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BY MARCIA ARMSTRONG
FOR THE FREE LANCE-STAR
Alice Whalen didn't know what was happening in the hospital nursery.
It was 1975, she'd just had her first child--a baby girl--and the hospital quiet was pierced by a cacophony of painful, frightened cries coming from the newborn nursery next door.
Whalen asked her doctor what was going on. The baby boys are being circumcised, he told her.
DECLINING RATES
The cries were so full of misery that Whalen vowed not to subject any sons she might have to the painful procedure. When her three baby boys were born years later, she kept her promise.
"I was a 22-year-old crusader with my first child and was extremely protective," said the King George resident.
Circumcision--the practice of removing part or all of the foreskin from the penis--is typically done in the first few days of a baby boy's life.
Fifty-six percent of boys born in the United States in 2006 were circumcised, according to the National Center for Health Statistics. That's a dramatic decline from the early 1960s, when circumcision rates in the U.S. peaked at about 90 percent.
Typically, circumcision rates are highest in the Northeast and lowest in the West. In some states, such as California, Medicaid and some insurance companies refuse to cover the procedure because it is considered cosmetic.
Circumcision rates in the Fredericksburg area are between 70 and 80 percent, said Fredericksburg pediatrician Roxanne Allegretti.
SHIFTING VIEWS
While some doctors and parents cite medical reasons for the procedure--a decreased risk of urinary tract infection and sexually transmitted diseases--the American Academy of Pediatrics doesn't recommend it. Neither does Allegretti.
"It's unnecessary," she said.
It is true that circumcision reduces urinary tract infections and the transmission of sexually transmitted diseases, she said.
"But, if you use a condom--which you should be--it doesn't make a difference. And, urinary tract infections are so rare in baby boys that the increased risk of it isn't significant," she said.
Though circumcision remains extremely common, opposition to the procedure has become widespread.
Type "oppose circumcision" in a Google search and 291,000 links pop up, many hosted by doctors, parents and people taking up the torch for babies to remain intact. Others are run by members of religions and cultures that have practiced the rite for hundreds of years, who now question the procedure's health benefits when weighed against the pain.
All cite the risk of infection, bleeding, injury to the head of the penis and penile sensation deficits. They declare it mutilation.
But there is another side to the story.
ON THE OTHER HAND
Dave, who didn't want his full name used to protect the privacy of his circumcised 19-year-old son, objected to the practice after his son's birth.
"I went through it, and I didn't want him to go through it," said the 48-year-old electrical engineer from Chantilly in Northern Virginia. "They cut millions of nerve endings that would be nice to have."
But, as his son grew, he couldn't pull the foreskin back far enough to clean it without significant pain. He stopped cleaning, and infection after infection of the penile head and foreskin ensued, turning his penis beet red.
"We ended up doing the circumcision when he was 5," Dave said. "It was awful. For years after, he got into the bathtub only gingerly, putting his hand over those parts the whole time."
Now, Dave advocates having the procedure done as soon as possible after birth.
"My son suffered by not being circumcised early," he said. "And I wonder what long-term impact that has had on him."
PAIN AND HEALING
Circumcision's short-term impact on a child is immediate and clear.
"After the circumcision, the penis looks like road rash. All the skin is taken away," Allegretti said. "It takes a week for the skin to heal up."
Doctors used to do circumcisions without giving babies anesthesia, Allegretti said. While this saved the infant from risks associated with the medication, it caused considerable pain when the foreskin was peeled away from the head of the penis.
Such severe pain experienced so early in life can cause problems down the road. Studies show that babies circumcised without painkillers have a much stronger reaction to pain if they ever need another surgical procedure, Allegretti said.
Nowadays, doctors administer two shots of painkiller into the penis to numb it before beginning the procedure.
"But even with anesthesia circumcision is uncomfortable," Allegretti said.
Parents wondering whether to circumcise their baby boys often use family history and religious beliefs as their guide. Religion and family traditions can make the choice an easier one.
For those who want to weigh the pros and cons from a strictly medical perspective, try nlm.nih.gov/med lineplus/circumcision.html.
Marcia Armstrong can be reached at
Email: thisfullhouse@gmail.com.
