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What you need to know before you decide

*Names of parents and children have been changed to protect their privacy

When Bob and Jeanette Sullivan* welcomed their first son, Trevor, into the world 13 years ago, they had already decided not to have him circumcised.

"I read about the procedure before he was born," remembers Jeanette. "I talked with other Christians who felt there was a scriptural reason for circumcision, but I couldn?t see it. I noticed that the New Testament spoke only of circumcision of the heart. Then I asked, ?Is there a physical reason?? and after researching it, felt that no, there wasn?t.

"God created boys this way, and it?s all meant to work fine without the procedure. It seemed like there was no point to cause that pain." All five Sullivan boys are uncircumcised, and Jeanette has no regrets. "I just wasn?t convinced by any of the arguments," she says. "And it seemed so permanent. I guess I figured they could do it later if they want or need to. But once it?s done, it?s irreversible."

At first, Heidi Moore had a similar opinion. "When Michael was born, most of what I?d heard supported the idea that circumcision was unnecessary and painful. Even my birthing coach was vocal in her opposition to it. At the time I didn?t have much information, so I was persuaded by her.

"But," says Heidi, "when he was 3 years old, Michael?s penis became red and infected and I just couldn?t keep it clean." That?s when Heidi?s husband, Sam, spoke with his own father and learned that his dad had not been circumcised as an infant and had experienced problems much like Michael?s. Sam?s dad had to undergo the surgery as an adult. Heidi says, "We had Michael circumcised when he was 5?at this point using total anesthesia. Needless to say, it wasn?t a question when our second son same along!"

A generation ago, most people of Judeo-Christian heritage didn?t think twice about having their sons circumcised at birth. But that was then. Today, many parents agonize over whether to allow the procedure. The circumcision rate in the United States has dropped to less than 60 percent and, if present trends continue, soon will be closer to 50 percent.

In truth, there is no right or wrong decision about circumcision. Parents may have strong feelings one way or the other that will guide their choice. But for those who don?t, it?s essential to get accurate information from trustworthy sources, such as your doctor, your pastor and other parents (see sidebar). Then, use that information to make the decision you feel is right for your child.

just the facts

Getting accurate information isn?t easy. Circumcision is often a hotly contested issue, making unbiased facts hard to come by. Even the American Academy of Pediatrics has changed its position several times over the years. In March 1999, after analyzing almost 40 years of medical research, the AAP released this rather ambiguous statement: "Circumcision is not essential to a child?s well-being at birth, even though it does have some potential medical benefits." These benefits, they concluded, "are not compelling enough to warrant the AAP to recommend routine newborn circumcision. Instead, we encourage parents to discuss the benefits and risks of circumcision with their pediatrician, and then make an informed decision about what is in the best interest of their child."

What are the benefits of circumcision? Some studies indicate that the risk of developing a urinary tract infection is higher for baby boys who are uncircumcised, about a 1 in 100 chance versus 1 in 1,000 for a circumcised infant. In addition, while penile cancer is extremely rare (9 or 10 cases per year per 1 million men), uncircumcised men do get this cancer more often. Some research also suggests that circumcised men may be at a reduced risk for developing syphilis and HIV infections, though the AAP also stresses that, obviously, behavior has a great deal more to do with who contracts sexually transmitted diseases.

On the con side, the AAP says that, as with any surgery, there are risks involved in circumcision such as bleeding, infection and improper healing. Although the AAP says these complications are rare and usually minor, some parents may feel that there?s no compelling reason to take a chance on a procedure they believe is unnecessary.

Those opposed to circumcision also point out that the foreskin keeps the tip of the penis, the glans, protected from trauma and injury. The AAP says that the foreskin is easy to care for, and that boys can be taught simple hygiene as they grow.

a biblical perspective

For many parents, however, the decision of whether or not to circumcise has less to do with cold medical data than with more emotive factors. "I wanted the boys to look like their dad," admits Helen Brinkman, mother of two boys. "And I was concerned that later on, they?d be teased in the locker room if they looked different." Others make their decision for religious reasons. Sherry Hall, mother of four, says, "I figured if God ordained circumcision for his people in the Old Testament, there probably were some good spiritual reasons as well as health reasons."

Dr. Robert Hubbard, Professor of Biblical Literature at North Park Seminary in Chicago, notes that through out the Old Testament, the procedure was seen as "a sign of the covenant" (Gen.:17:9-14), although the ritual was practiced by people besides the Israelites.

Yet Dr. Hubbard also points out that in the New Testament, "circumcision is a metaphor for the heart attitude of faithfulness to God, of staying away from idolatry. In fact, in several of his letters, Paul discourages circumcising on spiritual grounds (Rom.:4:4-12; Gal.:5:1-13). Baptism replaces circumcision as an outward sign of membership in the community of God (Col.:2:11-13). Now the emphasis is on relationship?identifying with the death and resurrection of Christ?and not on ritual."

the decision is yours

One thing everyone agrees on when it comes to circumcision: do your homework before the baby comes, not in the delivery room after 12 hours of labor! Read the studies and medical statements, and talk to knowledgeable people on both sides of the issue. Talk to your pastor about any theological concerns you might have. Ask other parents why they did or didn?t have their boys circumcised, and find out how they feel about their decision. How do their sons feel about the decision?

"Usually the decision will come down to a matter of preference, and that?s fine," says Dr. John Briggs, a family practitioner in Fremont, Michigan. As a dedicated Christian and the father of four sons, Briggs reasons, "God wouldn?t have mandated it in the Old Testament if it was harmful, and it doesn?t have to be painful either, since more doctors are administering pain killers during circumcision." Conscientious doctors, Briggs notes, should not apply undue pressure for or against circumcision. Look out for caregivers who have an axe to grind.

If you decide to go ahead with circumcision, make sure that the attending doctor is experienced and competent. Not all circumcisions are alike. Your doctor can help you decide how much skin to remove and how much of the glans will remain covered. Also, ask your doctor about the possibility of using painkillers, as recent studies indicate that infants do suffer pain during circumcision. Be sure to put your intentions in writing before the baby comes just in case your doctor is not on call when your baby is born.

The decision whether to circumcise is a difficult and emotional one. But by praying about it, getting straight forward, accurate information and working closely with your doctor, you can be confident you?ve made a choice you?ll feel good about now and in the years to come.

Ginny Nieuwsma is a writer and the mother of six. She and her family live in California.

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