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The Circumcision Decision

If you're having a boy, be prepared to answer this question in the hospital: Do you want to circumcise your baby? The procedure, which is most often performed by OB/GYNs within a day of your child's birth, is a simple one that involves using a clamp or scalpel to remove the foreskin covering the end of your baby's penis.

Is circumcision necessary? That depends on whom you ask. In the United States, circumcision became popular following a study conducted among military personnel in the 1940s. The study showed that men who were not circumcised had higher rates of sexually transmitted diseases than uncircumcised men. This was a flawed study, in that it didn't look at the sexual practices of the men involved; regardless, by 1965, about 80 percent of U.S. boys were being circumcised, supposedly to reduce the risk of infection.

The practice is less common now, with about 65 percent of newborn boys being circumcised. Circumcised males do have a small health advantage: Baby boys are slightly less likely to get urinary tract infections if circumcised, and the rate of penile cancer among circumcised men is lower than among those who are not circumcised. However, both of these conditions are extremely rare and may be more a result of poor hygiene. Another factor to consider is that complications do occur in about 1 in every 1,000 circumcisions; very rarely, there can even be severe damage to the infant's penis during the procedure.

In short, there is no absolute medical reason to circumcise, so it's really up to you. Some couples want their baby to look like his father and make the choice accordingly. Others worry about locker room differences, but researchers say men worry more about penis size than foreskins. In addition, by the time your child plays a sport, the numbers of circumcised versus uncircumcised boys will probably be 50-50.

If you do decide to circumcise your son, talk to your physician about anesthesia. Although substantial clinical research demonstrates that the procedure does cause newborns to feel pain, many physicians still do not use an anesthetic. Safe pain relief is available in the form of a numbing topical cream applied half an hour before the surgery or a local anesthetic medication injected with a needle.

Originally published in You & Your Baby: Pregnancy.

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