I think I have thought of a pet for Lea that Roscoe won't immediately kill. . . or at least it will be tiny enough that we can hide it from him and it won't smell strongly enough for him to ever be the wiser. A pet cricket! We can get the setup and cricket at the pet store, they're easy to care for, and they all look alike, so Lea will not notice when his little life is over and we replace him. They don't live very long and I don't want her heart to break every 8 to 10 weeks.
I am a strong believer that pets teach kids so much about life. I just couldn't think of a pet that Ros wouldn't use to teach her about dissection. . .
Hmmm
Saturday, January 30, 2010
Saturday, January 23, 2010
Rough Times
“Babies just cry a lot. It’s okay”. That’s what I always tell Lea in order to help her know that there’s no serious urgency in her baby brother’s cries (which usually only occur when you change his wee little diaper). In my mind, there should be no grave reason for a newborn to cry—it ‘s a form of communication, not an expression of sadness or pain.
A few days ago, I was folding laundry next to Noah’s swing. It was the first time that I really put him down in order to get some housework done. He had been in there for about 10 minutes before he turned dark blue around the mouth and fingers. I had been looking over at him throughout my chore and grabbed him as soon as I noticed his coloring. He startled and drew in a deep breath, but it took about 5 minutes for his color to return to normal. He felt cold in spite of the blanket and fleece sleep n’ play that covered him.
I called the Army’s nurse’s advice line and they told me to take him to the ER as soon as possible. From there, he was admitted into the pediatrics’ ward for testing and 48 hour monitoring. In one day, I heard hours of pain-filled cries from my newborn as he was pricked and tested for everything under the sun. It was by far the worst day of my life and I know for sure that it was the worst of his. My calm thoughts on the cries of newborns changed into a kind of sad panic as I sat with him through unsuccessful IV attempts and listened as they withdrew his spinal fluid.
After two days of monitoring, the test results came back clear, and aside from one additional incident where his levels went down and he was given oxygen, the stay was uneventful. I am emotionally exhausted, and Noah has been sleeping soundly for the first time in days. He was diagnosed with exaggerated cyanosis, or bluing of the mouth and extremities. I should have checked his feet and mouth coloring when this happened, but I didn’t know to.
I have a lot to be thankful for in this. I was awake when this happened, and there’s no telling what would have happened if I hadn’t startled him awake. He may have woken himself up. Maybe not. Will it happen again? There’s no telling. Machines that monitor infants with apnea have shown to cause more harm than good and are considered by the medical community as being ineffective. For this reason, we were not given one.
Dr. Sears has presented arguments that attachment parenting reduces SIDS, and perhaps the fact that I practice it will ensure that I can help Noah through any reoccurrences that he may have. I feel confident in the fact that I am doing everything that I can possibly do, but this whole thing shook our entire family in a big way. Lea and Miles were stressed for several reasons.
On the upside, Noah has been gaining weight steadily. One half of a pound in his first week! He seems to be in good health.
I am done writing for now. I’m exhausted.
A few days ago, I was folding laundry next to Noah’s swing. It was the first time that I really put him down in order to get some housework done. He had been in there for about 10 minutes before he turned dark blue around the mouth and fingers. I had been looking over at him throughout my chore and grabbed him as soon as I noticed his coloring. He startled and drew in a deep breath, but it took about 5 minutes for his color to return to normal. He felt cold in spite of the blanket and fleece sleep n’ play that covered him.
I called the Army’s nurse’s advice line and they told me to take him to the ER as soon as possible. From there, he was admitted into the pediatrics’ ward for testing and 48 hour monitoring. In one day, I heard hours of pain-filled cries from my newborn as he was pricked and tested for everything under the sun. It was by far the worst day of my life and I know for sure that it was the worst of his. My calm thoughts on the cries of newborns changed into a kind of sad panic as I sat with him through unsuccessful IV attempts and listened as they withdrew his spinal fluid.
After two days of monitoring, the test results came back clear, and aside from one additional incident where his levels went down and he was given oxygen, the stay was uneventful. I am emotionally exhausted, and Noah has been sleeping soundly for the first time in days. He was diagnosed with exaggerated cyanosis, or bluing of the mouth and extremities. I should have checked his feet and mouth coloring when this happened, but I didn’t know to.
