FOR BIRTH PROFESSIONALS

Something to hand the families who ask

If you attend births outside a hospital, you get asked about circumcision — usually in the week you have least time, and usually because the family has just discovered that the hospital will not do it and that you cannot. Below is a one-page answer you are welcome to print, email or link to.

Three things worth saying first

There is no ask attached to this. You are already in our birth support directory — 313 birth centers, midwives and doulas across Michigan, Ohio, Indiana and Pennsylvania — and you were listed without being asked, because families planning an out-of-hospital birth need to find you. Nothing about that listing depends on what you do with this page.

We will not contact your clients. We have no mailing list, no ad retargeting and no referral-tracking arrangement to offer you. If a family calls us, it is because they chose to.

The handout does not argue for circumcision. It answers the practical question a family is stuck on — who can do this, how long do we have, what should we ask — and it includes what to do if they decide against it, because the advice families get on caring for an intact baby is frequently wrong. We would rather it be something you are willing to hand over than something that reads like an advertisement. If it still does, tell us and we will fix it.

See the directory

Printing this page gives you the handout alone, on one sheet. Or send families straight to this page.

Circumcision after a birth outside a hospital

What parents actually need to know, in the first few weeks — whichever way you decide.

Why the hospital says no

A hospital will generally not circumcise a baby it did not deliver. There is no admission and no chart; from their side your son was never their patient. This is not a judgement about your birth.

Why your midwife says no

Newborn circumcision falls outside midwifery scope of practice. Your midwife is not withholding anything — it is simply not within what she is trained and licensed to do, in the same way she would not perform any other surgical procedure.

How much time you have

For a healthy, full-term baby the straightforward window runs to roughly four weeks, once feeding is established. After the newborn period it becomes more involved — more likely to need general anesthesia, slower to heal, and with a measurably higher complication rate. A Jewish brit milah is on the eighth day.

You do not need to decide today. You should not leave it for three months.

Who can actually do it

  • An in-home provider — a mohel or physician who travels to you, usually with local anesthetic, baby in your arms.
  • Your pediatrician — some practices perform office circumcisions in the first weeks. Availability varies a lot. Worth one call.
  • A circumcision clinic — high volume, efficient; you travel to them.
  • A pediatric urologist — the usual route for an older baby or an anatomical reason. Waits can be long.

What to ask anyone you call

  • How many newborn circumcisions do you perform?
  • What anesthetic do you use, and how long do you wait for it to work?
  • What would make you decline? A provider who never says no is not screening.
  • What does aftercare look like, and can I reach you on day three?
  • What is the total cost, including travel?

When it should wait — or not happen

Tell any provider about all of these, before anything is scheduled:

  • Hypospadias or any anatomical variation. A reason not to circumcise — the foreskin may be needed for a later repair.
  • Prematurity, NICU time, or a baby who is not yet stable and feeding well.
  • A bleeding disorder in the family.
  • Declined or oral vitamin K. Not an automatic no, but it bears directly on bleeding and must be discussed openly.

If you decide not to circumcise

That is a complete answer, and no major medical body says you must. One rule matters more than all the rest:

Do not retract the foreskin.

It is naturally attached at birth and separates on its own — often not until school age, sometimes later. Forcing it early causes pain, bleeding and scarring. Wash the outside only, like any other skin. No cotton buds, no antiseptics. White material (smegma) and small white “pearls” as it separates are normal, not infection.

Where the medical bodies stand

The American Academy of Pediatrics concluded that the health benefits of newborn circumcision outweigh the risks — and explicitly does not recommend it routinely. Both halves are the position. Other national bodies weigh the same evidence more cautiously. It is genuinely your decision, and it is meant to be.

Who wrote this. Rabbi Tzvi Fischer is a certified mohel, trained in New York and certified by the International Bris Milah Association, performing newborn circumcisions since 2001. He is not a physician. In-Home Circumcision travels to families across Michigan, Ohio, Indiana and Pennsylvania; the fee is a $980 professional fee, plus travel expenses, quoted before you commit. A consultation is free and commits you to nothing — including if the honest answer is that an in-home circumcision is not right for your son.

General information, not individual medical advice. Reviewed September 2026. Full guides and sources at inhomecircumcision.com/learn/ · Birth support directory at inhomecircumcision.com/birth-support/

If a listing needs fixing

The directory is only worth having if it is right. If your details have changed, your practice has moved or closed, or you would rather not be listed at all, tell us and we will change it the same week — no questions, no retention email.

And if you know a birth center, midwife or doula who should be in there, send them over. The list exists for families, not for us.