U.S. Newborn Male Circumcision Falls Under the 50% Mark

Neonatal male circumcision involves the surgical removal of a male infant’s foreskin. The surgery is usually performed within the first month for various cultural, religious, or health reasons. It is regarded as safer than having the surgery performed later in life and offers several health benefits, such as a reduced risk of contracting certain STIs and urinary tract infections. Yet, despite these advantages, newborn circumcision rates are now falling below 50% in the United States. 

Why are Newborn Circumcision Rates Falling

According to a new cross-sectional study, neonatal male circumcision has dropped over the last 10 years, and rates now sit under 50%. The study was conducted by Dr. Aaron Tobian from Johns Hopkins University School of Medicine in Baltimore, and his team. To find out more about male inpatient circumcisions, the researchers used a dataset of U.S. pediatric hospitalizations, called the Kids’ Inpatient Database. The study included more than 1.5 million hospitalizations from 2012 to 2022. 

Any newborn males who were born prematurely or had any penile anomalies or coagulation disorders were left out of the study sample. According to Dr. Tobian, the prevalence of neonatal male circumcision in the first 28 days has decreased from 54.1% to 49.3%, a drop of almost 5 percentage points. The research team noted that the percentage had dropped to 60% among white male newborns. 

Meanwhile, the percentages among Hispanic (21%) and African-American (66.1%) newborns have remained somewhat stable. Newborns whose families have private insurance and come from the highest income areas had the highest percentage of newborn male circumcisions, but also experienced the biggest decline. According to the researchers, “These findings align with prior trends and reflect sociodemographic changes and evolving cultural, clinical, and policy landscapes.” There were certain limitations to the study, however. For one, the database used ICD codes to capture inpatient circumcision, which could potentially lead to an underestimation. 

The Benefits and Risks of Newborn Circumcision

While the benefits of neonatal male circumcision have been shown to outweigh the risks, the practice has been criticized for ethical reasons. One of the reasons cited is that newborns cannot provide consent as to whether they want the procedure done or not. Yet trials have found that circumcision reduces the risk of urinary tract infections, inflammation, genital herpes, HIV, and HPV (human papillomavirus). There are also several health benefits for the man’s female partner, such as a lower risk of trichomoniasis, bacterial vaginosis, and HPV-related cervical cancer. 

Due to these findings, the American Academy of Pediatrics [AAP] started to support male circumcision, updating its policy in 2012. The team wrote that “Although the AAP affirms that circumcision benefits outweigh the risks and supports access to the procedure, it recommends leaving the decision to parents. There is also increased skepticism toward medical recommendations in the U.S.” The overall decrease may also be impacted by the fact that the group with the lowest prevalence of circumcision is also continuously growing. 

Furthermore, by 2011, 17 states ended their Medicaid coverage for the procedure, which made it harder for low-income families to afford. The study revealed that there was a decline in newborn circumcision across all census regions. The West had the lowest prevalence in 2022, with 19.7% while the Midwest had the highest at 68.5%. While the prevalence among Hispanic and black newborns remained stable across all regions, it declined significantly among white newborns across all regions. 

Considerations Regarding Newborn Circumcision

Timing is important when it comes to circumcision. Whether for religious, cultural, or personal reasons, the sooner a circumcision is carried out, the quicker it heals and the less it costs. It’s also a good idea to do some research in advance, as insurance coverage, costs, and even the surgeon’s skill level can vary from state to state and hospital to hospital. Safety should be the highest priority, and steps should be taken to manage the pain after the surgery. If the parents decide not to circumcise their newborn, they should seek advice on cleaning and when to see a doctor, such as in the case of urinary infections, etc. 

No matter which route the parents decide to take, they should have access to balanced information that enables them to make the best decision for their particular child. As circumcision numbers continue to drop, there is the possibility that the risk of some STIs and urinary infections may rise. However, there are certain factors that can minimize that risk, such as vaccines, sex education in schools, practising safe sex, and regular checkups. At the end of the day, when parents have access to balanced information, they can make the decisions that best serve their child. Beyond the health considerations, though, many people still continue to practice circumcision for religious and cultural reasons. 

Read More: Low iron during pregnancy might change a baby’s gender, Study finds