Circumcision (newborn)

What it is

Circumcision is the surgical removal of the foreskin of the penis. What makes the newborn version its own procedure, rather than a smaller copy of the one done later, is the technique: in the first days of life a ring- or clamp-type device is fitted over the foreskin, which compresses the tissue and controls bleeding while the foreskin is trimmed away. No stitches are usually needed and no operating room is involved — it is done at a bassinet or in a treatment room. Older infants and children are circumcised differently, under general anesthesia and with sutures, and that is a separate procedure at a considerably higher price.

Why it is done

• Most often for religious or cultural reasons, or family preference, rather than to treat a medical problem
• In the United States it is commonly performed before a newborn leaves the hospital; in Jewish practice it is traditionally done on the eighth day
• Medical opinion on routine newborn circumcision is not uniform, and it is treated as a parental decision

What to expect

The procedure takes only a few minutes. Local numbing is used. Afterward the area looks red and swollen and a yellowish film forms as it heals — both expected rather than signs of infection. Care is minimal: petroleum jelly to keep the area from sticking to the diaper, and watching for bleeding or trouble passing urine. Newborns generally heal within about a week and need little in the way of pain relief beyond the first few days. It is regarded as a safe procedure; bleeding and infection are the uncommon complications.

Questions worth asking

• Is this covered by my plan, or treated as elective and billed to me? Many plans and some state Medicaid programs do not pay for routine newborn circumcision.
• Is the charge bundled into the newborn's hospital stay or billed as a separate procedure, and does the baby's own deductible apply?
• Who performs it — the obstetrician, a pediatrician, or a urologist? The professional fee differs by specialty.
• If it is done after discharge in a clinic instead, what does that cost compared with doing it before we go home?
• If it is delayed past the newborn period, does the price change? The later procedure is a different, more expensive one.