I have a lot to be thankful for in this. I was awake when this happened, and there’s no telling what would have happened if I hadn’t startled him awake. He may have woken himself up. Maybe not. Will it happen again? There’s no telling. Machines that monitor infants with apnea have shown to cause more harm than good and are considered by the medical community as being ineffective. For this reason, we were not given one.
Dr. Sears has presented arguments that attachment parenting reduces SIDS, and perhaps the fact that I practice it will ensure that I can help Noah through any reoccurrences that he may have. I feel confident in the fact that I am doing everything that I can possibly do, but this whole thing shook our entire family in a big way. Lea and Miles were stressed for several reasons.
On the upside, Noah has been gaining weight steadily. One half of a pound in his first week! He seems to be in good health.
I am done writing for now. I’m exhausted.
Thursday, January 14, 2010
Baby Noah
Okay, I am going to make this short because I am exhausted and I still have some school work to do.
On the night of the 12th, I put Lea to bed and took Roscoe for a walk. About midway, I had a healthy little contraction and I was starting to feel a bit off by the end. When I got inside, I had another contraction and decided to start timing them. Within 45 min, I went from one every 10 min to every 2 or 3. Within an hour, we were off to the hospital. Upon arrival, I was told that I was 8cm dilated. A few minutes after that, I felt like I needed to push, so I did. Noah came into the world to the sounds of my totally unrestrained screaming (umm. . . oops?) at 1248am on January 13th after about three hours of labor. He was 7lbs 11 oz, 21 inches long, 9/10 Apgar, with Freddy Cougar nails and a big voice. I wanted to go natural and am infinitely grateful for the quick labor that made it impossible for me to cave in. How different it was this time around!! Miles was a great coach. He managed to hold my hand and not look outwardly nervous by my repeated claims that I was going to die. Noah is an awesome nurser. Post labor contractions have been awful, but they are getting better.
That about sums things up!!
Miles has Noah's photos saved in his Aperture library and for the life of me, I cannot figure out how the heck to download them on here. Grrr. Friend me on facebook and I have a few on there.
On the night of the 12th, I put Lea to bed and took Roscoe for a walk. About midway, I had a healthy little contraction and I was starting to feel a bit off by the end. When I got inside, I had another contraction and decided to start timing them. Within 45 min, I went from one every 10 min to every 2 or 3. Within an hour, we were off to the hospital. Upon arrival, I was told that I was 8cm dilated. A few minutes after that, I felt like I needed to push, so I did. Noah came into the world to the sounds of my totally unrestrained screaming (umm. . . oops?) at 1248am on January 13th after about three hours of labor. He was 7lbs 11 oz, 21 inches long, 9/10 Apgar, with Freddy Cougar nails and a big voice. I wanted to go natural and am infinitely grateful for the quick labor that made it impossible for me to cave in. How different it was this time around!! Miles was a great coach. He managed to hold my hand and not look outwardly nervous by my repeated claims that I was going to die. Noah is an awesome nurser. Post labor contractions have been awful, but they are getting better.
That about sums things up!!
Miles has Noah's photos saved in his Aperture library and for the life of me, I cannot figure out how the heck to download them on here. Grrr. Friend me on facebook and I have a few on there.
Friday, January 8, 2010
duhnuhnuhnuh
Nothing yet. Each night I have the signs that labor is imminent, but as I said before, sleep takes care of everything. Without writing anything that would make my poor daddy's eyes fall out when he reads my blog, I'll just say that there has been much to indicate that labor could come any minute. . . it's just the suspense of waiting in discomfort that is getting to me. I can't really take Lea out alone at this point (I think it's a bad idea to take out a toddler who you can't easily pick up or have trouble physically controlling), which kills me because she needs more stimulation than she's had the past couple of days. Miles can't start leave until labor starts, so I am home alone at night. Bah. I just hate waiting.
