Wednesday, August 6, 2008

Wise Women


First of all, read this and see how you feel.

I felt relieved.

Last night I went to a farewell gathering for one of the most delightful people I discovered in college. It was so fabulous to see her and see how she is becoming more of herself. The college girl who charmed my pants off is now a married woman on her way to becoming a Doctor of Philosophy, and seeing her feels just the same, and better.

While there, I was also graced by the presence of several other women who are and have been my friends. We chatted about life, the happenings and the news. Had a few laughs, had some potluck wares. Later in the evening an acquaintance showed up whose ripe waistline belied her fate. I heard someone ask her if she knew the sex of the fetus and she said the fateful words, "Oh, yes. It's a boy."

It is always a stressful moment for me. Has the mother considered the future of her child's genitals? Does she know that he will be unceremoniously tortured unless she refuses to sign the consent that will be presented to her, coupled with absolutely no information about the procedure she is about to allow? Has she ever seen an intact penis, and does she have any idea how one works?

Because I know all about it. It nearly kills me when I know that, for the sake of my conscience and the future health and safety of an unborn boy, I have to say something.

I start gently. "Have you done much research about circumcision?"

Usually she hasn't, unless I have spoken with her previously about the subject myself. She doesn't know. Nobody has ever said anything before.

I usually give a little information, things about the important function of the foreskin in adult males, or the fact that the surgery is not medically indicated, it is cosmetic and is performed with no anesthesia. I mention the footage I have seen of routine circumcision, the babies strapped down, the screaming until the child vomits on himself. I explain that, though it may seem a minimal amount of tissue is removed, the tissue that is removed is the most erotogenic a male body possesses and that removing it is tantamount to cliterodectomy in the eyes of some experts and, besides, it is larger than a 4x6 index card by the time the boy is a man.

Then, before she gets a chance, I rebuff some of the myths she may be using to justify her decision. If hygiene is the concern, then women have frankly got men beat a thousand times over in the folds of skin department; is it baby girls we should be after? If she has heard that it will make masturbation less pleasurable or enticing and she finds this idea appealing, I invite her to consider the number of men, cut or intact, who have not experimented with masturbation and suggest that if eliminating this habit is the paramount goal, perhaps infant males should have their hands surgically removed since the removal of their foreskins hasn't been enough discourage them significantly. If she thinks the child will be ridiculed, I mention that my husband, who was born in merciful Canada, has never felt inadequate for still having all the body parts he came with, and then follow up by adding that the numbers of parents who consent is declining all the time and it won't be long before cut men are the minority and considered anomalous; in fact intact babies are already the majority in most western states and in California 80% of babies remain intact.

Whether the moms are convinced is usually more about them than me. Some look horrified, knowing their consciences will not allow them to sign the dotted line, but distressed about how to bring it up with their partners who may find the new information to be painful and threatening. Some say that they will "do some research" but that they would never be able to watch "that sort of thing" on a video; precisely the "thing" that they will shortly consent to have inflicted upon their hours-old baby boy.

It sickens me, I can't lie. It depresses me. And when that pregnant mother left last night, head held high despite all I had told her, I wanted to cry.

But then all the other women who had been listening to my pleading and cajoling from the sidelines approached me. "Tell us more" they said.

There we were, in the very living room in which we sat as college roommates, where they once listened as I shared the information I was sucking out of birth literature as fast as I could find it. And, years later, they said "We have missed you; tell us more."

Women want to know, and they have a right to know about their bodies and what they can do. They have a right to know the power they possess as mothers, and the ways they can protect themselves and their offspring. They want to know how they can avoid being transplanted into the horror stories they have heard, and how they can create something that seems different and better. They want to bring a baby into their family in the end, of course, but they also want to bring into the family a mother.

I tell my friends to find a midwife who will support and attend them, who is educated about normal birth and how to help it along. I tell them that trying for this type of birth in a hospital is like going to a Chinese restaurant and trying to order pizza: no matter how many birth plans you have drafted and how many bradley classes you have attended, you are likely to be disappointed. I encourage them to have their babies at home, and tell them they can call me every day of their pregnancy if they like and I will answer their questions or find someone who can. I tell them I will come when they go into labor and not leave until the deed is done.

Homebirth midwives do good work and eventually the tides will change, but until then I will keep shouting it from the rooftops because it is too, too important for me to sit still and keep the peace.

16 comments:

e said...

I agree about your midwife and birthing opinions and information you provided. Thanks for posting it.

I've seen 8 or 9 circumcisions as a nursing student. None of the babes cried to the point of vomiting. Some of them didn't cry at all, the others whimpered for a few seconds and quieted down with a soother. I'm not saying it's right or wrong, I'm just saying what I have witnessed personally.

