There are many, many things in this pregnancy that I get to control (well, as much as one ever is able to control a pregnancy). Although I ask my husband's input, I got to decide on things like genetic testing, finding out the gender, and how I eventually want to give birth. There is one thing that my husband is going to make the final decision on.
I know there is absolutely no way to write about this controversial topic without opening a Pandora's box of medical links, opinions, facts, youtube videos, dancing puppies, or anything else that can be thrown at it. And, luckily, since I have decided not to have an opinion on the issue and leave this one completely to him, I welcome them all.
But, despite my lack of opinion, and despite my refusal to weigh in, I still like to learn as much as I can. So, I asked my OBGYN what I need to know about circumcision.
After 30 minutes of discussion, I decided I was even more glad I'm not responsible for this decision.
I learned that there are many different ways a circumcision is performed, and locally it depends on which hospital you give birth in, or if you take your son to a clinic after you check out. Because insurers are much less likely to cover the procedure than they were in the past (advocates against circumcision claim it's due to the fact that it's an entirely elective, cosmetic, non-necessary procedure, those who are for circumcision remind you that insurers will do anything to get out of any coverage they can), more people are heading to clinics to get lower out of pocket circumcisions done, a practice that may be responsible for some of the decline in numbers of male babies being circumcised recently.
My doctor told me about the two most likely to be used in my hospital system: Plastibell and Mogen.
My OBGYN prefers to use the Mogen, although his constant referral to it as "the guillotine" definitely didn't inspire a ton of confidence in me. Still, if we decide to have the procedure done, I think that would be the way I would want it performed. Unlike the other main types of circumcision, in which a cut has to be made into the foreskin in order to put the apparatus on before the horizontal cut can be made (or, in the case of Plastibell, to then pull the foreskin over the "bell" in order to pull the plastic strip down tightly enough to cut off circulation to the foreskin until it falls off on its own), the Mogen only requires one cut and then it's finished.
He also advocated that if we circumcise, we do it within the first three days, while I am still in the hospital. According to him, it becomes obvious as the boy is out of the womb longer and becomes more aware of his surroundings, more of his brain synapses "turn on," making his potential to understand and feel pain more acute. At the very least, he asked, try to have it done within the first ten days, especially if, like him, the doctor performing it does not use anesthesia.
My OBGYN also told me that there will be crying. Much crying. But the crying doesn't necessarily mean the intense feeling of pain that we associate with some newborn cries. They are also crying because they are strapped, because their genitals are exposed, and because they really, really hate being on their back at this early of a stage, especially unswaddled.
Frankly, I sort of need to go on faith when it comes to that talking point. One thing I have learned from looking online for circumcision information is that there really isn't any "pro-circumcision" sources out there. Pretty much anyone who bothers to put information on the internet is against it.
I've watched video after video of screaming baby. I've seen even "med-wiki," the medical wikipedia site, push stats that say it is never medically necessary, that possible health concerns over not having it done are a lie. I've seen nurses state that babies won't breastfeed for up to two days after it's done, with some of them ending up on bottles for the rest of their infancy, or that the baby will then sleep for 24 hours straight because you have utterly traumatized him.
Then there's the "less sensation when he's older" crowd. And I can't help but have a tiny suspicion that's the line of reasoning that may be giving my husband second thoughts.
We aren't religious. I don't believe that circumcision would be anything but a cosmetic choice for our family. And, when it all comes down to it, do we really want to perform a minor surgery on a child less than a week old just for the sake of a pretty penis that might or might not be cleaner down the road?
Because that's where I get nervous -- the cleanliness aspect. I'm a little scared of newborn foreskin. I don't know how you're supposed to deal with it. I don't know what happens as he grows into a toddler, or a young boy. Yes, I'll say it...I have a minor foreskin phobia.
But then I realize that this is what my husband went through, too. Faced with a newborn girl, he had no idea how to clean the poop from her genitalia. The idea of cleaning out "the girls" terrified him, and it took him weeks to get comfortable with it. Now, he can bathe her like a pro (although I suspect he's fairly relieved that thanks to potty training he's off "the girls" duty for the most part).
So I'll get used to whatever penis I'm given to deal with, just like he had to deal. But he still needs to finally make a decision.
We do have some rules nailed down. If we circumcise:
1) It will be done in the hospital, right away. Although it will cost $2000 to do it there, versus $300 to do it at the clinic later, we will have already maxed out our insurance for the year, so the costs should not be any different.
2) It will only be done by our pediatrician. There is one doctor in our hospital system who had an "oops" three years ago. My OBGYN will not tell me the doctor's name, as he can't release that, but he did tell me that my pediatrician has never had any issues with the procedure.
3) We will only do it if the Mogen is used, not the Plastibell. For one thing, I'm not willing to have the baby go through two steps. But also, I'm not sure if I can cope with a piece of foreskin eventually falling off into his diaper. I was a little bothered by the umbilical cord when i found it. I'm not sure I can handle penis-watch, too.
So there is follow up still to be done, and almost exactly two months in which to complete it. And whichever way things turn out, I sincerely hope that what to do about his penis is the biggest medical issue I have with giving birth.
This post was originally published at RH Reality Check, a site of news, community and commentary for reproductive health and justice