Helping parents achieve safer male infant circumcision

Male circumcision or the removal of the foreskin holds a deep spiritual significance in Judaism and Islam. The Judaic origins are reflected in our language as no other part of the human body is afforded a negative prefix, as in ‘uncircumcised.’

A better understanding of foreskin problems and the use of steroid creams for phimosis have led to a decline in the operation for medical reasons (Naguib et al, 2012; Hutson et al, 2015). However, the development of a more ethnically diverse society has led to an increasing demand for non-therapeutic circumcision (Stringer and Brereton, 1991). Sadly, the complications caused by unregulated practitioners documented by these authors have continued, with increasing concerns regarding sterility and infection control (Paranthaman et al, 2011; Poole, 2014). In England, community-based circumcisions have resulted in two recent tragic deaths, which involved unqualified personnel, poor communication and the failure to appreciate the dangers of continued blood loss (Fogg, 2012). Scotland has attempted to resolve such problems by requiring midwives to ‘ask all parents’ about circumcision at antenatal booking, ‘rather than presume someone's religion or belief’ (The Scottish Government, 2008). Religious circumcision is then offered free of charge under a general anaesthetic between the ages of 6 and 9 months (The Scottish Government, 2008). However, most approved services in the rest of the UK usually consider local anaesthesia up to 6 months of age as perfectly safe (Hutson et al, 2015). Midwives can help significantly by ensuring that information relating to such recognised providers is widely available.