Circumcision

Circumcision removes the foreskin covering the head of the penis. Most circumcisions in the United States are performed on newborns, in the first days or weeks of life, as a brief office or hospital procedure under local anesthesia.

Dr. Adeeb Alshahrour, MD, FACOG, performs newborn circumcision at the Women's Health Center of Chicago.

It is your decision

Families choose circumcision for religious reasons, cultural reasons, family custom, or health reasons, and families decline it for equally good reasons. The American Academy of Pediatrics has concluded that the health benefits outweigh the risks and justify access for families who choose it, while stopping short of recommending it routinely for every newborn. That is a deliberate position, and it means the decision properly belongs to parents.

We will give you accurate information and perform the procedure carefully if you decide to go ahead. We will not push you either way.

What it involves

Timing. Usually within the first few weeks, once your baby is feeding well, has a normal newborn examination, and vitamin K has been given. Some conditions — prematurity, a bleeding disorder in the family, hypospadias or other anatomical variation — mean it is deferred or referred, and hypospadias in particular is a reason not to proceed, because the foreskin may be needed for repair.
Anesthesia. Local anesthetic, given as an injection to block the nerves, plus a sucrose solution and swaddling for comfort. Local anesthesia is standard and is not optional — an infant feels this procedure, and pain control is part of doing it properly.
The procedure. A protective device is placed under the foreskin, the foreskin is separated and removed, and bleeding is controlled. Common techniques are the Gomco clamp, the Mogen clamp and the Plastibell device; each is well established, and the choice makes less difference than the experience of the person performing it. It takes roughly 10 to 15 minutes.
Afterwards. Your baby is watched briefly to confirm there is no bleeding and that he passes urine normally before you go home.

Aftercare

Clean gently with warm water at each diaper change. No soap, no alcohol wipes, no baby wipes on the site.
Apply petroleum jelly generously to the site or to the front of the diaper for the first several days, so the diaper does not stick. If a Plastibell was used, follow the specific instructions you are given instead.
Expect it to look worse before it looks better. A yellowish film over the healing head is normal granulation tissue, not infection or pus. Do not try to clean it off.
A few spots of blood on the diaper in the first day is normal.
Healing takes about 7 to 10 days.
If a Plastibell ring was used, it falls off on its own, usually within a week to ten days. Do not pull it.

Call us or seek care the same day for bleeding more than a few spots or bleeding that will not stop with gentle pressure, spreading redness, swelling, foul-smelling discharge, a fever of 100.4°F or higher in a baby under three months, if your baby has not passed urine within about 12 hours, or if a Plastibell ring has not fallen off after two weeks.

Risks

Circumcision is a low-risk procedure, and the risk is lowest in the newborn period. Complications occur in a small minority and are usually minor: bleeding, local infection, and taking too little or too much skin, occasionally needing a revision later. Serious complications are rare. Performing it later in childhood or adulthood generally means general anesthesia, a longer recovery and a higher complication rate, which is why families who intend to circumcise are usually advised to do it early.

Cost, insurance and the Illinois Medicaid gap

We do not publish circumcision prices on this page, and that is deliberate. The honest figure depends on your baby's age, where the procedure is performed, whether anesthesia is billed separately, and what your particular plan covers. A headline number that turns out not to apply to you is worse than no number — it just becomes a surprise on the bill. Call the office and we will give you a figure for your actual situation.

What you do need to know before the birth:

Many commercial insurance plans cover newborn circumcision, and many do not, or apply your deductible. Coverage varies plan by plan, not insurer by insurer.
Illinois Medicaid does not cover routine elective newborn circumcision. Illinois is one of a number of states that removed this benefit, and it is the most common cause of unexpected cost for families here. If you are covered by Medicaid, confirm this with your plan before the birth rather than after.
Circumcision performed for a documented medical indication — phimosis, recurrent balanoposthitis, paraphimosis — is treated as a treatment rather than an elective procedure and is generally covered, subject to your usual deductible.
Ask your insurer directly: is circumcision covered under my plan, for a newborn specifically; is prior authorisation required; is this provider in network; what is my remaining deductible. Get the answer in writing where you can. "It should be covered" is not an answer worth relying on.
If you are paying yourself, you are entitled to a Good Faith Estimate under the federal No Surprises Act. Ask us for one, and ask any facility involved for theirs.

The full breakdown is in circumcision cost and insurance coverage in Chicago.

Talk to us

Medical disclaimer

This page is general health information, not medical advice for any individual, and it is not a price quote or insurance advice. Whether circumcision is appropriate for your baby depends on his examination and health, and insurance benefits vary by plan and change over time — confirm your own coverage with your insurer. Seek care immediately for bleeding that will not stop, spreading redness, or a fever of 100.4°F or higher in an infant under three months.