That said, if parents do decided to circumcise their child they should pay special attention if their child is born in the months of June and July when there is an influx of new medical residents for the school year. Someone had better follow that baby into the nursery and make sure no one other than the attending physician or nurse midwife does the circumcision because in the medical community it is widely circulated that new residents are notorious for botching the circumcision badly.

Anyhow, just a few different perspectives from a nurse.

amy said...

e,

thanks for your professional insights. did you watch the video i linked to? it was my understanding, based on things i had read written by ob/gyns, that the procedure was as traumatic as you would expect from an unanesthetized genital amputation surgery. were the procedures you witnessed anesthetized? if not, how do you explain the lack of response from the babies?

it would be important to note that while i understood the procedure to be brutal, and considered that to be one of several reasons to leave babies' penises alone, my greater concern is the lack of foreskin and sexual ramifications for the adult males. i have read things to the effect that cut men are more likely to suffer a host of troubles, including premature ejaculation. there is lots of reading to be done on the subject and in general i think it is un-hippocratic at best.

nice to hear from you, by the way. further discussion welcome!

e said...

I did watch the video. The circumcisions I saw did not use those large metal clamps or do that much cutting as shown in the video. It probably varies greatly between hospitals/facilities and techniques of the doctor or midwife.

All the ones I saw used Plastibells, which is a sort of plastic cap that is inserted between the foreskin and glans. I understand the device decreases blood flow to the foreskin and it (foreskin and the bell) eventually falls off within a week or so.

Circumcisions are not usually anesthetized because injecting anesthesia to the site would cause swelling and make the procedure difficult. In the ones I saw, the babies were swaddled in a blanket from the groin up and then given a soother (ie, a pacifier) dipped in essentially sugar water. I can't explain the mechanism for how that calms them, but it seemed to work.

I was discussing circumcision the other day and asked a friend if he plans on circumcising his sons. He replied, "Of course it's more sanitary and we come from a Judeo-Christian religion." Both reasons don't make sense. If you wash something it gets clean-- end of story. Also, since when did unquestioningly adhering to the traditions of our forefathers = a good thing? I would posit that the Book of Mormon very explicitly teaches us otherwise.

amy said...

hi e,

thanks for your thorough and thoughtful response. i was aware of the reasons not to anesthetize, but couldn't figure out how the babies were not responding when they were getting sliced and diced. i have heard that the most painful part of the plastibell procedure is the separating the foreskin and the glans which, as you know but others may not, are adhered at birth and should remain so until such time as they naturally separate in early childhood. I imagine this separation would be painful- did you witness the placement of the device? i wish you were in the neighborhood as i would be very interested in discussing the matter further. i do not want to be hysterical, but i do want to call attention to the fact that the procedure is not medically indicated and, most importantly, the function of a foreskin in the adult male. the gliding function reduces loss of lubrication, improving the experience for both partners, and the foreskin itself is, as i understand, the most highly innervated part of the penis; not a part of a person i would want to remove without his permission.

i agree that the logical fallaciousness of the hygiene argument is supreme. basic washing would clear up any problems a person might have. i have heard some say that the intact elderly have greater hygiene concerns than those who were cut as babies, but don't people who work with elderly clients/patients expect a pretty, shall we say, organic experience? i can't imagine women at that age are a bed of roses either, but you dont see anyone cutting up their parts as babies to spare a hypothetical hospice worker eighty years down the road.

to me, as it sounds like to you, the arguments are inadequate to warrant the procedure. i wouldn't want to be responsible for a choice my child wouldn't have made for himself.

Jami said...

Please keep shouting from the rooftops. I'm listening.

Jen said...

I just have a couple of thoughts. I don't think the hygiene concern is a logical fallacy. Elderly people often receive mediocre care at best. And it is not only "elderly" who are in hospice care. Adults can fall deathly ill at any age. But I digress. I just don't think all nurses or CNA's have the guts to clean that area out. Furthermore, it is very difficult to get young boys to take a bath in general, much less clean themselves in a nice thorough manner. Not a huge issue, but I don't feel it ought to be dismissed as fallacy.

Also, my son cried when he was circumcised about the same amount that he always cried when I changed his diaper at that time. I think it was the cold air that bothered him. I have heard him cry harder at having scratched his own face than at having the Plastibell placed. So I don't feel like it is a cruel practice.

I was seriously considering not having the procedure done for him, but when I brought it up with my husband, he strongly felt we should do it so that the boy matches his father. I don't feel like this is clinging blindly to tradition. We considered. We chose. And family solidarity was a good enough reason for us.

While men don't talk about this stuff like women do, I have a hard time imagining some man going around thinking, "Man, my parents are such jerks for having me circumcised."

And I heart hospitals and epidurals, though I think natural birth women are totally awesome.