Anyways, speaking of the boy, he had a little nesting episode last night. All of that baby-related stuff that I've been asking him to do was done in a couple of hours. He was so cute about it. The car seat had to be just so. Everything had to be perfectly organized. I thought it was very sweet, even though I don't think he understood my spontaneous giggle fits. While sorting through everything last night, Roscoe managed to be in everyone's way all while looking totally bewildered. . . like he's been here before but can't recall what all of this pastel colored crap could possibly mean. If he only knew.
Anyways, speaking of the boy, he had a little nesting episode last night. All of that baby-related stuff that I've been asking him to do was done in a couple of hours. He was so cute about it. The car seat had to be just so. Everything had to be perfectly organized. I thought it was very sweet, even though I don't think he understood my spontaneous giggle fits. While sorting through everything last night, Roscoe managed to be in everyone's way all while looking totally bewildered. . . like he's been here before but can't recall what all of this pastel colored crap could possibly mean. If he only knew.
Wednesday, January 6, 2010
Circumcision
In one of my recent classes, we had to research a subject that involved some degree of debate and present each side as unbiasedly as possible. I thought to look into some subject that I would have to research anyways to save myself time and to motivate myself to get a better grasp of the issues at hand. I chose routine neonatal male circumcision. I thought I would share because I think that both sides present some compelling arguments. I hope that in the end, you guys find this to be an entertaining, if not informative, read and take no offense at my closing opinion. Forgive any typos because this was my rough draft (my final was sadly lost somewhere in computerland).
Circumcision is a surgical procedure in which the skin (Along with mucosa, nerves, and small muscle) covering the end of the penis is removed (AAP, 2009). Although the exact frequency is unknown, it is estimated that 1.2 million newborn males are circumcised in the United States annually at a cost of between $150 and $270 million. This practice has been advocated for reasons that vary from symbolic ritual to preventive health measure (AAP, 2009).
Circumcision of males has been undertaken for religious and cultural reasons for many thousands of years. It probably originated as a hygienic measure in communities living in hot, dusty and dry environments. It remains an important ritual in several religious and cultural groups (RACP, 2009).
In the 1920s, for the first time in history, a majority of American males were to be circumcised. This was the beginning of a trend that increased over the years, and then leveled off to about 85 percent of newborn males by 1980 (Harrison, 2002). In the United States, many hospital-born male infants undergo circumcision regardless of the religious affiliation of their parents (Wallerstein, 2008). This is due in part to what is considered normal and also the belief that circumcision promoted cleanliness and disease prevention.
Documented health circumcision originated in the nineteenth century, when most diseases were of unknown etiology. During that time, a theory emerged that masturbation caused many and varied ills. It seemed logical to some physicians to perform genital surgery on both sexes to stop masturbation; the major technique applied to males was circumcision (Wallerstein, 2008). Ailments that were attributed to the foreskin included madness, muscle spasms, and sexual promiscuity.
For many who oppose neonatal male circumcision, the continuing practice of routine neonatal nonreligious circumcision in the United States represents an enigma. About 80 percent of the world's population do not practice circumcision, nor have they ever done so. Among the non-circumcising nations are Holland, Belgium, France, Germany, Switzerland, Austria, Scandinavia, Russia, China, and Japan (Wallerstein, 2008). Ironically, many pro circumcision groups argue that circumcision decreases chances for penile cancer, but incidents of penile cancer are at least .1% lower in countries that do not practice circumcision.
A number of medical societies in the developed world have published statements that do not recommend routine circumcision of male newborns. In its position statement, the Australian College of Pediatrics emphasized that in all cases, the medical attendant should avoid exaggeration of either risks or benefits of this procedure (AAP, 2009). Furthermore, many governments, including Australia’s, do not pay for neonatal male circumcision as a part of their social assistance programs.
Evidence regarding the relationship of circumcision to STD in general is complex and conflicting. Studies suggest that circumcised males may be less at risk for syphilis than are uncircumcised males. In addition, there is a substantial body of evidence that links non-circumcision in men with risk for HIV infection. There does appear to be a plausible biologic explanation for this association in that the mucous surface of the uncircumcised penis allows for viral attachment to lymphoid cells at or near the surface of the mucous membrane, as well as an increased likelihood of minor abrasions resulting in increased HIV access to target tissues (AAP, 2009). This said, the AAP goes on to state that behavioral factors appear to be far more important risk factors in the acquisition of HIV infection than circumcision status.
