By Karen Kaplan
8:45 AM EDT, August 22, 2013
A baby boy born in Chicago or St. Louis is about 77% more likely to be circumcised in a hospital in his first days of life compared with an infant born in San Francisco or Seattle, according to new data from the Centers for Disease Control and Prevention.
Nationwide, the proportion of newborn boys who are circumcised before they leave the hospital has declined nearly 10% since 1979, when the CDC’s National Center for Health Statistics began keeping track. In 1979, 64.5% of baby boys had the procedure done during their initial hospital stay; by 2010, that figure had dropped to 58.3%.
During that 32-year period, newborn circumcision was most popular in 1981, a year when 64.9% of boys had the procedure. The low point was 2007, when 55.4% of parents opted to circumcise their infant boys before leaving the hospital.
The national figures mask distinct regional differences, however. Generally speaking, in-hospital circumcision rates have fluctuated a bit over the last three decades but generally ended up close to where they began:
In the Northeast, 66.2% of newborn boys were circumcised in the hospital in 1979, as were 66.3% in 2010, the most recent year for which figures were available. During those 32 years, rates ranged from a high of 69.6% in 1994 to a low of 60.7% in 2007, with an average rate of 66%.
In the South, 55.8% of newborn boys were circumcised in the hospital in 1979, as were 58.4% in 2010. The average rate over the 32-year period was 59.4%, with a high of 66.1% in 1995 and a low of 53.8% in 1988.
In the Midwest, where newborn circumcision is most popular, 74.3% of infant boys were circumcised in the hospital in 1979, along with 71% in 2010. Rates ranged from a high of 82.9% in 1998 to a low of 68.8% in 2009, with an average rate of 76.8%.
But the story was different in the West, where two cities – San Francisco and Santa Monica – have proposed banning the procedure altogether. In 1979, 63.9% of parents in Western states decided to circumcise their newborn boys before they left the hospital – putting them very close to the nationwide average. But then interest in circumcision fell steadily, dropping to 34.2% in 1994. After a few years, rates dropped even further, going as low as 31.4% in 2003. By 2010, they had climbed back up to 40.2%.
The figures in the report do not include circumcisions performed by a doctor after a newborn is discharged from the hospital, nor do they include those performed during religious ceremonies. As such, “these rates cannot be used as prevalence estimates for all male circumcision in the United States,” the report authors noted.
The CDC researchers who compiled the report noted that the nation’s pediatricians altered their position on circumcision several times during the 32 years covered in the study. In the 1970s, the American Academy of Pediatrics advised parents that there was no medical reason to circumcise baby boys. In 1989, the academy stated that the practice had the potential to provide medical benefits; a decade later, AAP reiterated those potential benefits but said there still wasn’t enough hard medical evidence to recommend the procedure for all baby boys.
In 2012, the academy released a new policy statement that said males who were circumcised had lower risks of urinary tract infections and of sexually transmitted diseases, including HIV, while the risk of complications was small. However, the group stopped short of making a blanket recommendation in favor of the procedure and said parents should consider their own religious, ethical and cultural beliefs when deciding what to do.
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