Lindy’s Blog: Where Mom is Always Right

January 22, 2010

In which I take on the “C” word.

Filed under: childbirth,Health — by lindyborer @ 8:07 am
Tags: , , , ,

Photo of a baby boy, mid-cut. photo credit: Amy Arbus

As usual, I seem to have an affinity for leaving things like this to the last possible minute, and I have a hunch that because I’ve done so this baby will most likely be a boy (Murphy’s Law has a 99.9% chance of applying to me).  I’ve been in somewhat of a quandary regarding a topic of which is seldom spoken, but highly charged among parenting circles.

Nope, not vaccination.  The C-word.  Circumcision.  There.  I said it.

Okay, as usual, I try to keep things balanced here at Lindy’s (take that however you wish.)  Those of you who are recent parents realize the sensitive subject matter that circumcision is.  Let me just say this up front:  We are going to circumcise our son if this baby is a boy.  I would be just fine not doing it; however, my husband would not.  I realize that many in the “NOCIRC” camp will automatically call me a barbarian and equate our actions as the equivalent to the male form of genital mutiliation.  I realize those on the other side of the debate will think I’m stupid for even entertaining the notion of NOT getting my son snipped. 

Let me cut to the point (no pun intended):  I’m simply trying to research the possibility of getting a “dorsal penile nerve block”–that’s local anesthetic, much like Novacaine at the dentist–for the baby prior to the placing of a scalpel to what I’m told is a highly sensitive area.

Now, it’s always good to step away from “what is and what has always been done,” and to actually–with a pure mind–run the scenario through one’s head.  According to Dr. Sears (who I’ve generally found to be quite balanced and who has performed thousands of circs himself), this is how a circumcision today is commonly performed on infants before they leave the hospital:

Baby is placed on a restraining board, and straps secure his hands and feet. The tight adhesions between the foreskin and the glans (or head) of the penis are separated with a medical instrument. The foreskin is held in place by metal clamps while a cut is made into the foreskin to about one-third of its length. A metal or plastic bell is placed over the head of the penis to protect the glans, and the foreskin is pulled up over the bell and the circumferentially cut.

Easy as pie!  Sounds quite painless.  Oh wait, except that it totally DOESN’T!!!!

Let me back up.  When my first child was born, I really hadn’t looked into this at all.  When the time came for my son to go under the knife, inner reservations surfaced, but a voice in my head told me, “We live in an enlightened age.  Surely the common argument that newborns’ nervous systems aren’t fully developed and it doesn’t hurt them is completely research-based, because how could we as a society just allow a poor defenseless newborn to get his foreskin ripped away without local anesthetic on a routine basis?”  (Of course, this same “enlightened” society allows for much worse with abortion, but I digress…)

Feeling somewhat better, the nurse then came in to get my son and flippantly told us to “take a walk so you won’t hear him scream,”  and then that abhorrent woman LAUGHED.  That is something that I have never forgotten. 

Since then, I’ve learned that babies who “seem to fall into a deep sleep toward the end of the procedure” have actually passed out from the pain.  Ahem.  I AM a barbarian.

I emailed a friend about this yesterday; she has two boys.  She related this anecdote:

I was concerned about the pain, too.  At that time, we had a female pediatrician who did the procedure and this is what I remember her saying when she brought him to me afterwards—she said that yes, it hurts like the devil, and they always cry…but they can be comforted and within minutes they are fine.  And that’s the difference between pain and agony.  That has always stuck with me. 

No shit.

Her sisters, who have seven uncircumcised boys between them, likewise chimed in.  One said:

When Bryan and I realized that the ONLY reason we were being encouraged to have the boys circumcized was so they wouldn’t be laughed at in the locker room, we decided that that just wasn’t a good enough reason to have a piece of skin ripped off our little boys’ you-know-whats when they were hours old, with no anesthetic.  It was a Jewish tradition.  We’re not Jews.  Ergo, we didn’t have it done.  I don’t know anything about the block, but it sounds like a good idea to me.

Which is so true.  The locker room argument, I’ve found, is one of the top arguments in favor of the procedure.  (Must be a brutal place.)  The pressure to “look like one’s peers” is actually becoming less and less relevant, though, because more and more parents are not getting it done.  This may come as a surprise to folks my parents’ age, but it’s true.  Several friends of ours have chosen to forego the procedure for their boys. 

So, I guess there might be a new meaning to the phrase “shirts vs. skins” in locker room lingo in the near future. 

Back to Dr. Sears.  In answering the question, “Does it hurt?” he says:

Yes, it hurts. The skin of the penis of a newborn baby has pain receptors completely sensitive to clamping and cutting. The myth that newborns do not feel pain came from the observation that newborns sometimes withdraw into a deep sleep toward the end of the operation. This does not mean that they do not feel pain. Falling into a deep sleep is a retreat mechanism, a withdrawal reaction as a consequence of overwhelming pain. Not only does circumcision cause pain in the penis, the newborns over all physiology is upset. New research shows that during unanaesthetized circumcision, stress hormones rise, the heart rate speeds, and valuable blood oxygen diminishes. Babies should never be subjected to the shock of unanaesthetized circumcision.

Can the baby have anesthesia to lessen the pain?

Yes, a local anesthetic can and should be used. Painless circumcision should be a birthright. I have used a local anesthesia in nearly a thousand babies for over twenty years. It is a safe procedure and it works. Sometimes the anesthetic will not remove all the pain, but it certainly helps. Within a few hours, after the anesthetic wears off, some babies exhibit no discomfort; others will fuss for the next twenty-four hours. The most common and effective method is called a dorsal penile nerve block, in which a few drops of Xylocaine (similar to the anesthetic your dentist uses) is injected into the nerves on each side of the penis circumferentially around the base of the penis.

So there ya go.  That’s where I’m at.  I simply don’t know if a block is available around here.  I’ve heard mention of some sort of “plastic cap.”  Anyone know if this is just a convenience thing, or a mechanism to lessen the pain? 

One final argument that has been most commonly thrown at me when I’ve brought this up:  “They don’t remember it.”  Can I just say how completely stupid this is, on so many levels?  You know, I don’t remember most of my life up to probably age three or four; does this then make it okay to scrimp on anesthesia during common childhood maladies (like tonsillectomies, for example?)  How utterly ridiculous.  Mom and Dad could have saved some money when I had to get stitches at age two! 

For those out there who persist in thinking I’m off my rocker, fine, but let me just say that we mothers–especially those of us who still have small children and are about to have a baby–we’re a ruthless set.  We are like the grizzly mothers who will not hesitate to maul and kill in order to protect our young.  And that is the frame of mind that leads me to question this procedure the way it’s currently done. 

In my informal survey of asking the males in my life if they, themselves, would elect to be circumcised NOW without some sort of block, they abruptly and deliciously change their tune.  Which, to me, says it all.

Can anyone out there give me some insight?

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