Postpartum Depression & Circumcision: What Parents Need to Know

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Help is available now.

If you are experiencing a crisis, call the National Suicide Prevention Hotline at 1-800-273-TALK (8255) or your local emergency number for immediate assistance.

Read about and get help for postpartum depression and other PMADs at Postpartum Support International.

Note: This article has been written to shed light on the feelings that many regretful parents experience when first learning about the harms of circumcision. It is meant to serve as a resource for these parents — to support their own health and the health of their whole family — and for expectant parents who may not yet have considered mental health aspects of choosing circumcision for a future son.

Some mothers share their experiences here. Their purpose is not to diminish the pain and the voices of direct victims of male genital cutting. Your Whole Baby also offers resources for people who have had their bodies altered against their will.

This article is not meant to substitute for medical advice.


Circumcising a newborn son CAUSES BIRTH-RELATED TRAUMA FOR A MOTHER. Do you hear that, birth providers?

I know it did for me. Complex post-traumatic stress disorder. Depression. Suicidal thoughts. Anxiety. Birth trauma isn’t just before or during birth — it’s the care of both parties after the birth as well. We may not be connected by a placenta anymore — but our energy and very being (on a cellular level) are still connected deeply. Watching our baby suffer causes our suffering — whether we are conditioned to accept the particular cause or not.
— Sonia Fetherling, Your Whole Baby State Director
Just think of the hormonal chemical responses involved in a split second of handing over your baby. Even for those mothers who ‘want’ circumcision. There’s an underlying process happening that they’re most likely not even aware of — and it DOES affect them, whether they know it or not.
— Nicole, Your Whole Baby volunteer

Postpartum depression is the No. 1 most common childbirth complication in the United States. The illness affects an estimated 15 percent of new mothers/birthing parents — that’s 1 in 7.

Postpartum depression falls under the larger umbrella of perinatal mood and anxiety disorders (PMADs), which also include perinatal anxiety, perinatal obsessive-compulsive disorder, perinatal panic disorder, perinatal post-traumatic stress disorder, perinatal psychosis, and perinatal bipolar disorder. Dads and non-gestational parents can experience PMADs too. Parents with PMADs generally respond well to prompt, comprehensive, compassionate treatment, which may be individualized to include mental health therapies, medications/supplements, group support, exercise, and mindfulness. [1]

As anyone who has waded through one or more of these illnesses can attest, PMADs can be debilitating and life altering for a new parent. Symptoms can surface anytime during pregnancy or the first year after birth, and may include any of the following persisting longer than two weeks:

  • intense sadness/despair/emptiness

  • loss of joy or interest in things that normally make a person happy

  • anxiety/panic

  • irritability or rage

  • exhaustion

  • trouble concentrating

  • appetite changes

  • sleep disturbances

  • obsessions or intrusive thoughts, including thoughts of harm [2]

(In the case of perinatal psychosis, a rare emergency, a person can experience delusions or hallucinations. These symptoms, or those of mania and hypomania, need immediate medical attention.) [3]

Each person’s experience is different, but many common factors can contribute to a PMAD diagnosis, including a previous history of mood disorders or abuse, economic or relationship difficulties, lack of support, and traumatic experiences surrounding the birth of a child. [1,2]

IMG: Newborn baby held in gloved hand of hospital personnel

One potential but completely avoidable source of trauma for a birthing parent is infant circumcision surgery. (Read about why circumcision is unnecessary and harmful here.) Unfortunately, there’s a lack of research exploring connections between this specific form of trauma and PMADs, but that doesn’t mean the link doesn’t exist. The possibility of parental psychological harm from infant circumcision is just one more aspect of this antiquated, risky practice that deserves further scrutiny (like death rates, complications, and psychological distress/discontent of circumcised men and boys). But people tend to suppress negative feelings and discourse about circumcision because the subject is surrounded by intense emotion.

In what ways can this surgical procedure performed on an infant affect a parent’s mental health?

IMG: Black-and-white photo of a woman’s head and shoulders from the back, hunched over

Infant health concerns are recognized as triggers that can cause or intensify PMADs. When an infant is premature, sick, or injured, this creates an extra set of stressors — and often a feeling of helplessness — for the birthing parent, on top of whatever else they may be recovering from themselves, all while getting used to their new role and their new baby. Circumcising a baby creates an injury. This injury might be added on top of other infant health concerns. Circumcision surgery can cause further medical issues or make pre-existing problems worse. In addition, it can interfere with breastfeeding, and breastfeeding struggles are a risk factor for PMADs.

