Physician Perspectives on Performing Newborn Circumcisions: Barriers and Opportunities

Emilie K. Johnson*, Ilina Rosoklija, Ryan F. Walton, Derek J. Matoka, Catherine M. Seager, Jane L. Holl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Over half of infant boys born in the United States undergo newborn circumcision. However, available data indicate that boys who are publicly insured, or Black/African American, have less access to desired newborn circumcision, thus concentrating riskier, more costly operative circumcision among these populations. This study ascertains perinatal physician perspectives about barriers and facilitators to providing newborn circumcisions, with a goal of informing future strategies to ensure more equitable access. Methods: Qualitative interviews about newborn circumcision care were conducted from April–June 2020 at eleven Chicago-Area hospitals. Physicians that provide perinatal care (pediatricians, family medicine physicians, and obstetricians) participated in qualitative interviews about newborn circumcision. Inductive and deductive qualitative coding was performed to identify themes related to barriers and facilitators of newborn circumcision care. Results: The 23 participating physicians (78% female, 74% white, median 16 years since medical school graduation [range 5–38 years], 52% hospital leadership role, 78% currently perform circumcisions) reported multiple barriers including difficulty with procedural logistics and inconsistent clinician availability and training; corresponding suggestions for operational improvements were also provided. Regarding newborn circumcision insurance coverage and reimbursement, physicians reported limited knowledge, but noted that some insurance reimbursement policies financially disincentivize clinicians and hospitals from offering inpatient newborn circumcision. Conclusions: Physicians identified logistical/operational, and reimbursement-related barriers to providing newborn circumcision for desirous families. Future studies and advocacy work should focus on developing clinical strategies and healthcare policies to ensure equitable access, and incentivize clinicians/hospitals to perform newborn circumcisions.

Original languageEnglish (US)
Pages (from-to)144-154
Number of pages11
JournalMaternal and child health journal
Volume28
Issue number1
DOIs
StatePublished - Jan 2024

Keywords

  • Circumcision
  • Delivery of healthcare
  • Qualitative research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Obstetrics and Gynecology
  • Epidemiology
  • Pediatrics, Perinatology, and Child Health

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