Wow, my first three volume novel! I must be totally awesome, too. Just not in the give-birth-without-epidural sense.

Julie said...

Amy

Thanks for this post and to all for the interesting discussion surrounding it. Like most issues around birth these days opinions seem fairly polarized and I'll be upfront about my bias - I'm with you on this one.

Mothering magazine's most recent edition has a great article on some of the myths surrounding circumcision - mainly focused on some recent discussion about the cleanliness and potential prevention of STD's circumcision is said to provide. I recommend the article - it's interesting and thoroughly researched. 've also heard arguments to the effect that just as the vagina is a self-cleaning organ full of folds and hard to reach places - so too is the penius except under extreme examples of uncleanliness (but then a vagina suffers as well). Anyway the mothering article gives a medical illustration of how the foreskin is removed on a penius. After reading the article, my husband (who doesn't want to circumcise any boys we might have) talked about how violent circumcision feels to him. He is circumcised and aware of the many different arguments surrounding this issue and doesn't want circumcision at all. He is one of the men, albeit perhaps rare, who wishes that his parents had thought more carefully before making that choice for him as a newborn.

His brother talked about wanting his son to match his body in deciding to circumcise their newborn. My husband pointed out that for most mainstream American families, it's rare for father and son to hang out together naked. Especially when the son is old enough to comment and remark on any genital differences. He also talked about how difference doesn't have to be a bad thing - and teaching children to be compassionate and kind about differences is a really valuable life tool.

Thanks for your thoughts.

amy said...

you see what i mean about wise women? i am so profoundly blessed to have thoughtful, intelligent women with whom to discuss important topics that affect us as women and mothers (ok, not me yet as a mother, but you know what i'm saying. an ovary-bearer). thanks to all for your hearts and minds, which have clearly been offered in this conversation.

jen,
i am so relieved to hear that your son's circumcision did not appear to be traumatic or painful to him, first of all. i have felt such profound sadness for the babies i imagined screaming, helplessly strapped to a circumstraint, without anyone who noticed that their pain should be considered. since you said he hardly responded to the placement of the plastibell, does that mean you were present? just curious; i thought circumcision was typically performed by a doctor without the mother present.

i would like to address a couple of other things you mentioned, just as a matter of course. as far as young boys cleaning themselves thoroughly, the foreskin is adhered to the glans until the kid is old enough to handle other hygienic tasks, like washing and wiping all his other sundry parts, and so is not able to collect a single micron of debris until that time. little boys, like little girls, do not produce (or, therefore accumulate) harmful amounts of smegma or anything unpleasant. the foreskin retracts most accomodatingly to allow for easy cleaning of the area; it really presents less of a challenge or opportunity for disease than a navel. as for the elderly, if they are in hospice care and it is determined that such a surgery would be truly in their best interest at that time, they or their legal guardian may deem the procedure medically necessary (which it is not deemed in infants). i think that a man spending a lifetime without all his genital parts in service to the possible convenience of a hospice worker doesn't make sense. not that an intact old man wouldn't pose slightly more of a challenge to his caregivers, this much i am sure is likely, i just dont think it's a good enough reason to perform such a significant and invasive procedure. the fact is, the united states is the only western country that practices routine infant circumcision, and i have a hard time thinking all of the men in australia and the UK and disease-ridden and filthy. the hygiene reason really has a lot of holes, in my opinion.

as far as the feelings of men who discover as adults that their penises may be compromised, the news is very painful. i have seen many humble men, crestfallen, who are willing to admit their sadness at never knowing the full potential of their own anatomy. i actually think it is the horror at thinking their genitals may be in some way inadequate that makes so many husbands the fierce advocates of circumcision. if a father was missing any other body part, and had learned to love life without it, i doubt he would still persist in amputating that part of his child's body without medical reason. but, when the man's penis is in question, it is just more difficult to consider the possibility of having missed out at all. i have discussed this matter with many, many men, and some are indeed angry and disappointed with their parents for having made such a choice for them. so that is a very real possibility.

as far as the natural birth stuff, i am so glad that the hospitals in southern utah are amenable to giving women the kind of experience they want. while i do think there are some benefits to natural childbirth, i agree that the most important part is that the mother has access to information and choices and that she receives all the support and kudos she deserves. when we spoke earlier this summer, i could tell that you were happy with your birth experiences, which is more than i can say for lots of women, and i am glad you have a doc you like so much.

man, these topics are loaded and difficult. it is scary to think i may offend some friends or other folks in the process of having an honest conversation, so i really appreciate the feeling that has been communicated here. women respecting one another and listening to one another's stories promises all of us a little better world in which to be female, so a hearty thanks to one and all.

amy said...

also, julie, i forgot to mention this before...

ryan's father is cut but all of his son's are intact and their family is strangely inclined to spend gender-segregated time naked (hot tubs, etc.). nobody has been negatively impacted by the differences between father and sons, in fact, i really don't think it comes up much. just an anecdote to show that EVEN if a father and his sons do have occasion to spend time together pants-less, nobody will necessarily be traumatized :)

Jen said...

