best intentions for their son’s whether that be to have it done or not. I don’t think using angry, emotionally charged or violent language is helpful or informative. I think it makes mom/parents feel bullied into a specific decision, and often times one they aren’t comfortable with because they feel pressure from each angle- as if there is not a right choice.

These facts on the other hand really made the confusion turn clear for me:

• Penile cancer is very rare, and usually effects elderly men. The benefit of circumcision to reducing the cancer rates is statistically insignificant
• Circumcision doesn’t actually reduce STI transmission rates in any statistically relevant way for American boys
• Babies are often times not fully anesthetized for the procedure. It is rushed, and in the medical field there is a history of believing babies don’t feel pain – they definitely do, and I know midwives who speak to knowing that babies are not always numbed when this happens. They have witnessed it and I believe most moms believe whole heartily when they send their son off for his circumcision that he will feel very little pain. Unfortunately, that is not something they can know for sure.
• It is the most frequently preformed “routine” procedure in our country… now I wonder why doctors are so supportive of it? Hospitals are making a lot of money off of it
• It is a routine cosmetic procedure being performed on day old infants. I wonder if most parents consider risks of something going wrong or infections when they think of it in those terms. I sure didn’t. Doctors assured me problems just don’t happen and that is false information. I appreciate transparency from my care provider.
• The foreskin is not just a flap of skin. It is a significant part of the male anatomy.

When I heard all of that, a lightbulb went off… I have been questioning women’s reproductive health practices for YEARS. Doctors pushing of birth control (at UT they never wanted me to leave an appointment without a birth control prescription – basically harassed me about it, but that is for another blog.) Writing off actual problems or issues to continue treating symptoms. I question the over medicalization of pregnancy and labor. A scavenger hunt for a problem to treat. The push for inductions, repeat caesareans, a push for interventions and pain medications. It all makes hospitals a TON of money. But is it evidence based? Is it best practice? According to statistics it doesn’t seem so.

Our culture has long accepted this as routine because of a history and cultural acceptance of circumcision. From a Judeo-Christian background it has been accepted as the norm, even non-religious people have accepted this norm. But we have failed to consider that America is one of the only countries where this procedure is being done routinely, aside from countries with a strong religious influence.

There are plenty of other things to consider when making this decision. Religious factors, more emotional arguments and testimonies of families who have had bad experiences. If we only listen to good, happy, safe and healthy stories are we doing ourselves or our sons any favors? Are we making informed, well rounded, educated decisions?

There is plenty more I could say about this topic, but my goal in sharing this isn’t to persuade or convince, but to make people aware of all sides of the information to know. Since I feel like I finally got the full spectrum of information I feel much more confident in my choices about everything in motherhood, but especially circumcision. That confidence is what I want for every mom. Confidence that they are making a good, well informed choice. No mother should feel bullied or pressured into a choice that leaves her feeling uneasy or unsure of herself.

When I started my birth plan series on Instagram my intention was to present well rounded information to mothers. To let them know there are choices, options, and risks and benefits to various interventions and procedures. There might not be one best choice, but with accurate information women can make the best choice for them and their baby.