The following are some examples of sites representing both sides of the circumcision debate:
Medical video of the procedure (neither pro nor anti circumcision):
http://video.google.com/videoplay?docid=-6584757516627632617#
Pro (infant) Circumcision Sites:
http://www.gilgalsoc.org
http://www.medicirc.org
Anti (infant) Circumcision sites:
http://www.nocirc.org
http://www.circumstitions.com
http://www.mothersagainstcirc.org
Generally, those who endorse circumcision do so on either medical or religious grounds (or both). Those who are against routine male neonatal circumcision argue medical claims to the operation stating that no major health organization in the world recommends the surgery as a routine norm.
Those who are pro circumcision argue for many possible health benefits. It is common thought (particularly in America) that male circumcision promotes easier hygiene. This belief is based on the fact that there are fewer creases in the circumcised penis and that a man does not have to go through the hassle of manually retracting his foreskin in order to clean the area that normally lies underneath it. Those against circumcision maintain that it is simple to clean an uncircumcised penis, as well. Modern hygiene products make it quick and easy to cleanse under the foreskin.
Individuals who promote neonatal circumcision argue that medical research has indicated that indicated a decreased risk of urinary tract infections in circumcised males. The risk of urinary tract infections in the first year is low, but these infections may be several times as common in uncircumcised baby boys (AAP, 2009). Nonetheless, those against the operation argue that chances for the infection are still very low, at 0.9% of uncircumcised infants contracting an infection in the first year of life and rates decreasing from there.
Those who are in favor of circumcision argue for the prevention of penile problems. Occasionally, the foreskin on an uncircumcised penis may be difficult or impossible to retract (phimosis) (AAP, 2009). Those who argue against the operation state that most problems with phimosis either fade with time argue in favor of milder methods of treatment such as the forced retraction of the foreskin slightly every day over a period of months, which is reported to be painless.
Decreased risk of penile cancer is also something that is a reported benefit of circumcision. Although cancer of the penis is rare, it's less common in circumcised men (AAP, 2009). Oddly enough, in countries that do not routinely practice circumcision (Japan and most European nations), penile cancer rates are lower than in America (The Circumcision Reference Library, 2009). To further arguments, those who do not support circumcision also stress the extreme rarity of penile cancer.
The most avid circumcision supporters argue for the decreased risk of sexually transmitted diseases. Safe sexual practices remain essential, but circumcised men may have a slightly lower risk of certain sexually transmitted diseases — including HIV, the virus that causes AIDS (The Mayo Clinic, 2009). Studies have not been robust or conclusive enough for major health organizations to begin supporting the operation, which is the main counter-argument of those who are against it. Other arguments for circumcision include religious ones and the desire for a child to look like his father who is circumcised. Some parents fear that their child will be scorned for his uncircumcised penis.
Those who are against neonatal circumcision stress the surgical risks involved in the operation. Excessive bleeding and infection are uncommon, but possible. The foreskin may be cut too short or too long or fail to heal properly. If the remaining foreskin reattaches to the end of the penis, minor surgery may be needed to correct it. Complication rates ranging from 0.06% to 55% have been cited, though experts predict between 3 and 6 % actually experience true complications (Canadian Medical Association , 1996).
According to the American Academy of Pediatrics' 1999 Circumcision Policy Statement, “There is considerable evidence that newborns who are circumcised without analgesia experience pain and psychological stress.”(AAP, 1999) This is another focus of those against the operation. Local anesthesia can block nerve sensations during the procedure (Mayo clinic, 2009), but the infant still cries and it is unknown what he is actually feeling. The healing process after the surgery is also painful for the infant.
As stated before, those who are against routine male circumcision stress that no national or international medical association recommends routine circumcision as a worldwide norm. That said, the World Health Organization (WHO) does state “WHO/UNAIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence. Male circumcision provides only partial protection, and therefore should be only one element of a comprehensive HIV prevention package.” (WHO, 2009)
Lastly, many believe that the foreskin is a normal, protective, functioning organ that should not be removed and that circumcision denies a male's right to genital integrity and choice for his own body.
