Thursday, April 01, 2010

Pain is the topic of today’s post. I’ll begin by saying that I do not plan to measure or quantify the lasting effects of infant trauma, or discuss the various methods of pain relief available, or the frequency or willingness of circumcisers to employ them- although I may mention these things- that is not the theme of today’s blog. Today I am going to cast off the burden of providing scientific evidence for everything I want to say, and simply discuss some of my personal thoughts on our commonly held beliefs about the pain circumcised infants endure.

A great place to find articles on pain research: The CIRP Library

The idea that infancy is the best time to circumcise a boy is one of the most common justifications we find held by today’s parents. The main reason they believe infancy is best, is because they would like to exploit infant amnesia; that pain which will be forgotten is the best kind of pain to endure if one has to endure it. This relies on so many beliefs that I do not share, I will break them down as best I can.

The first is the belief is that the pain of circumcision is a pain that a man will endure at some point in his lifetime. This is false. In non-circumcising cultures, the chances that a man will need to be circumcised at some point in his life are extremely low. Therefore, parents do not need to choose the best time for their son to endure circumcision pain. By leaving his body alone, they have made a choice with fantastic odds, and the only choice that gives their son the opportunity to possibly live his entire life without ever enduring the pain of circumcision.

Next is the belief that forgotten pain is the best kind of pain. This is a field that is very tricky to study in a scientific way- if you are willing to listen to experts who have a more wholistic approach to the human body and experience- you will find lots of backing- but the medical world does not feel a need- nor do they have ethical permission to perform studies that would give us concrete answers. One of the more famous studies was done by Anna Taddio and it involved the pain responses of infants when they were vaccinated at several months old. The research revealed that infants who were circumcised, even the ones who had some pain relief for the circumcision, had a heightened pain response to the shots four and six months later. So the pain of the circumcision did not inoculate their body to pain- it actually worked more like the first exposure to an allergen- making them hyper sensitive to the next exposure.

Last is the belief that adult men should never have to suffer the pain of circumcision. That they should be protected from enduring elective or necessary pain by moving the experience forward in time to the point that it is both unnecessary and non-consensual. I offer the common phrase, “Take it like a man.” Although that’s also loaded with lots of cultural baggage that makes me uncomfortable- how can we believe that there is such a thing as taking it like a man, if we feel that newborn babies are better equipped to take it than men are?

Many parents (and Doctors and maternity nurses) also repeat dismissive apologist comments about the infant’s experience. They say things like, “He slept through it.” “He was so brave.” “What a trooper.” and “He only cried because he didn’t like being strapped to that board.”

Over twenty years ago I was raped, and part of that experience included being pinned, and then tied in a spread eagle position. I have a lot of personal empathy for a person who is crying because they have been strapped down. The violation of the rape did not begin with penetration or beating, it began with the fear I felt when I no longer had the liberty to protect myself. The terror and betrayal I felt over being tied, was just as much a part of the horror of the experience as any other aspect of it. I do not think that babies who cry from the moment of being tied are not experiencing true and deep distress. The spread eagle circumstraint position (did you know that the pelvic area of the board is slightly elevated- so even the spine is flexed backward?) is the opposite of the fetal position! Imagine how alien it would feel to have your limbs extended so unnaturally, all of them at the same time, when they had never been asked to open so far!

The question of a baby sleeping through a circumcision is in my opinion, not a matter of his experience, but a matter of our desire to define his experience. In this video, you will hear two people describe the lasting effects of the trauma- but you can also witness a circumcision- at first the infant screams and fights very hard- but at a certain point he becomes silent and his tear filled stare, vacant. As Marilyn Milos says so poignantly- “He has left his body.”

Link to the video

Circumcision is quick! Babies heal fast! True- typically it does not take very long. Do you remember how long your summer vacations were as a child? – and now those summers fly by. I often think about time- relative to the infant’s life. If you are one day old, 15 minutes is 1% of your life. Proportionally, if you were 50 years old- that experience would take six months. If a circumcision wound takes a week to heal- that is the only week of their life. The first week with their penis- their penis hurts!

I think of the nerve pathway that travels between the receptors in the baby’s genitals deep into the core of their body and finally to the special zone of their brain designed to receive sexual pleasure. I think of the miracle of those delicate nerve pathways and the synapses, miniaturized in this beautiful new person for whom the world is just unfolding. I think of those nerves like virgins…clean and pure, a new leaf. I cringe to think that the very first transmission through those wires, like when Alexander Graham Bell said, “Mr. Watson come here!”… How can we rationalize the first message through those most beautiful wires of love and intimacy to be a story of the most excruciating searing pain? This was not meant to be!

