Smoking, circumcision, and doula responsibility

What if I told you there were benefits to smoking cigarettes during pregnancy?  Would you start (or continue) smoking?

Why not?

Studies have shown one benefit of smoking during pregnancy:  a reduced risk of preeclampsia.  See here, here and here.

However, as a doula I would always caution against smoking while pregnant because the risks, as you well know, far outnumber the benefits.


When I was pregnant with my first child, and not knowing the baby would be a girl, my midwife asked if I would circumcise if I had a boy.  One of my first thoughts was isn’t that just what you do?  The question prompted a quest for information, and four years later I’m still reeling from all I have learned about this cultural norm.

Did you know. . .

  • Non-religious circumcision became popular in the U.S. as a means to prevent masturbation?  Along with other physicians, Dr. John Harvey Kellogg, of breakfast cereal fame, recommended it as a preventative measure and as punishment for boys caught masturbating, for whom the procedure would preferably be performed without anesthesia.  (He recommended carbolic acid for girls’ genitals.)
  • Circumcision is painful and can be traumatic?  The foreskin must be ripped and cut away from the glans (head) to which, in infancy, it is adhered like a fingernail to a finger.  Anesthesia is not always used and even when it is, it’s not 100% effective.  The kind of post-operative pain medication adults would receive is not an option for babies, so the pain may continue for days, especially when the wound comes into contact with urine and feces.
  • Circumcision can disrupt breastfeeding?  The baby is often too agitated to latch on or falls into a deep sleep, or sleep-like state, from which it is difficult to awake to feed.
  • Circumcision does not prevent UTIs or HIV or any other STD?  Besides, antibiotics can treat UTIs, and condoms prevent STDs.
  • The foreskin is not a useless flap of skin?  It provides an immunological and physical barrier against disease and supports the growth of beneficial bacteria.  It also contains thousands of nerve endings, supplies lubrication, and offers a gliding action that enhance sexual pleasure.
  • Over time the exposed glans becomes keratinized and loses sensitivity as it is forced to become an external organ that must weather constant chafing from clothes?  The glans of an intact penis is much like the inside of the cheek.
  • Circumcision can lead to complications including infection, excessive blood loss, adhesions, excessive skin removal, buried penis, meatal stenosis, skin bridges, amputation of glans, necrosis, PTSD, scarring, bent penis, painful erections/intercourse, impotence, and death?  It can also interfere with the sexual partner’s experience by causing pain, dryness, and difficulty reaching orgasm.
  • There is an aftermarket for neonatal foreskin?
  • The majority (approximately 80%) of the world’s men are intact?
  • The U.S. and Israel are the only two countries in the world where the majority of male infants are circumcised?  (In Muslim countries circumcision occurs anytime during childhood.)
  • The rate of circumcision in the U.S. is declining as almost 50% of babies are now left intact?

    born perfect

    Image courtesy of Made by Momma

  • Since 1997 females have been protected by U.S. law from routine infant circumcision?
  • The female genital mutilation we abhor in other countries is ethically no different from male circumcision in the U.S.?
  • No major medical association in the world recommends circumcision?  Some take a neutral stance while others come out against it.
  • The intact penis is not difficult to clean (just wipe like it’s a finger) or prone to infection or gross or smelly?
  • Many men are not happy about being circumcised; many circumcised men keep their sons intact; many Jewish and Muslim families keep their sons intact; and many families have circumcised older sons before learning the truth and keeping younger ones intact?

As a doula it would be irresponsible of me to suggest that smoking is a valid choice for you and your baby.  The same can be said of circumcision.

For more information please read this series from Psychology Today and watch Part 1 and Part 2 of NOCIRC’s Circumcision–Just Say NO!


5 thoughts on “Smoking, circumcision, and doula responsibility

  1. As a doula, this is a tough conversation. Many doulas feel that this isn’t an appropriate topic to even open, nevermind provide information about. There have been many online arguments of whether or not we *should* inform our clients about this, just as we do about aspects of the labout process or important skin to skin contact afterwars. I love this blog… I have to ask: Do YOU bring it up with clients, wait until THEY mention it, or only provide information if they ask for it? As an IBCLC, it’s an easier intro as I can say “Did you know how that might affect breastfeeding?”… and go from there. As a doula, with a different scope and focus, it’s a tough topic to bring up and does not always go over well…

    • Thanks for your comment. I’ve only been a doula for 5 months, so I’m still learning how to approach the issue. Nonetheless, I bring it up with my clients (if I don’t who will? and so far I’ve been well received) and have recently realized the way I approach it in this blog post is the way I want to approach it with my clients. I think it would be an insult to their intelligence to pretend that circumcision is a reasonable option. To do so I would have to either downplay its risks or embellish its benefits because the two sides are far from equally weighted.

  2. I have a question regarding my 4 month old’s mild hypospadia. I really have come to a crossroads here..I want to keep him intact and was decided on waiting until he was older to help me make the decision about his body (surgery or not), but my pediatrician brought to my attention that he may not be able to successfully reproduce considering his urethra is about 1/2 a cm down from the normal placement. You can understand that as a mother I was very upset to think about altering my son, but I also do not want to be the cause of his infertility in the future. I even brought up the fact that I’ve read about foreskin restoration, after he told me that he’d most likely have to get circumsized because he was also born with a hooded foreskin. I only want the best for my son. I would greatly appreciate any advice or experience.

  3. The article is a good place to start researching this issue. I think the push to perform corrective surgery on infants is well-intentioned but misguided. Weighing the benefits versus risks of performing the surgery during infancy/childhood compared to waiting until the age of consent is really the issue here. Considering the importance of the sexual organ to a boy/man’s psychological health as well the fact that a fully formed sexual organ is easier to perform surgery on, I would think that waiting would be most prudent. Afterall, he won’t be needing to reproduce for some time and may very well want his body to be left just as it was created.

  4. Pingback: Should Your Baby Be Circumcised?: Controversial Parenting - The Real Supermum

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