Neonatal male circumcision after delisting in Ontario. Survey of new parents

Abstract

Objective: To determine the prevalence of neonatal circumcision immediately following delisting of the procedure in Ontario and to examine parents' knowledge, attitudes, and behaviours regarding circumcision.

Design: Cross-sectional survey.

Setting: Perinatal tertiary care centre in southwestern Ontario.

Participants: Of the 151 mothers approached, three were excluded because they did not speak English and two declined participation; 112 of 146 mothers of healthy male newborns responded for a response rate of 77%.

Main outcome measures: Circumcision status of infant and parents' knowledge, attitudes, and behaviour.

Results: The circumcision rate before delisting had been 56.2%; in the months immediately after, the rate was 59.8% (95% confidence interval was 51%, 69%). Mothers of infants in the outcome groups did not differ significantly in any demographic feature other than education, where the group deciding against circumcision reported higher education levels (Wilcoxon nonparametic two-sample test: zeta = 2.29, P = 0.02). Mothers who chose circumcision listed medical (59%) and sociocultural considerations (40%) a most important to their decision. Father's circumcision status was strongly associated with the infant's (chi 2[df 1] = 25.13, P = 0.0001). Although 74% discussed circumcision with their family physicians, many parents were not well informed about risks or benefits. Anesthetic use during circumcision was reported by 29%, but 48% did not know whether any had been used.

Conclusions: The prevalence of neonatal circumcision did not change after delisting. Informed consent was often lacking. Sociocultural issues are important to some parents and need to be addressed in the consultation process.