NEONATAL MALE CIRCUMCISION AFTER DELISTING IN ONTARIO - SURVEY OF NEWPARENTS

OBJECTIVE To determine the prevalence of neonatal circumcision immedia tely following delisting of the procedure in Ontario and to examine pa rents' knowledge, attitudes, and behaviours regarding circumcision. DE SIGN Cross-sectional survey. SETTING Perinatal tertiary care centre in southwestern Ontario. PARTICIPANTS Of the 151 mothers approached, thr ee were excluded because they did not speak English and two declined p articipation; 112 of 146 mothers of healthy male newborns responded fo r a response rate of 77%. MAIN OUTCOME MEASURES Circumcision status of infant and parents' knowledge, attitudes, and behaviour. RESULTS The circumcision rate before delisting had been 56.2%; in the months immed iately after, the rate was 59.8% (95% confidence interval was 51%, 69% ). Mothers of infants in the outcome groups did not differ significant ly in any demographic feature other than education, where the group de ciding against circumcision reported higher education levels (Wilcoxon nonparametric two-sample test: z = 2.29, P = 0.02). Mothers who chose circumcision listed medical (59%) and sociocultural considerations (4 0%) as most important to their decision. Father's circumcision status was strongly associated with the infant's (X-2[df1] = 25.13, P = 0.000 1). Although 74% discussed circumcision with their family physicians, many parents were not well informed about risks or benefits. Anestheti c use during circumcision was reported by 29%, but 48% did not know wh ether any had been used. CONCLUSIONS The prevalence of neonatal circum cision did not change after delisting. Informed consent was often lack ing. Sociocultural issues are important to some parents and need to be addressed in the consultation process.