Tragedy in Italy: The Risks of Home Circumcisions

Background

Last month in Italy a 20-day-old boy bled to death following his circumcision. The procedure was performed on him by two women during a home surgery. As most hospitals in Italy prefer to wait until children are out of infancy before they will perform non-therapeutic circumcision, many parents who demand the procedure will opt for backstreet surgeries, home circumcisions, or private clinics.

Circumcision isn’t illegal in Italy and neither are is performing them in non-medical environments. This raises questions of safety and health standards.

History Repeats

In 2012, there was discussion in the UK as to whether home circumcisions ought to be to be regulated or banned altogether to ensure that basic health standards are upkept. This discussion began after the death of an infant in a tragic parallel to last months news.

‘Following the death of a baby in Manchester after a home circumcision a mother has called for mobile circumcision services to be banned.’ – BBC (2012)

Sadly, nothing came of this. There will continue to be more cases similar until the major risks have been addressed.

In the UK circumcision is ‘presumed legal’ despite the practice being performed without medical necessity (sometimes on new-born infants) for cultural and religious reasons, though this is not permitted in statute leaving the procedure in a grey area. Confounding this messy situation, circumcision performed at home is usually non-medical, but it is lawful as long as the infants parents give consent on behalf of the child.

Surgical Risks of Performing a Home Circumcision

Surgical risks of performing a home circumcision increase as standards can’t be ensured, and no there is no oversight. Additionally, surgeries that heal but leave mutilated genitalia, scarring or abnormalities can often go unaddressed, and complaints are harder to escalate with private practitioners.

Within the home setting, there is a lack of medical expertise, support, and appropriate facilities to react to emergency situations. None of these are available in the home environment, and parents can be left unsure with inadequate aftercare.

Public Awareness of Dangers

The dangers of performing home circumcisions aren’t widely spoken about before considering the procedure. This is because the only trusted experts that parents will speak to are the practitioners themselves, who are financially incentivised to minimise concern and encourage parents to trust their capabilities.

One practitioner told parents that home-circumcisions were no less sterile than clinical environments. He then went on to perform a botched circumcision and causing significant trauma to an infant under his care. Whilst we are aware of this incident, there is no knowing how many similar cases go unaddressed. These are the stories that most parents will never hear from a practitioner, especially if they are ideologically attached to the idea of circumcision, and financially and incentivised to persuade parents to use their services.

Standards must be improved

There are various articles and websites that present information regarding the risks of home circumcision and advocate in banning the performance of the procedure at home altogether. Unlike FGM (female genital mutilation) however, there hasn’t been any legislation or significant public discourse in the political sphere regarding male home circumcision, likely due to fears of appearing culturally insensitive or prejudiced. The reality however, is that these parents deserve better information to make better health decisions for their children.

Despite these risks, the bare minimum to address this problem in the long run is accurate record keeping. 15 Square have long advocated recording –

Who performed and received the procedure.
Why it was performed.
Where the procedure took place.
When the procedure was performed.
What method was used.
Complications arising and complaints.

If we improved standards to ensure that these fields were recorded, we are confident that the public would see the problems associated with performing surgery outside a clinical setting. Every parent should understand the dangers and complications. Poor healthcare practices used in performing home circumcisions should be legislated against in order to avoid life threatening accidents and botched circumcisions.