School started again on Tuesday. I'm taking only two classes at the moment: Women's Health and Management of Care. Management of Care is going to be boring and you probably won't hear me talk abou it much. Women's health, on the other hand, means I get to play with babies. Oh, and women, most of them pregnant. You'll hear about that a lot (disclaimer for the parents: Yes, I adore the little babies, and no, I do not plan on getting pregnant any time in the near future.)
I've had two clinical days so far on the OB floor. The first day we were jsut there to observe for a couple of hours, but I still got to hold a couple of newborns and see a bunch more. And their moms. Can you tell which I'm more interested in? The second day I go to use a doppler to find fetal heart beats in pregnant moms and watch two circumcisions. (Disclaimer #2: I'm going to go into detail about the circumcision procedure. Skip the next paragraph if you don't want to know.)
Before I start, I should say that I don't really like circumcision, because there is no proof that it has any benefit whatsoever. Recently a study came out about how circumcised men have a lower chance of contracting HIV during heterosexual sex, but the most current literature reviews say that there is no significant benefit (trust me, I just checked). That's how I felt about circumcision before I'd ever seen one. Now, what does an actual circumcision look like? First they give the baby some sugar water (which somehow calms them down) and then inject lidocaine into the nerves that run along the top of the penis. Then they let the lidocaine do it's thing for about 5 minutes so the area is numb. The baby is then put on a little tray thing with slots for his legs, which are held in place with velcro. A kicking baby would be a very bad thing during this procedure. One nurse holds down the baby's top end while the doctor takes some forceps and separates the foreskin from the glans of the penis. Naturally, the foreskin may not separate from the glans until he is 5 years old. Once the foreskin is separated, a cut is made so that it can be pulled back exposing the glans. Then they put a little plastic bell shaped thingy (called a plastibell, shockingly) over the glans to protect it. The doctor then ties a piece of string as tightly as possible around the base of the glans to cut off circulation to the foreskin. The foreskin is then cut off close to the string and the plastibell is removed, leaving a little plastic ring between the remaining bit of foreskin and the glans. Over the next 7-10 days the foreskin will become necrotic, turn black, and fall off, along with the string and plastic ring. For the most part, the baby doesn't feel anything during the procedure except for the initial lidocaine injection. The painful part is urination and diaper changes for the next week or so while he heals up.
Okay, so that's how it's done. Why is it done? We got a little history lesson from the doctor who did the ones we watched. She was Norwegian, where almost no one gets circumcised, so she went and looked up the history of it when she arrived here. Apparently it gained popularity in America after WW1 when many men developed infections because they were unable to clean themselves properly underneath their foreskin while in the trenches. I don't know if that's true or not, but that's definitely the time period when circumcision took off in the US. Now 80% of American men are circumcised. In the rest of the world, the cultures that circumcise are mainly Muslims and Jews and only 30% of the total male population is circumcised. None of the national medical associations in the US recommend circumcision and most families say that they do it because they, "want him to look like his father." Anyway, I'll get off my soapbox now and go back to my usual blogging.
I haven't really been doing anything since I got back except school and sleep. It's been freezing cold here for the past couple of days, about -10 and frequently snowing. I'm mostly hiding out inside and trying to stay warm. I did manage to get to a blood drive yesterday, which was good. My hemoglobin is still nice and high (12.9!), which I love to see, and they only had to poke me once. I even got a free movie ticket and coupon for coffee. Also, I discovered that hospitals that use blood from the red cross get charged based on how much blood is donated at their facilities, so support your local hospitals by going to their blood drives! I may be going with a couple of other students to donate platelets sometime in the near future too. I haven't done that yet, but I've been wanting to give it a try.
That's about all for now. I'm sure there will be more to write about soon. A lot of the next 5 weeks is going to be OMG BABIES!!!!! so consider yourself warned.
5 comments:
I consider myself encouraged, not warned!
Also eww, necrotic foreskin
I'm the mom of two children who live in Rochester, and I'm so proud of my daughter who gave birth to her son at Strong Hospital in Rochester in November. She protected my grandson from circumcision because she was educated about its harms. Unfortunately, too many doctors, nurses, and parents are not. The Norwegian doctor who said circumcision started after World War I should have gone back even further, when it was promoted to prevent masturbation in the 19th century.
It is disturbing that a Norwegian doctor, who comes from a culture where male genital mutilation is not practiced, would come to the U.S. and genitally mutilate American babies. This violates not only the human rights of these babies, but also medical ethics and the dictum to "First, Do No Harm."
The foreskin serves a protective function during infancy, and later a sexual function for both males and females. Most doctors are ignorant about the function of the foreskin. You can learn more than they probably know at: http://www.icgi.org/birth_care_providers.htm
I strongly encourage you to educate yourself. In particular, I recommend "Full Disclosure," the articles at "Function of the Foreskin," "Complications of Circumcision," viewing "The Prepuce", and the "Medicalization of Circumcision" slideshow. The slideshow will inform you of how the original maker of Kellogg's Corn Flakes promoted circumcision. This site is a good one to recommend to this doctor, expectant parents, and others who are ignorant about the harms of circumcision.
If you are asked to participate in any way with circumcisions or any other procedure to which you object, you should be aware that the new Conscience Protections from HHS go into effect next Tuesday, January 20, 2009. You and all other health care workers may legally refrain from participating in any medical procedure that violates your conscience or religious beliefs. Any hospital that violates these rules risks losing its federal finds. You can read the press release about this and the new ruling at:
http://www.hhs.gov/news/press/2008pres/12/20081218a.html
http://edocket.access.gpo.gov/2008/E8-30134.htm
I hope you will be an advocate for the bodily integrity rights of all children, including newborns who are defenseless against circumcising doctors. In 2003, William Stowell sued the doctor and hospital that circumcised him 18 years before, and he received a financial settlement for the inherent damage done to him by circumcision. He went on to restore his foreskin non-surgically, a long process he would not have had to undergo if his bodily integrity rights had been respected when he was born. You can learn about his case at:
http://www.cirp.org/news/mndnewswire04-29-03/
This Norwegian doctor, and all others like her, run the risk of being sued by the males they circumcise when these men realize the loss they have suffered from circumcision. Those men who want their baby boys circumcised so they will "lack like them" would be better off restoring their foreskins so they would "look like" their intact sons.
Actually, non-religious circumcision started because 19th century doctors thought that :
a) masturbation caused various physical and mental problems (including epilepsy, convulsions, paralysis, tuberculosis etc), and
b) circumcision stopped masturbation.
Both of those sound ridiculous today I know, but if you don't believe me, then check out this link:
A Short History of Circumcision in North America In the Physicians' Own Words
Over a hundred years later, circumcised men keep looking for new ways to defend the practice.
If I could go back in time, my mother's doctor would mysteriously suffer severe injuries hours before he was to circumcise me.
I am so glad a Nurse is against circumcision. It needs to be stopped!
Please watch this educational video when you get a chance:
CIRCUMCISION DECISION
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