I wonder how our society would take it, if I was to suggest- “Wait- before you desecrate that pathway with a story of pain- would you pause for a minute to teach your infant about sexual pleasure first? So that at least his brain would know what sweetness was possible before it learned this trauma? Of course this is unacceptable! We can not morally sexually pleasure a little infant… that’s WRONG! …and so I ask- if it’s wrong to touch them with the intension to give pleasure? How can it be right to touch them with the knowledge that it will inflict pain?

I really need to wrap this up, but I am going to touch on one last item which is a bit of crossover activism- with breastfeeding, and it concerns the use of the sucrose pacifier for circumcisions and the fact that it has been shown to actually help reduce pain responses during a circumcision. I have nursed three children so far, and with the birth of each child I am always overwhelmed by the amazing miracle of the rooting and suck reflex infants are born with. It is the key to their survival and a blessing from God. Without it, no amount of milk could help an infant who did not have the instinct to help himself- he would just waste away quietly without putting in the work he needs to ensure his survival. When I first learned about the sucrose pacifier, something deep in me felt that this was wrong- but it took me a little while to dissect and reconstruct what it was that I found so disturbing.

When a baby is hungry, he will cry in response to the pain in his belly. When he is put to the breast, the infant must calm himself and stop crying in order to nurse effectively and resolve his problem. The pain is his belly is not gone, his hunger is not satisfied- but the correct answer has been offered and he must have faith that sucking at the breast is the solution to make the pain go away. I feel that there is something sacred here, in this gift, in this order. To give a sucrose pacifier to an infant being circumcised is an abuse in his trust that sucking will resolve his pain. Yes it may work, but it works by deceit. To take that most precious maternal association- and exploit in order to silence him- is a lie and betrayal of both mother and baby in the highest order.


Anonymous said...

Thank you, Sarah, for these insights!

James Loewen said...

Thanks very much for your clarity here Sarah. What a different society we would enjoy if the sensitivities you understand and describe here were more common knowledge.

Restoring Tally said...

Such a powerful blog. You have done a very good job discussing pain.

As a circumcised man I often wonder if my distrust of others, my avoiding touching and being touched, is somehow related to my circumcision. I am restoring my foreskin and notice that I am more free with my emotions as my foreskin covers my glans. I am more open, now.

Elaine said...

Powerful post. Although I chose to circumcise both my sons, I have felt for some time that, if I had the decision to make over again, I probably wouldn't do it. I will say that they did heal very fast.

In any case, I *DO* think it's important to remember that parents who circumcise do not love their sons less than parents who do not.

Cultural norms take a LONG time to break.

TLC Tugger said...

We can't forget the other pain the infant feels. It literally hurts to be nuzzled close to Mommy's tummy to nurse because of the pressure on the tender healing skin and the denuded mucosa.

keepthemintact said...

I can recall a friend saying that at the birth of his son the doctor advised him that he had a problem and he had to be circumcised. The only problem that child had was that he had a grubby doctor who was out to get every cent out of my friend as he could or he (the doctor) was under the misapprehension that a child’s foreskin had to be retractable at birth.
Many years ago when working on a large sheep station one of the station hand’s wife was due to have a baby. Late at night there was a knock on my door and a tearful station hand was there and proceeded to tell me the child had died. He told me the doctor advised him that the child was born frail and did not survive. But the doctor told him that he won’t charge him for the circumcision. It has taken this long for me to work out that the doctor murdered the child with an unnecessary painful operation especially since the child was fighting for its life. The only charging that should have taken place would have been having the doctor charged with murder.
A friend wrote to me when I advise him of my recall of this event he said “I wonder if circumcision is ever put on the medical records as “cause of death”. The doctors write the records and can ascribe a death to infection without mentioning that the circumcision wound was the point of entry. Also they can write “exsanguination” instead of bleeding to death from a circumcision wound.
He added “the medical establishment is very good at covering their tracks. There are likely far more serious injuries and deaths from circumcisions than we hear about. We only hear about the cases that go to court. But doctors/hospitals can largely hush things up. Uninformed parents would have a very hard time getting good documentation from a hospital as to what went wrong. The guilty write the records, and professional courtesy does not allow a doctor to squeal or even pass judgment on another doctor.”

Anonymous said...

As an intact American Baby Boomer, I want you to know that your richly detailed memoir is truly insightful, and a tribute to the growing power of female common sense. I give you a long standing ovation.

Here as elsewhere, we can all learn a great deal about sex and genital integrity by reading the thoughts of women, especially women like yourself who use the internet to take responsible sexual candor to a new level. I admire Camille Paglia, BTW.

As Marilyn Milos has written, circumcision is the crossroads where sex and violence meet. A baby boy is as vulnerable as humans get, and circumcision is a sexual violation grounded in this vulnerability.

Georg Shteln said...

Thank you. I didn't think of the pacifier as a 'betrayal', but of course I absolutely believe it. A cruel betrayal- and the boy learns to mistrust his mother as a result. The worst case scenario for all involved.