We throw around terms in this culture like circumcised or uncircumcised, you know, kinda like it's no big deal, but have you ever really thought about what that means or how it comes to be? Have you thought about the steps it takes or what a baby feels or goes through? We are making decisions for babies who can't decide for themselves, and these decisions are something that cannot be undone.

​So we really need to understand what we're doing today. We're gonna walk through the procedure. It's not gonna be easy, but you've gotta listen. You owe it to your baby boy to listen. So let's not put it off too much longer. I know you don't wanna do it. I don't wanna do it either. But let's dive in. 

In the next blog, we're gonna look at potential benefits, myths, ethical considerations, but today we're just gonna look at the procedure itself, how it's done. And this won't take too long, but at the same time, it may feel like the longest minutes of your life.

But today we're just gonna dive in and get it over with. Okay. Let's just get it over with. So what is a circ? What is a circumcision? In the medical world, we call 'em circs. We make it even shorter. A circumcision is the removal of the foreskin from the penis. We talked in the last blog about the anatomy of the penis, what the foreskin is, what the glands is.

If you miss that, maybe stop and go and read that. First, it was a pretty short blog, but you can kind of hear what the normal anatomy is so you'll understand what the foreskin is that is being removed. The circumcision is usually done for presumably medical reasons. A lot of people think that there are medical reasons for it.

​We're gonna talk about that more tomorrow, but mainly in our country, it's mainly cultural reasons.

So how is the circumcision done? I'm just gonna walk you through it. I'm going to tell you the steps that I would participate in from a nursing perspective, and then what's also done by the doctor.

Oftentimes there was a day or a time when most of the circumcisions were done, the nurses would go around and gather up all the baby boys, basically line 'em up. It was kind of like an assembly line, for lack of a better term. The first thing you would do is you would take the baby and you would strap them onto the board, onto a board.

The boards were kind of like a plastic mold that had an imprint of a baby to where there was arm spots and leg spots and a head spot. And so you would lay the baby on this cold board, you would strip the baby down other than its diaper until, you know, time for the actual procedure. So the baby's skin is on this cold plastic.

This baby is then strapped down, usually with Velcro straps. The penis is cleaned with Betadine or something like that, but it's a cold fluid. Even if it's room temperature, it's still gonna feel cold on the baby's skin. The baby might be offered a pacifier with some sugar water on it, or a little bit of sugar water in it for presumed comfort.

I'm not really sure how much that helps or how comforting that is to a baby, but it's often done. Anesthetic might or might not be offered, and I know that's a hard pill to swallow, but there are physicians even today, and in the past there have been many more who did not believe that babies felt pain. I don't fully understand that.

I've read different accounts of why they thought that, but any physician who has ever performed this procedure and can walk out and say that they believe that babies feel or do not feel pain is not being honest. Mainly these days, anesthetic is usually offered, at least for my experience, but I have seen it done without it, and it is traumatic. It's traumatic even with it, but it's more traumatic without it.

Oftentimes first it'll start with a topical anesthetic, something like you would think about an ora gel kind of a thing where you put it on the penis to numb up that area so that then they can inject lidocaine through the area that was numbed. But sometimes they don't do the topical. Sometimes they just inject the lidocaine and then just give it some time to soak in and to be absorbed. During that time that it's being soaked in and being absorbed, they don't get to go back to mama for comfort. Now they stay strapped to that board. They're just laying there waiting for what's coming.

​There's no comfort. There's no one holding them. There's no one often even talking to them because usually there might be only one or two nurses if that, and they are helping with whichever baby is undergoing the procedure at the time. So different instruments are used for the procedure. There's three or four different kinds. I'm not gonna go into all the specifics of each kind 'cause it doesn't really matter. The concept is still the same. So I'm just gonna go through the overall concept.

