For nearly all of Nada Mouallem's pregnancy, she and her husband, Tony, had a running argument. She wanted to have their son circumcised. He didn't. "Many days, I'd go off and research all the pros. He'd go and research all the cons. Then we'd get together at night and fight," she says.
Arguments about circumcision often polarize today's parents. The procedure, dating to ancient Egypt, is -- in simple terms -- the removal of the foreskin, the piece of skin that surrounds the tip of the penis. But imbued in that small piece of skin are passionate opinions on sex, money, religion, tradition, health, hygiene, human rights and locker room pressure.
Parents of baby boys have to weigh all those factors.
Forty years ago, when almost every male born in this country was circumcised, the decision was easier. In 1965, 85% of boys born in the United States were circumcised, so parents followed the crowd.
But as of 2005, 56% of newborn boys were circumcised, according to the Agency for Healthcare Research and Quality, which analyzed hospital-based circumcisions that year. That figure varies by region: In the report, 75% of boys born in the Midwest were circumcised, 65% in the Northeast, 56% in the South and only 31% in the West. Factors influencing the decline, experts say, include immigration from Latin America and other countries where circumcision is less common, declining insurance coverage and a tendency for parents to choose less medical intervention.
Dr. Doug Diekema, pediatrician at Seattle Children's Hospital, where he's chairman of the academic committee on bioethics, says today's climate makes parents think harder about this decision.
"The fact that circumcision is an even split these days is not a bad thing," he says. "If there are not religious beliefs, then parents really are left with the primary question of whether circumcision offers another benefit. The data are not compelling in either direction.
"The social pressure parents faced before to circumcise their sons was not the best reason to do it."
Tandy Parks, childbirth education specialist at Santa Monica-UCLA Medical Center and Orthopaedic Hospital, has seen the numbers of parents electing to have sons circumcised drop dramatically since she began teaching these classes in the 1970s. "Before, everyone did the procedure. There was no discussion." Now, she estimates, out of every six West L.A. couples she teaches, three plan to circumcise; two will not, and one is on the fence.
