Lacy Case

Over the decades, circumcision in America became and was almost a standard practice. Nevertheless, in recent years many parents are choosing to go against this practice. According to a federal estimate in 1999 the rate of circumcisions in the United States was that of 62.7 percent, but has now declined to 54.5 percent and continues to do so (Rabin 2012). The push for circumcision may have been for faulty reasoning, but nonetheless it wasn't extensively questioned, until the last couple decades. We will briefly review how the procedure is done, it's beginnings in the country and some of the controversy that accompanies the topic.

It is well known, but circumcision is the surgical removal of the continuation of skin that covers the glans of the penis. The procedure is generally performed during the post-natal hospital stay. The first or second day of life is preferred, because then the baby will have synthesized enough vitamin K, thus preventing the possibility of bleeding due to lack of coagulation (Pillitteri, 2010). A protective device is generally used to maintain the integrity of the penis during the excision of the foreskin. The most common devices include the Gomco clamp, Plastibell, and Mogen clamp. There is also the method of free hand cutting, which is generally practiced when the circ is performed for religious reasons (Morris, 1999).

As with any of the above methods, the infant is placed lying supide and restrained either manually or via a swaddling board. Unlike in the past, the use of anesthesia is now usually used to minimize the pain. The area is cleansed, and the Plastibell, which is a specially designed plastic bell, is fitted over the end of the penis. Next, a suture is tightly tied around the rim of the bell and a circle of prepuce is excised, thus allowing the foreskin to be retracted without difficulty and the glans completely exposed. The rim of the bell remains in place for 4 to 7 days and fall off by itself. Its purpose is to protect the penis so that healing can occur without interruption. The Gomco clamp is somewhat similar to that of the Plastibell. This clamp is made of metal, and for the procedure, the foreskin is stretched over the bell-shaped portion of the clamp, and the skin excised. A piece of gauze with petrolatum is wrapped around the penis to protect the area (Pillitteri, 2010).

These are generally very safe procedures so long as they are performed by experienced hands, and ultimately it is the parent's choice, which to use. Interestingly, parent's decision to choose circumcision in the first place has been more than for medical reasons and continues to be so. These could be religious or even social as we will discover seeing that social trends and media played an important part in the history of circumcision.

How circumcision became so prevalent in America is quite interesting. Very early on in, circumcisions were not either encouraged or practiced by surgeons, unless they for religious or in specific medical reasons (phimosis). It was only in the nineteenth century, when it first started to become popular.

According to Gollaher, a historian of medicine, in February 1870 a circumcision was performed in a five-year-old boy, who suffered from leg paralysis by Lewis A. Sayre, a well known and surgeon. When the boy's condition showed a noticeable improvement, he deduced that by stopping a severe irritation to the penis, he was able to relieve the young boy's paralysis. In light of this, Sayre and others began performing the procedure in other boys. They too appeared to produce comparable improvements, and naturally, Sayre began to promote the procedure due to its healing powers in an array of disorders. As the procedure became more known among other doctors, they began to praise the preventive qualities of circumcision (Gollaher, 1994).

About ten years later, Peter C. Remondino, who was both a physician and the vice president of the California Medical Society, wrote a text named History of Circumcision in early 1891 that explored the topic in detail. In this text he stated that the foreskin was an "outlaw". He explained that the foreskin was once useful, but at that time in history that was no longer true. Remodino (1891) wrote, " the prepuce was well enough in out primitive and arboreal days,-ages and ages ahead of our cave and lake dwellings,-when the notch in a tree and its rough bard formed out couch; but in these days of plush-cushioned pews and opera-seats, cozy office-chairs, car-seats, and upholstered furniture or polished-oak seats, it serves no intelligent purpose "(p. 245-246). He also concluded that it insured better health, a longer life, less danger from masturbation, syphilis, cancer, and epilepsy.

As the practice grew towards the end of the nineteenth century, those who supported the procedure recommended that the procedure be done soon after birth in order to reap the most benefits. It became somewhat a signs of wealth, status, and modernity for the families who had the means to afford this procedure. By the beginning of the twentieth century circumcisions were quite common, and its popularity continued to rise, particularly during the World Wars (Balter, 2000).

During First World War, circumcision of the soldiers and sailors was greatly encouraged because of the perceived aspect of cleanliness and as a preventive measure from sexually transmitted diseases. Thus, thousands of men, young and old, were circumcised. Naturally, when give the choice, these men opted to have their newborn boys circumcised, so they would not remember the traumatic experience when they were older. Additionally, just like today, they likely feared estranging their child with a different appearance than theirs. The rate of the procedure at this point is said to have been around 40 to 50 percent, but many children who were still being born outside a hospital and these were not circumcised(Darby, 2011).

Along with the prosperity brought on by the Second World War in the 1950's, private health insurances offered by employers came about. Most of which covered the costs of male circumcisions. The number of infants being born in hospitals rose significantly, especially among the middle-class. Bearing children elsewhere was viewed as backward. Parents were also influenced by publications of the press. Particularly, Dr. Benjamin Spock, the author of Baby and Child Care, which was an encyclopedia about child care, was very a popular text. In its early editions, he argued the benefits of circumcision including: easier care for the baby, and the child wouldn't feel different from others. Interestingly, later in the 1980's he revoked his stand. In fact, he went against it stating that it was a traumatic, painful procedure of questionable value. However, it's