After the anesthetic is applied, and I guess I kind of did this one out of order, but there's a drape that's put over the baby that has a hole in it, so that really happens before the cleaning part is done. I should have said that part first, but so the drape goes over the baby with the hole that the penis comes through to try to make some semblance of a sterile field. Then the anesthetic part is done that I've already gone over.

So at this point, some clamps are put on the tip of the foreskin. Those clamps are like, they're like hemostats, if you know what those are. They're used to just apply some traction to that foreskin to kind of pull it up and hold it a little tighter, a little stronger, because a special instrument has to be slid underneath the foreskin to break up those adhesions. You remember? In the last blog, I talked about the adhesions that hold the foreskin in place to the glands.

Well, all of those adhesions are there and they have to be broken up. So a suction is placed on the foreskin and an instrument is slid around and kind of just dragged back and forth, back and forth, and around and side to side all around the entire head of the penis to release those adhesions because we're trying to take the foreskin off and so we have to remove it from the glands, which it's attached to.

Once that's done, the foreskin is stretched out a bit, a clamp is put across part of it, going kind of straight up and down. If you can imagine, I guess perpendicular would be the right word. A clamp is put on there, and that clamp kind of pushes the skin and the nerves out of that one area, and it's left for a minute. Then if there's an instrument being used that will protect the head of the penis, at this point it's applied.

​Then the foreskin is cut and there's a circumferential cut. That cut goes all around the whole penis. And this is the part that varies based on the technique and based on the instrument, but the end result is the same. At this point, the foreskin is cut off and the procedure is essentially finished.

And it's hard to think about that. But what I've gone through so far is just me talking. I'm just describing it. You can probably check out, you can kind of make it a very academic thing to where you don't really think about what that all means that I just said. So what I want you to do when you're done reading is I want you to go watch this YouTube video.

The whole video is well worth your time. In fact, a lot of the information I'm sharing with you came from that video. I have a lot of practical experiences with this and witnessing it, but as far as the data and the details, this man that did this video did a great job of putting together a lot of information. The video is about 30 minutes, but the part that you must watch starts around the 10:30 mark, I believe.

You've gotta go watch. You have to turn up the volume, and you have to listen because for that minute of that video, that is the reality of a circumcision. You're gonna hear a baby crying in a way that you probably never have. It's an awful cry. You're also gonna hear a doctor talking as if he's out on his back porch, just chatting it up with somebody. It's as if there's nothing major going on. He's detached from what he's doing. Babies often actually go into a shock-like state after that cry.

​And that's one of the things that led doctors to think that babies didn't feel pain, because they would stop crying, but really they're in shock and check out. It's like they're not even there anymore. It's awful. So I need you to go watch that video. I want us to think about what we are doing psychologically to a boy during this time. After you've watched that, maybe even push pause and come back to this. I want you to think about after you've heard that cry, what are we doing to our boys?

Psychologically during that time, when they're screaming like that, they don't have their mother, their father, anything of comfort. He's removed from his norm. I read one place that moms could be present during the procedure, but we never allowed it anywhere that I worked. Honestly, I don't know how any mom could be there when it was your boy.

He is placed on that cold restraint board, highly uncomfortable and cold. He has no comfort. He's strapped down. He's given a rubber nipple, especially for a breastfeeding baby that's never had anything like that in their mouth, with something on it they've never tasted before. Then he has all these painful things done to him, and he's only two or three days old. He's not even been out that long.

What kind of trauma are we causing? What long-term impacts are we imposing on these boys sexually? Because as hard as it is to think about, that little baby boy is gonna grow up someday to be married, and he's gonna wanna have a normal sex life. What are we doing? What kind of psychological damage is being done to these babies that they can't communicate to us? What kind of trust issues are we ingraining in these babies that they can go through this kind of pain and have to suck it up and deal with it on their own?

​It's a lot to wrap your head around. So I want you to take some deep breaths. Watch that video that I mentioned. Think this through. Meet me back here tomorrow because we're gonna look at ethical considerations, myths, and think about all of these things so you can fully understand and make a good decision for your baby boy.