Circumcision creates a problem where there was not one. For the brain of a new parent, in a naturally heightened state of protective instincts and reactivity, this can be too much to process. The decision to circumcise a son can put long-term strain on the partner relationship, as well.

We’re told we’re being sensitive or hormonal. It’s so easy to say, ‘Oh, she’s just hormonal because she had a baby.’ WELL YEAH, NO KIDDING! Simply seeing her baby have a shot or a heel stick can cause a mother’s cortisol to rise and make her more vulnerable to emotional reactions. Think about how that magnifies when you see a genital wound for weeks at a time. And the simple fact that you know deep down that your baby was born perfect. It’s subtle. It’s ignored and explained away by ‘norms.’

Add on top of that the realization of what circumcision actually is, and then you have much more than a subtle reaction, physically, emotionally, and spiritually. The spiritual aspect of mother/baby bond is damaged — and those of us who become enlightened to the facts are suffering a deep, acute spiritual sickness.
— Nicole
Seeing him in pain and tending to his wound. Wrestling with my weakness. Failing (crashing and burning) on the first turn of motherhood. Dealing with the inconsolable crying that occurs. And being led to think that this is normal. That babies are meant to be circumcised, that they are meant to cry (THAT hard?), and that we are just learning to be new moms...it’s tricky at the lowest level. ALL of it.
— Sonia

When another boy is on the way

If a parent had a previous baby circumcised, and is anticipating the process all over again with a new pregnancy (perhaps accompanied by pressure from family and friends), this can fuel prolonged anxiety during a time otherwise reserved for excitement and “normal” worries. Even keeping a younger son intact (not circumcised), while immensely healing in some ways, can dredge up difficult feelings.

IMG: Pregnant belly with blue baby shoes held up to it

...having subsequent baby boys — there is a triggering aspect of that, as you are now wrestling with a new level of guilt and pain, caring for an intact son and comparing constantly between the two, revisiting your failures again…
— Sonia

Why doesn’t our society recognize the pain associated with circumcision regret?

Generations of U.S. parents suffered from perinatal mood and anxiety disorders in silence. Widespread societal acknowledgement is a relatively new development. Going one step further to recognize circumcision regret as a potential factor in PMADs presents some particular challenges for the U.S. medical community, as well as for mental health care providers, and for parents who have chosen to circumcise.

Many, many U.S. pediatric and obstetric providers opt to perform infant circumcisions. Yet it’s common to hear these same providers utter phrases like, “I hate doing them.” There is likely some trauma and guilt wrapped up in their participation that makes acknowledging the harmful nature of the procedure that much harder. Mental health care providers have their own background experiences and biases that might affect how likely they are to recognize the practice as traumatic for both baby and parent. In addition, if the family belongs to a religious community that commonly circumcises boys, parents may face intense pressure to continue the practice.

Birth trauma is a related and under-acknowledged issue that can factor into decisions parents make about their children. As YWB State Director Sonia Fetherling states, “Birth isn’t always a walk in the park. Some awful, extraordinarily traumatizing things can happen in those birthing rooms. Women/[birthing parents] can be victims to birth trauma, and in the case of circumcision, the extension of that trauma can be put on to another victim as well.”

Frighteningly, many parents are solicited for infant circumcision consent during active labor and/or under the influence of birth medications. This is a time when confusion, stress levels, and physical and emotional exhaustion are at their peak; a time that under any other circumstances would be considered unacceptable to seek consent for an unnecessary, irreversible surgery on a child’s body.

It may be a long while until we hear providers sharing with us the possible mental health risks of having a baby circumcised. This is a great disservice, some might say a violence, to birthing families who need support and information in a vulnerable time. And it’s why Your Whole Baby is working to get the word out.

I felt like I had to deal with it completely on my own. I was thrown to the wolves. No family or friend support. They all thought I was crazy. One therapist even questioned my ability to care for my son because I told her I was triggered at every diaper change.
— Lindsey, Your Whole Baby volunteer

If you are a parent who regrets circumcision and you are suffering with depression or other mood disorders, here are steps you can take right now to get help:

IMG: B&W photo of mom cradling baby, bending over and kissing forehead

Reach out.

Talk about it. It can be so hard to do at first, but essential for healing to begin. Join our YWB community group specifically for regret parents. If posting in a group feels overwhelming, you can message an admin privately. Every admin was once in your shoes as far as circumcision regret, and they run the group because they understand its necessity. You are far, far from alone.

Give yourself grace, and know that your feelings are valid.
— Elise Carin Wicklund, Your Whole Baby volunteer

Your Whole Baby has a list of therapy providers who understand the potential traumatic effects of circumcision for both sons and parents. Some offer web- and phone-based services. In addition, contacting your trusted local healthcare provider can facilitate immediate support.

