(NEW YORK, NY) — James F. Smith, M.D. is calling on obstetricians and gynecologists to stop performing routine infant circumcision. Dr. Smith argues that infant circumcision belongs in the medical field of pediatrics, and that pediatricians are the ones who should be performing circumcision.
In an article published in the American Journal of Perinatology, Dr. Smith notes a wide body of literature on the subject of male circumcision: "supporters advance the literature indicating a reduction in urinary tract infection, human immunodeficiency virus infection, and penile cancer;" opponents "cite lack of uniform or predictable benefit, invasiveness, and risks;" and some even "debate whether ethical constructs allow parents to consent to, let alone request, removal of a normal genital structure of the infant son." However, Dr. Smith also notes, "these opinions are rarely published in contemporary obstetric and gynecologic journals, nor are they authored by obstetrician-gynecologists."
Dr. Smith discusses the early history of circumcision in the medical profession in the United Sates, a procedure that was "promoted to reduce the risk of syphilis, various neurological conditions, and [masturbation]." While historically circumcision was performed immediately after birth by delivery attendants out of convenience, Dr. Smith argues that OB/GYN professionals should no longer perform this procedure, as "[t]he clinical, epidemiological, social, and ethical issues related to the procedure of circumcision reside squarely in the male pediatric, adolescent, and adult medical and surgical realm."
Dr. Smith outlines steps to complete this move: professional OB/GYN societies such as the American College of Obstetricians and Gynecologists must recognize infant circumcision as a nongynecolic procedure; education and training on infant circumcision should be dropped from OB/GYN curriculums, which are currently offered in about 90% of these programs; and OB/GYN professionals should not perform circumcision, and instead focus more on women's health issues.
In 2004, the University of Michigan Department of Obstetrics and Gynecology stopped performing routine infant circumcision, a procedure now handled by the Pediatric Hospitalist Service. While the idea of consolidating male infant circumcision to the realm of pediatrics has been gaining traction, there are currently no studies on how this transition would affect incidence and complication rates.
(For more information on normal penile anatomy and the harms and risks of circumcision, please visit our medical resources page.)
Dr. Smith is chairman of the Department of Obstetrics and Gynecology (OB/GYN) at the Creighton University School of Medicine, a maternal/fetal medicine specialist with Creighton Medical Associates, and a professor of OB/GYN with Creighton University School of Medicine. Smith has practiced in Virginia, Colorado, California and New York. Smith served as chief of perinatal medicine at New York Medical College/Westchester Medical Center. A professor of clinical obstetrics and gynecology at New York Medical College/Westchester Medical Center, Smith’s previous academic activities have included serving as director of the OB/GYN residency program at Exempla St. Joseph Hospital in Denver and on the faculty of Stanford University in California as a clinical associate professor of maternal/fetal medicine.