Both arguments present facts that can be used to strengthen each case. Considering that this is a subject involving human infants, emotions run high and each argument has the potential to become unprofessional as a result.
The evidence that male circumcision at infancy is medically beneficial is debatable and inconclusive. It seems that each argument in favor of the procedure has an equally convincing counter comment from the opposing argument that makes points in favor seem less significant. Evidence against the procedure tends to be more emotional in nature but also present a valid argument.
I believe that most parents want what they feel is best for their child and that parenting comes along with many decisions that can be quite difficult to make. Furthermore, I think that it is a staple of good parenting to make any and all decisions based on research, gathered facts, and evaluation. The opinions of a single health care provider or family members should play a lesser role. Practices need to be questioned because in spite of their popularity, common decisions are not always the right decisions.
While researching this issue, I focused on finding empirical articles and governmental/health sites that would give me access to the most accurate information. Warning signs that indicated that perhaps I should not include the site in my analysis were an abundance of emotion, accusations, and opinionated remarks. These sites were avoided.
I found the AAP (and other governmental equivalents such as Australia’s RACP) to have the most accurate and trustworthy information. They seemed generally unbiased and provided facts that influenced my final decision. Their closing statement on the subject of circumcision was that “Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.” This statement helped me to solidify my opinion on the matter.
I cannot say that this research has swayed my beliefs either way. I knew quite a bit from my own personal internet meanderings when I was trying to decide about whether or not to circumcise my own son. Before that, however, I assumed there was a good reason behind the operation—I just didn’t know what it was. Now that I have more information, I have made my own decisions through my own research and that makes me more confident about my decisions as a parent.
After researching the different positions surrounding routine male circumcision at infancy, I think that each side has made some legitimate points. There are some slight health benefits to male circumcision. I do, however, agree with those who say that the risks involved in the operation, the trauma associated with it, and lack of solid evidence as to the validity of some purported health benefits al serve to tip the balance against the operation.
Furthermore, I find moral issues with neonatal male circumcision. It is the removal of an entire body part and the child has absolutely no say in whether or not he wants it to be done. In fact, videos that I downloaded which showed the operation indicate that the infant doesn’t agree with the process of foreskin removal at all.
In the end, I understand that there are benefits and risks associated with both sides of the argument and that it can feel like a no win situation for parents. I wouldn’t look down my nose at a parent making an educated decision about what to do with his or her child. As I stated previously, however, I do not believe that any practice should go unquestioned. Parents should know the facts before making their decisions.
Works Cited
American Academy of Pediatrics (AAP). (2009). Circumcision: Information for Parents. Retrieved November 21, 2009 from http://www.circumstitions.com/AAP-bro.html
American Academy of Pediatrics (AAP). (2009). Circumcision Policy Statement. Retrieved 21 November 2009 from http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686
DeLaet, D. L. (2007). Framing Male Circumcision as a Human Rights Issue?: Contributions to the Debate Over the Universality of Human Rights. Retrieved on 21 November 2009 from http://www.allacademic.com/meta/p179332_index.html
Fetus and Newborn Committee. (1996). "Neonatal circumcision revisited". Canadian Medical Association Journal 154 (6): 769–780. Retrieved on 29 November 2009 from http://www.cps.ca/english/statements/FN/fn96-01.htm
Harrison, Daniel. (2002). Rethinking Circumcision and Sexuality in the United States. Vol 5. Sage Publications. Retrieved on 21 November 2009 from http://sexualities.sagepub.com.pegleg.park.edu/cgi/reprint/5/3/300
The Circumcision Reference Library. (2008). United States Circumcision Incidence. Retrieved on 21 November 2009 from http://www.cirp.org/library/statistics/USA/
The Mayo Clinic. (2009). Pros and Cons of Circumcision. Retrieved on 22 November 2009 from http://www.mayoclinic.com/
The Royal Australasian College of Physicians (RACP). (2009). Policy Statement On Circumcision. Retrieved on 29 November 2009 from http://www.racp.edu.au/index.cfm?objectid=D7FAA93E-E091-4209-15657544BA419672
Wallerstein, E. (2008). Circumcision: The Uniquely American Medical Enigma. Retrieved on 21 November 2009 from http://www.cirp.org/library/general/wallerstein/
World Health Organization (WHO). (2009). Retrieved on 29 November 2009 from http://www.who.int/hiv/topics/malecircumcision/en/index.html
Circumcision is a surgical procedure in which the skin (Along with mucosa, nerves, and small muscle) covering the end of the penis is removed (AAP, 2009). Although the exact frequency is unknown, it is estimated that 1.2 million newborn males are circumcised in the United States annually at a cost of between $150 and $270 million. This practice has been advocated for reasons that vary from symbolic ritual to preventive health measure (AAP, 2009).