Postpartum Support International has several resources including a warm line for non-emergencies, phone and online chat groups, and connections to local support coordinators.

Recognize the necessity of self-care.

Parents who regret having a son circumcised can struggle long-term with emotional health. They may believe that they deserve to exist in a perpetual state of depression for allowing the circumcision to happen, by signing their name on a consent form or by not standing up to a partner who did. These parents often feel overwhelming guilt at the thought of addressing their own feelings, in light of what their sons went through. But reluctance to pursue healing can impede the health of an entire family. Recognizing that you have faced a trauma as well, and that you need and deserve support, is a crucial step in getting healthier. This will ultimately help you support your son.

For ideas on day-to-day coping mechanisms, check out the blog at Postpartum Progress and this Psychology Today article.

Every time I realize just how strong one must be in order to face the truth and still continue on instead of giving up, I heal a little on the inside.
— Nicole

In addition, the guidebook How to Heal a Bad Birth: Making Sense, Making Peace, & Moving on by Birthtalk.org founders Melissa Bruijn and Debby Gould serves as a resource for birth trauma recovery. Though it doesn’t address circumcision directly, much of its content applies to parents’ struggles surrounding the issue. The “Pathways to Healing” guide from Improving Birth also offers insight on recovering from traumatic birth experiences. Improving Birth promotes the Mother-Friendly Childbirth Initiative in maternity care systems across the U.S., and this program encourages providers to advise their patients against newborn circumcision.

Remember how much your son needs you right now.

Different parents have different experiences. You may feel solely responsible for the decision made; you may have experienced coercion or force from a partner or someone else. Whatever has already happened, you are now aware of the truth. You are your child’s primary advocate, and now you are armed with the knowledge and strength you need to protect him from others who might hurt him going forward. He needs you, he loves you, and no one can take your place.

The single most important thing that I have to repeat to myself is that I was a victim of birth trauma, and taken advantage of and bullied in my most fragile/vulnerable state and time of need. If I had known even a fraction of the information the doctors were legally required to have told me in order to have obtained true informed consent, there’s no way it would have happened. I have conquered the feeling of being an inadequate mother by knowing that I did not consent to what was actually done and that now with the knowledge I have, my son is safest with me.
— Lindsey

If you’re expecting a baby and you’re undecided about circumcision, here are three PMAD-related reasons to keep your son intact:

1. Parent/son relationship protection. PMADs can make caring for and bonding with a new baby more challenging. By opting to leave your son’s penis intact, you can take comfort in the fact that you are protecting him from unnecessary early childhood trauma, even if infant care and bonding are still difficult at first. In addition, the respect and autonomy you afford his body and psyche in choosing to leave his genitals in their normal, natural, healthy state will help lay the groundwork for a continuing healthy relationship.

Read more about circumcision’s potential effects on parent-infant bonding here.

2. Protection from circumcision complications. As discussed above, without unnecessary surgery, there is no accompanying worry, and no possibility of circumcision-related health issues you would have to help your son deal with.

Read more about parents’ experiences with circumcision complications including meatal stenosis (here and here), bleeding, adhesions, pain and feeding difficulty.

3. Mental health protection. No one deserves to experience PMADs, but they happen sometimes. You deserve the best chances of staying healthy or returning to health quickly — this includes avoiding unnecessary trauma for you and your son. Circumcision, being permanent, can add a long-term layer of emotional difficulty for both of you.

[Circumcision trauma is] for life and there are little triggers and reminders every day.
— Lindsey
One breath and one day at a time. Grief is a process. This IS grief, with many emotions involved.
— Sonia

Stock photo of mom sitting in field playing with baby

Your Whole Baby recognizes the emotional distress circumcision can cause for entire families. We are here to help those who are suffering, and to prevent such pain when we can.

We do this work for our boys and the future of American men, really.
— Lindsey

If you are involved in academic research regarding circumcision and perinatal mood and anxiety disorders, please let us know. If you are a mental health care provider interested in having your services listed on our Trauma page, contact us here.

References

  1. Pregnancy and postpartum mental health overview. Postpartum Support International, 2018. http://www.postpartum.net/learn-more/pregnancy-postpartum-mental-health/

  2. What is postpartum depression and anxiety? American Psychological Association, 2018. https://www.apa.org/pi/women/resources/reports/postpartum-depression.aspx

  3. Postpartum psychosis. Postpartum Support International, 2018. http://www.postpartum.net/learn-more/postpartum-psychosis/


Published March 22, 2019