STC 2010 Hospital/home birth/circumcision survey

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1. Are you expecting a boy, or have you recently given birth to a boy?

Are you expecting a boy, or have you recently given birth to a boy?   Expecting a boy soon. Recently had a boy 1 year or less ago. Had a boy 1 to 5 years ago. Had a boy more than 5 years ago.

2. Where are you planning on giving birth or,
Where did you give birth?

Where are you planning on giving birth or, Where did you give birth?   Home Birthing center Hospital Car on the way to the hospital

3. What kind of practitioner attended or will attend the birth?

What kind of practitioner attended or will attend the birth?   Ob/Gyn, nursing staff Midwife and staff Midwife with Ob/Gyn on call Midwife only other

4. If your child is not a boy you may skip this survey. Please feel free to add any comments below. This information will likely appear in a publication. Thank you.

If your child is not a boy you may skip this survey. Please feel free to add any comments below. This information will likely appear in a publication. Thank you.

5. If your child had ambiguous genitalia, please comment below. Also if your child had any surgeries on his or her genitalia as an infant or child, please explain the problem, the diagnosis, who made the diagnosis and who consented to the surgery or if it was part of a ceremony or religious tradition.

If your child had ambiguous genitalia, please comment below. Also if your child had any surgeries on his or her genitalia as an infant or child, please explain the problem, the diagnosis, who made the diagnosis and who consented to the surgery or if it was part of a ceremony or religious tradition.

6. If you already have one or more boys, what year was he born?
If multiple boys, please indicate what year they were born.

If you already have one or more boys, what year was he born? If multiple boys, please indicate what year they were born.

7. If you are expecting a boy soon, have you been counseled by your prenatal provider about the circumcision choice that will be presented to you upon his birth?

If you are expecting a boy soon, have you been counseled by your prenatal provider about the circumcision choice that will be presented to you upon his birth?   Have been already counseled. Counseling has been scheduled already. Nobody has mentioned it yet. I was given a brochure or pamphlet. Already had my boy, was counseled. Already had my boy, was not counseled prior to the request for consent to circumcise.

8. When the infant or child circumcision option was presented, was it:

When the infant or child circumcision option was presented, was it:   Indicated as hospital policy to circumcise all male infants or children? Presented as a parent's choice? Presented when only one parent was present? Presented when both parents were present? Not presented, circumcision was not performed. Not presented, circumcision was performed anyway. Don't remember.

9. When circumcision was presented, were one or both parents present?

When circumcision was presented, were one or both parents present?   Mother present only. (Mother not sedated) Father present only. (mother was sedated) Both mother and father were present, not sedated. Mother sedated, father not present. We weren't asked, he got cut w/o our knowledge. Someone else gave consent to cut him.

10. If circumcision was presented and not accepted by parent(s), were there multiple attempts by the medical facility to obtain consent?

If circumcision was presented and not accepted by parent(s), were there multiple attempts by the medical facility to obtain consent?   Presented only once. Presented twice. Presented three times or more. Presented more than I can remember. I felt badgered about it.

11. If you would like to add a narrative to the above question, please do so here.

If you would like to add a narrative to the above question, please do so here.

12. If he was not circumcised,

If he was not circumcised,   Mother insisted to not cut. Father insisted not to cut. We both agreed not to cut. We disagreed at first, but he was cut. We disagreed at first, but he was not cut. Father is not cut, so he didn't get cut.

13. If he was not circumcised, what can you remember about the decision to NOT circumcise- i.e. what did you read, were you handed a pamphlet, did someone tell you something?

If he was not circumcised, what can you remember about the decision to NOT circumcise- i.e. what did you read, were you handed a pamphlet, did someone tell you something?

14. If circumcision was recommended, what can you recall about the reasons for the recommendation?

If circumcision was recommended, what can you recall about the reasons for the recommendation?

15. If you remember anything about the recommendations to circumcise your infant or child, please indicate any reasons you remember.

If you remember anything about the recommendations to circumcise your infant or child, please indicate any reasons you remember.   It's cleaner It's for the girl Everyone is circumcised His father is circumcised His brother(s) are circumcised Sex will be better He won't be teased in the locker room To reduce the risk of HIV To reduce the risk of any STD To reduce the risk of cervical cancer to his future female partner We're Jewish and we had the Bris at home. We're Jewish and we didn't have him circumcised.

16. If there were more reasons you remember, please write them in the box.

If there were more reasons you remember, please write them in the box.

17. If you have non-circumcised (intact) boys, can you tell us how many and if you had any problems with his penis? What age did the problems happen?

If you have non-circumcised (intact) boys, can you tell us how many and if you had any problems with his penis? What age did the problems happen?

18. If the father was circumcised, why was it done?

If the father was circumcised, why was it done?

19. If there was a problem, did the doctor make any attempts to correct the problem before recommending circumcision?

If there was a problem, did the doctor make any attempts to correct the problem before recommending circumcision?

20. Was phimosis ever mentioned? Was there ever a diagnosis of phimosis, or was it called "tight foreskin"? Was there some other diagnosis?

Was phimosis ever mentioned? Was there ever a diagnosis of phimosis, or was it called "tight foreskin"? Was there some other diagnosis?

21. If he was circumcised what kind of doctor did the surgery?

If he was circumcised what kind of doctor did the surgery?   Resident or intern OBGYN Pediatrician Don't remember Urologist Generalist/Family practitioner Other He wasn't circumcised

22. Please indicate your country, state and city of the hospital. You can name the hospital if you want.

Please indicate your country, state and city of the hospital. You can name the hospital if you want.

23. Do you have any comments to improve the survey or about circumcision?
Please refer others to this survey.
Thank you for your efforts!

Do you have any comments to improve the survey or about circumcision? Please refer others to this survey. Thank you for your efforts!