Circumcision of males has been undertaken for religious and cultural reasons for many thousands of years. It probably originated as a hygienic measure in communities living in hot, dusty and dry environments. It remains an important ritual in several religious and cultural groups (RACP, 2009).
In the 1920s, for the first time in history, a majority of American males were to be circumcised. This was the beginning of a trend that increased over the years, and then leveled off to about 85 percent of newborn males by 1980 (Harrison, 2002). In the United States, many hospital-born male infants undergo circumcision regardless of the religious affiliation of their parents (Wallerstein, 2008). This is due in part to what is considered normal and also the belief that circumcision promoted cleanliness and disease prevention.
Documented health circumcision originated in the nineteenth century, when most diseases were of unknown etiology. During that time, a theory emerged that masturbation caused many and varied ills. It seemed logical to some physicians to perform genital surgery on both sexes to stop masturbation; the major technique applied to males was circumcision (Wallerstein, 2008). Ailments that were attributed to the foreskin included madness, muscle spasms, and sexual promiscuity.
For many who oppose neonatal male circumcision, the continuing practice of routine neonatal nonreligious circumcision in the United States represents an enigma. About 80 percent of the world's population do not practice circumcision, nor have they ever done so. Among the non-circumcising nations are Holland, Belgium, France, Germany, Switzerland, Austria, Scandinavia, Russia, China, and Japan (Wallerstein, 2008). Ironically, many pro circumcision groups argue that circumcision decreases chances for penile cancer, but incidents of penile cancer are at least .1% lower in countries that do not practice circumcision.
A number of medical societies in the developed world have published statements that do not recommend routine circumcision of male newborns. In its position statement, the Australian College of Pediatrics emphasized that in all cases, the medical attendant should avoid exaggeration of either risks or benefits of this procedure (AAP, 2009). Furthermore, many governments, including Australia’s, do not pay for neonatal male circumcision as a part of their social assistance programs.
Evidence regarding the relationship of circumcision to STD in general is complex and conflicting. Studies suggest that circumcised males may be less at risk for syphilis than are uncircumcised males. In addition, there is a substantial body of evidence that links non-circumcision in men with risk for HIV infection. There does appear to be a plausible biologic explanation for this association in that the mucous surface of the uncircumcised penis allows for viral attachment to lymphoid cells at or near the surface of the mucous membrane, as well as an increased likelihood of minor abrasions resulting in increased HIV access to target tissues (AAP, 2009). This said, the AAP goes on to state that behavioral factors appear to be far more important risk factors in the acquisition of HIV infection than circumcision status.
The following are some examples of sites representing both sides of the circumcision debate:
Medical video of the procedure (neither pro nor anti circumcision):
http://video.google.com/videoplay?docid=-6584757516627632617#
Pro (infant) Circumcision Sites:
http://www.gilgalsoc.org
http://www.medicirc.org
Anti (infant) Circumcision sites:
http://www.nocirc.org
http://www.circumstitions.com
http://www.mothersagainstcirc.org
Generally, those who endorse circumcision do so on either medical or religious grounds (or both). Those who are against routine male neonatal circumcision argue medical claims to the operation stating that no major health organization in the world recommends the surgery as a routine norm.
Those who are pro circumcision argue for many possible health benefits. It is common thought (particularly in America) that male circumcision promotes easier hygiene. This belief is based on the fact that there are fewer creases in the circumcised penis and that a man does not have to go through the hassle of manually retracting his foreskin in order to clean the area that normally lies underneath it. Those against circumcision maintain that it is simple to clean an uncircumcised penis, as well. Modern hygiene products make it quick and easy to cleanse under the foreskin.
