Presentation Authors: Allison Morgan*, Yue-Yung Hu, Chicago, IL, Gina Lockwood, Iowa City, IA
Introduction: Newborn circumcision is the most common surgical procedure performed in the United States. Professional medical organizations leave the decision of whether to circumcise to parental discretion. There is a paucity of data regarding how parents gather and process information in order to make this decision.
Methods: Between March and June of 2017, semi-structured open-ended interviews were conducted with mothers of newborn males during their postpartum hospitalization. Purposeful sampling with a random component was employed to include subjects of differing races, ethnicities, religions, and decisions to circumcise. Interviews were audio recorded and transcribed. Multiple independent reviewers coded transcripts using a grounded theory approach to identify emergent themes regarding attitudes towards, sources of information about, and decision-making surrounding circumcision.
Results: Ten mothers were interviewed, of whom six planned to circumcise and four did not. Major themes emerged: the importance of cultural and social norms, limited yet influential discussions, and the lack of, but desire for, more knowledge (Table 1). Mothers&[prime] decisions were strongly influenced by cultural and familial norms. Discussions with medical providers were often limited, though when physician conversation was more extensive, provider input was highly influential. Parents lacked evidence-based knowledge of the risks and benefits of the procedure. They uniformly desire more information and counseling from their medical providers.
Conclusions: In this cohort, parental decision to circumcise was primarily driven by social and cultural influences. Parents lack empiric knowledge about the procedure, and conversations with medical providers are limited. Provider knowledge and willingness to discuss the risks and benefits of circumcision with parents is vital to improving shared decision-making and empowering parents to make informed circumcision decisions consistent with their own values. Decision aids with current and evidence-based information regarding circumcision may help both parents and providers to openly discuss this controversial topic and fill a critical information gap.