Abstract

In lieu of an abstract, here is a brief excerpt of the content:To Cut or Not to Cut?That is the QuestionTracy WilsonWhat is circumcision? In simple terms, it is the removal or excision of the foreskin of the penis. Seems so simple, right? In some families, it is that simple. In other families, it is a religious exercise. I am a doctorally-prepared Family Nurse Practitioner and started my nursing career in the NICU. I have seen my fair share of circumcisions. As a nurse, our role was to prep the room with whichever instrument the OB/GYNS preferred and then soothe the baby. Some OB/GYNS prescribed Sucrose, which is ultimately sugar water, for the babies to have while undergoing circumcision, while others wouldn't prescribe anything. What I learned in the NICU and by watching circumcisions being performed was that the doctor's preference determined the pain management protocol. Some doctors cared more about pain control, some cared [End Page 85] about presentation and ensuring the foreskin was cut properly, and some were just old school and had their preferences. I wanted to comfort the baby and make his world as comfortable as possible.Watching circumcisions being performed, I never formed an opinion about them. I really looked at circumcision like any other procedure. However, I did see some parents really toil over the decisions, especially fathers who did not want to "see their son tortured or mutilated like that" as one told me once. I didn't quite understand the comparison to mutilation, but I understood why he did not want his son to go through the procedure. It wasn't until years later that I understood the gravity of the decision when I became pregnant with our son and knew immediately it was a boy. Call it a mother's intuition, but I just knew. To circumcise my son was never a decision I had to deliberate very long because it was something I was accustomed to in my family. It wasn't until one of my relatives got married and had her first son that I became aware that this would ever be a weighty decision for someone in my family.I took it for granted all those years before working in the NICU because circumcision was superficial to me. I realized that it's not just a piece of foreskin to many people. For some circumcision is done for religious reasons, for others making the choice to circumcise is about sameness, or hygiene. For my extended family member, it happened to be about sameness. She didn't want her sons to look different from their dad. Since potty training was mostly going to be taught by their father, they wanted their sons to look like him. Many NICU parents told me they wanted their sons to look like their fathers, so this notion was familiar to me. After my extended family member explained why sameness mattered, I understood the reasons why some parents felt this way.There are other stories like this which we pondered upon when we got pregnant with our son, and I really began to reflect on whether we should circumcise or not. Then two additional frames of thoughts arose; one, I ensured that my husband and I jointly made the decision together, but I really leaned on him for his opinion because he was a male and most of the male teaching would come from him. Second, we considered if the decision to circumcise should come from him once he became an adult. His father and I discussed whether he should have a choice regarding being circumcised. He may have chosen a different decision than us and we didn't want to take away his right to choose. However, waiting to have a circumcision as an adult comes with its own sets of challenges, including the possibility of infection, increased pain, missed work, edema, etc. So, ultimately, we made the decision to go ahead with the circumcision.In our case, our pediatrician performed the circumcision. I asked him explicitly which instrument he used because I had my preference, and I was not going to allow my son to be circumcised by a healthcare professional that did not use my...