Facts about Circumcisions
A Guide for Parents of a Newborn
Contributed by Rabbi Gadi Levy, Certified Mohel
About This Article
Whether to circumcise or not is a deeply personal decision that should be evaluated by the parents with responsibility and without outside influences. When parents decide to move forward with the circumcision process for their son, there are a number of factors to take into account to ensure the procedure will be done in the best way for their baby. Clarifying these five basic facts about circumcision will enable parents to make a more informed choice regarding the best option for their newborn’s procedure
#1 Can my husband or I stay with our baby?
When your son is circumcised in hospital, you usually don't know in advance who will carry out the procedure. In the hospital, a baby is strapped down naked to a board in preparation for the procedure. He will receive multiple shots causing him unnecessary discomfort. The circumcision process is then carried out by an anonymous intern or doctor and usually, the child must wear an uncomfortable ring around the penis for several days afterward.
The home-based Mohel experience couldn't’ be more different!
You and I will have a detailed phone call and or meeting before the procedure takes place. I will learn and understand your needs and aspirations so I can make the ceremony personally meaningful to you and your family. The procedure, which usually takes less than two minutes, will be held in the comfort of your home. The baby will be placed on a pillow during the procedure and immediately after swaddled and given to his mother to feed and cuddle. I strive to imbue the entire process with meaning and spirituality keeping the atmosphere calm, caring, and loving throughout. I will be available both before and after the circumcision process for questions, support, and advice. I usually stay in touch afterward and consider the families as friends!
#2 Who will perform the procedure and how much experience do they have?
Let’s get straight to the point: you want the most experienced person performing the circumcision on your precious newborn son. Although the circumcision process is routine, and usually not a complex procedure if you had options, wouldn’t you want someone experienced with the delicate process? And wouldn’t you want to know the person doing the procedure? As parents, you should be aware that you could have your son’s circumcision performed by someone who has the experience of having performed hundreds of circumcisions, and it could also be done by someone who has done three circumcisions in his life!
Little do parents know, every doctor needs to perform at least five circumcisions in his internship. Unfortunately, one of those poor babies may be yours. As a parent, you have the right to know who will be performing the procedure and how many procedures he has performed in his practice.
In many hospitals, there is a pediatrician on call who performs most circumcisions and sometimes the midwives themselves are the ones doing the procedure. Clarifying who will perform the procedure and what experience they have is every parent’s obligation to their newborn son.
Choosing to wait a week or so to perform the procedure is also a great option. Allowing yourself and your baby to recover from birth prior may be a healthy alternative to an in-hospital procedure. Many pediatric offices welcome new accounts often by offering a circumcision option. The procedure would need to be done in the medical center.
#3 What technique will be used?
In truth, the technique used to perform your son’s circumcision is not as important as the experience the person has with the procedure. The risks involved with regards to circumcision are going to be much higher when they are performed by an amateur. But here are the three basic techniques for newborn circumcision:
1. The Gomco Clamp - The Gomco is a bell-shaped device that is fitted over the head of the penis under the foreskin. The foreskin is then pulled over the bell and a clamp is tightened around the foreskin to reduce blood flow to the area. The foreskin is then removed with a scalpel. The Gomco procedure takes anywhere from twenty to forty-five minutes.
2. The Plastibell - This method is similar to the Gomco technique. After separation with a probe, the plastic bell is placed under the foreskin and over the head of the penis. A piece of suture is tied directly around the foreskin, which cuts off the blood supply to the foreskin. A scalpel may then be used to cut off the extra foreskin, but the plastic ring is left on. About 6 to 12 days later, the plastic ring falls off on its own.
3. The Mogen - The foreskin is separated from the head of the penis with a probe. The foreskin is then pulled out in front of the head and inserted through a metal shield that has a slot in it. The foreskin is then cut with a scalpel and pushed back in place to heal. This is a technique that requires significant training and is the default technique of most Mohelim (circumcision specialists). Depending on their proficiency, it will take one to five minutes to complete this procedure.
Whatever the preferred method of the person performing the procedure, it is most important for you as a parent to clarify the amount of experience they have with the said method. Unfortunately, many hospitals will place newborns in the hands of interns with little to no experience in the procedure. It is a fair question for any parent to ask who will perform their son’s circumcision and what experience they may have. A Mohel or experienced pediatrician will have expertise from hundreds if not thousands of procedures, in contrast to less than five by most interns!
#4 Where will the procedure take place and what is the cost?
There is great value in having your baby’s procedure done in the comfort of your home. A home is a place that is familiar to you and your baby; a place where your baby feels loved and cared for. When taking leave of the most recent family for whom I had performed a circumcision, I looked back and the mom was resting on the couch, with a content and well-fed baby. A procedure done at a medical center would mean that the mom may need to nurse the baby afterward in a room with minimal privacy. The baby would most likely need to be strapped into a car seat afterward and unless he is given pain killers, this would cause him significant pain and discomfort. Regarding the cost of a home procedure, it may be more affordable than most parents think. Many Mohelim have a sliding scale regarding their fees so that parents of all backgrounds can afford the proficiency of a Mohel.
#5 Do I need to give my baby the vitamin K shot?
Whether or not the vitamin K shot is necessary, is a huge discussion in the medical field. I encourage parents to do their research and choose responsibly. Unfortunately, if parents wish to forgo the Vitamin K shot, most medical professionals will not perform the circumcision. As long as the procedure is performed on or after the eighth day (when vitamin K levels are elevated) , most Mohelim would gladly perform the procedure. For parents who wish to know the facts about circumcision and want to give their baby oral Vitamin K drops instead of a shot, it may be worth their while to reach out to a Mohel for their son’s circumcision.