PERIODIC SURVEY OF FELLOWS
American Academy of Pediatrics
Division of Child Health Research
This report presents findings from Periodic Survey #37 on
pediatricians' practices and beliefs on circumcision of healthy newborn
males, initiated by the Task Force on Circumcision. These data were
collected to help inform the revision of the 1989 policy on
circumcision. The survey was conducted from July to November 1997;
after five mailings a total of 1,165 completed questionnaires were
received for a response rate of 63.7%. These analyses are based on
responses from the 734 post residency pediatricians who provide health
supervision to newborns up to 2 months old (73% of all post residency
Current Counseling Practices Regarding Circumcision
Pediatricians were asked about the proportion of parents
(all/almost all, most, some, few/none) with whom they discussed
circumcision and gave advice regarding circumcision. The percents are
based on the number of pediatricians who responded to each question
- Most pediatricians (74.1%) discuss the pros and cons of
circumcision with all or most parents of healthy newborn male patients;
another 20.7% say they do so with parents of some patients, while only
5.2% do not discuss the options.
- Slightly more than half (52.3%) say they make a
recommendation regarding circumcision for all or most patients dependent
on discussion with the parents; 26.5% sometimes make a recommendation
dependent on discussion with parents. For 21.2% of pediatricians, a
recommendation is not dependent on such a discussion.
Regarding pediatricians' specific recommendation on circumcision:
- One fourth of all pediatricians (24%) recommend to all or most
parents that circumcision be performed; 12% recommend circumcision to
some patients, while 64% recommend circumcision to only a few or no
newborn male patients.
- Nine percent of pediatricians recommend to all or most
parents that circumcision not be performed; 14.6% so recommend to some
parents, while 76.0% say they recommend against circumcision to few if
- One half of pediatricians make no recommendation
regarding circumcision to all or most of the parents of newborn male
patients in their practice, and 16% make no recommendation to some
parents. About one-third (34%) of pediatricians say they make no
recommendation regarding circumcision to a few or no parents.
Pediatricians Who Recommend to:
|Recommend circumcision be performed
|Recommend circumcision not be performed
|Make no recommendation regarding circumcision
- The majority of pediatricians say most parents do not seek their
recommendation regarding circumcision. Only 5.4% of pediatricians report
all or most parents seek their recommendation regarding circumcision.
More than half (56.8%)of pediatricians say only some parents are
uncertain about circumcision and seek their recommendation, and 38.3%
report few parents do so.
Current Clinical Practices Regarding Circumcision
Sixteen percent of pediatricians say they always perform the
circumcision of their newborn male patients, 8.1% say they usually do
so, and 5.6% only sometimes do so. Seven out of ten pediatricians
(70.3%) do not perform circumcisions. Their reasons for not doing so
- The mother's OB/GYN performs the circumcision (71.2%);
- They prefer not to perform this procedure (31.8%);
- Their hospital policy does not allow them to perform circumcisions (10.2%);
- They refer circumcisions to another pediatrician (7.3%);
- They were not trained in this procedure (6.6%).
Attitude Toward Circumcision
- Most pediatricians (55.5%) think the medical indications for
circumcision are inconclusive; 33.6% say the potential medical benefits
outweigh the disadvantages and risks, while 10.9% say the disadvantages
and risks outweigh the benefits.