Individuals who promote neonatal circumcision argue that medical research has indicated that indicated a decreased risk of urinary tract infections in circumcised males. The risk of urinary tract infections in the first year is low, but these infections may be several times as common in uncircumcised baby boys (AAP, 2009). Nonetheless, those against the operation argue that chances for the infection are still very low, at 0.9% of uncircumcised infants contracting an infection in the first year of life and rates decreasing from there.
Those who are in favor of circumcision argue for the prevention of penile problems. Occasionally, the foreskin on an uncircumcised penis may be difficult or impossible to retract (phimosis) (AAP, 2009). Those who argue against the operation state that most problems with phimosis either fade with time argue in favor of milder methods of treatment such as the forced retraction of the foreskin slightly every day over a period of months, which is reported to be painless.
Decreased risk of penile cancer is also something that is a reported benefit of circumcision. Although cancer of the penis is rare, it's less common in circumcised men (AAP, 2009). Oddly enough, in countries that do not routinely practice circumcision (Japan and most European nations), penile cancer rates are lower than in America (The Circumcision Reference Library, 2009). To further arguments, those who do not support circumcision also stress the extreme rarity of penile cancer.
The most avid circumcision supporters argue for the decreased risk of sexually transmitted diseases. Safe sexual practices remain essential, but circumcised men may have a slightly lower risk of certain sexually transmitted diseases — including HIV, the virus that causes AIDS (The Mayo Clinic, 2009). Studies have not been robust or conclusive enough for major health organizations to begin supporting the operation, which is the main counter-argument of those who are against it. Other arguments for circumcision include religious ones and the desire for a child to look like his father who is circumcised. Some parents fear that their child will be scorned for his uncircumcised penis.
Those who are against neonatal circumcision stress the surgical risks involved in the operation. Excessive bleeding and infection are uncommon, but possible. The foreskin may be cut too short or too long or fail to heal properly. If the remaining foreskin reattaches to the end of the penis, minor surgery may be needed to correct it. Complication rates ranging from 0.06% to 55% have been cited, though experts predict between 3 and 6 % actually experience true complications (Canadian Medical Association , 1996).
According to the American Academy of Pediatrics' 1999 Circumcision Policy Statement, “There is considerable evidence that newborns who are circumcised without analgesia experience pain and psychological stress.”(AAP, 1999) This is another focus of those against the operation. Local anesthesia can block nerve sensations during the procedure (Mayo clinic, 2009), but the infant still cries and it is unknown what he is actually feeling. The healing process after the surgery is also painful for the infant.
As stated before, those who are against routine male circumcision stress that no national or international medical association recommends routine circumcision as a worldwide norm. That said, the World Health Organization (WHO) does state “WHO/UNAIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence. Male circumcision provides only partial protection, and therefore should be only one element of a comprehensive HIV prevention package.” (WHO, 2009)
Lastly, many believe that the foreskin is a normal, protective, functioning organ that should not be removed and that circumcision denies a male's right to genital integrity and choice for his own body.
Both arguments present facts that can be used to strengthen each case. Considering that this is a subject involving human infants, emotions run high and each argument has the potential to become unprofessional as a result.
The evidence that male circumcision at infancy is medically beneficial is debatable and inconclusive. It seems that each argument in favor of the procedure has an equally convincing counter comment from the opposing argument that makes points in favor seem less significant. Evidence against the procedure tends to be more emotional in nature but also present a valid argument.
I believe that most parents want what they feel is best for their child and that parenting comes along with many decisions that can be quite difficult to make. Furthermore, I think that it is a staple of good parenting to make any and all decisions based on research, gathered facts, and evaluation. The opinions of a single health care provider or family members should play a lesser role. Practices need to be questioned because in spite of their popularity, common decisions are not always the right decisions.
While researching this issue, I focused on finding empirical articles and governmental/health sites that would give me access to the most accurate information. Warning signs that indicated that perhaps I should not include the site in my analysis were an abundance of emotion, accusations, and opinionated remarks. These sites were avoided.