I was not in the room, but I did hear through the door. I had Grace with me, or I would have gone in. I have acute hearing when it comes to my babies crying, and there is a definite distinction between complaint and genuine distress. His crying was about the same as when he got his immunizations. Very upset for a very brief period then calm. Nothing that gave me an uneasy feeling in my gut.

I can see your point about adult men being frustrated at not having been given the choice. I suspect your persuasion will win out within the next few generations.

amy said...

jen, thanks for all the information you have shared. i really do want to be informed about this subject (it seems i encounter folks all the time who have never given it a first, let alone a second, thought) so that i am a reliable resource for people. i like to think that it isn't appropriate to hysterify a situation to manipulate others into agreement, but it sure is tough to avoid high-charged arguments when the subject is one about which one is passionate. anyway, thanks to you and everyone else who has participated in this discussion. i hope we have all learned something new and done some good thinking.

ixoj said...

Thank you so much for posting about this! Hopefully, when/if the time ever comes that I have a male baby to deal with I will be able convince dear T-rav to see the light.

Tom said...

Take your index finger and brush it lightly along the back of the opposite hand. Now lightly brush the palm of the opposite hand. That, I'm told, is the approximate difference in sensitivity between an uncircumcised penis and a circumcised one.

When I was born, my mother was debating whether or not to circumcise me. A doctor (I'll never know who, but I'll be grateful to him until the end of my days) asked her if she wanted to witness the procedure performed on another child before she decided. She agreed. Long story short, I'm (happily) uncircumcised. Thanks, Mom!

By the way Amy, I love the idea of your first question, upon hearing the gender of an unborn child, being, "Well? Are you gonna circumcise the little rugbug, or what?" I can almost see the fire in your eyes.

McCall B. said...

My friend (Missy) sent me a link to this blog post because I wrote one about the same topic recently and I am wondering where you got your information and statistics about the percent of uncircumcised babies because I couldn't find any when I was looking. Thanks!

amy said...

Hi McCall,

Nice to hear from you! I remember we met at a certain murder mystery party some time ago, and i hope you and your spouse are well.

The figure about circumcision rates in California, I admit, I got from my husband who has done quite a bit of research on this topic as well. In poking around today, the figure I came up with was just under 32% (but the article contained other inaccuracies, so I will not include it here), with the decline attributed somewhat to the high number of Asian and Latino immigrants who do not circumsize (and, for the record, do not seem to be suffering from penile plagues of any kind). Searching the internet is tricky, as we all know, when it comes to gaining actual information, and there are many sites and resources advocating both sides. Although I am compelled by the physiological reasons to refuse circumcision, to me the more compelling reason is emotional and has been determined not based on statistics but from intimate and honest conversation with many (many!) people over the last five or so years, when I first discovered what circumcision was and felt instinctively that it was wrong. Many cut men proudly maintain that they couldn't imagine their penis being any grander than it already is (an obvious response, given the serious cultural impact of recognizing a defect in your own penis). I recall one friend telling me I was unqualified to speak on the subject because I didn't even have a penis and I reminded him that NEITHER of us had an intact penis, so, really neither of us could comment (I have since wondered if that comment was hurtful and have hoped it was not). However, many others have expressed almost immediate grief to know that (at least when they themselves underwent the surgery) it was unaesthetized and horrifically painful, and left them with a penis whose potential they will never know for certain. Some cried. Even in Utah, with its conservative culture and biblical proclivities, intact men I have talked to do not express regret at still having all of their body parts. In fact, it seems a source of pride for many, and I believe I have heard the phrase "I'm ALL man" used a time or two. I worked at a treatment center for teenage boys and one of the boys was intact, and very proud of it. The other boys seemed more curious and jealous than anything else. How must it feel to know a component of your genitals was removed and wonder how your body would have felt if it hadn't been surgically altered?

whew! i know you asked me a simple question and I gave you a lengthy, impassioned response. Sorry, it's my personality :) I will ask my husband to see where he got the 20% from.

Thanks for keeping me statistically accountable!

McCall B. said...

it is nice to be able to put a face to the blog! Thank you for your response, I love people that are passionate about things which is 1 of the many reasons that I love Missy. I hope you don't think I was calling you out on your facts, just hoping to find some good stats when talking about this with others. Missy mentioned to me that on the east coast the rate is around 50/50. If you do come across some info on this please pass it along! Thanks.