I found the AAP (and other governmental equivalents such as Australia’s RACP) to have the most accurate and trustworthy information. They seemed generally unbiased and provided facts that influenced my final decision. Their closing statement on the subject of circumcision was that “Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.” This statement helped me to solidify my opinion on the matter.
I cannot say that this research has swayed my beliefs either way. I knew quite a bit from my own personal internet meanderings when I was trying to decide about whether or not to circumcise my own son. Before that, however, I assumed there was a good reason behind the operation—I just didn’t know what it was. Now that I have more information, I have made my own decisions through my own research and that makes me more confident about my decisions as a parent.
After researching the different positions surrounding routine male circumcision at infancy, I think that each side has made some legitimate points. There are some slight health benefits to male circumcision. I do, however, agree with those who say that the risks involved in the operation, the trauma associated with it, and lack of solid evidence as to the validity of some purported health benefits al serve to tip the balance against the operation.
Furthermore, I find moral issues with neonatal male circumcision. It is the removal of an entire body part and the child has absolutely no say in whether or not he wants it to be done. In fact, videos that I downloaded which showed the operation indicate that the infant doesn’t agree with the process of foreskin removal at all.
In the end, I understand that there are benefits and risks associated with both sides of the argument and that it can feel like a no win situation for parents. I wouldn’t look down my nose at a parent making an educated decision about what to do with his or her child. As I stated previously, however, I do not believe that any practice should go unquestioned. Parents should know the facts before making their decisions.
Works Cited
American Academy of Pediatrics (AAP). (2009). Circumcision: Information for Parents. Retrieved November 21, 2009 from http://www.circumstitions.com/AAP-bro.html
American Academy of Pediatrics (AAP). (2009). Circumcision Policy Statement. Retrieved 21 November 2009 from http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686
DeLaet, D. L. (2007). Framing Male Circumcision as a Human Rights Issue?: Contributions to the Debate Over the Universality of Human Rights. Retrieved on 21 November 2009 from http://www.allacademic.com/meta/p179332_index.html
Fetus and Newborn Committee. (1996). "Neonatal circumcision revisited". Canadian Medical Association Journal 154 (6): 769–780. Retrieved on 29 November 2009 from http://www.cps.ca/english/statements/FN/fn96-01.htm
Harrison, Daniel. (2002). Rethinking Circumcision and Sexuality in the United States. Vol 5. Sage Publications. Retrieved on 21 November 2009 from http://sexualities.sagepub.com.pegleg.park.edu/cgi/reprint/5/3/300
The Circumcision Reference Library. (2008). United States Circumcision Incidence. Retrieved on 21 November 2009 from http://www.cirp.org/library/statistics/USA/
The Mayo Clinic. (2009). Pros and Cons of Circumcision. Retrieved on 22 November 2009 from http://www.mayoclinic.com/
The Royal Australasian College of Physicians (RACP). (2009). Policy Statement On Circumcision. Retrieved on 29 November 2009 from http://www.racp.edu.au/index.cfm?objectid=D7FAA93E-E091-4209-15657544BA419672
Wallerstein, E. (2008). Circumcision: The Uniquely American Medical Enigma. Retrieved on 21 November 2009 from http://www.cirp.org/library/general/wallerstein/
World Health Organization (WHO). (2009). Retrieved on 29 November 2009 from http://www.who.int/hiv/topics/malecircumcision/en/index.html
Monday, January 4, 2010
Tick. . . . . . . tock. . . . . . etc
My past two nights have been spent in certainty that I am going into labor. By the end of each day, I have BHCs every couple of minutes, and by the time that I am off to bed, they've gotten rather painful. My body is teasing me, though, because a few hours with my feet up cure all labor symptoms. The fact that I can't sleep anymore seems to be irrelevant. My 39 week appointment is tomorrow, but I don't think they'll be able to tell me anything. I am a bit unwilling to have any internal exams done. I have heard of women being 3 or 4 cm dilated for weeks, so I'll forgo the intrusion and possible disappointment. I am not desperate enough to give birth (yet) that 5 mile walks and nipple clamps hold any appeal. I just wish I could bend over without getting a mouth/nose full of stomach acid. At this point, I have some strong arguments for the folks who sing of the beauty of pregnancy.
Subscribe to:
Comments (Atom)