Opposition Builds Against City On Brit Procedure

Opposition is building to a city Health Department campaign to warn new Jewish parents against a circumcision procedure it describes as life threatening: even before the plan is launched.

In a full-page ad in last week’s Brooklyn Orthodox paper, The Jewish Press, a new group calling itself Friends of Bris Milah (ritual circumcision) urged parents to call a 24-hour hot line "to report any conversation initiated by doctors, hospitals and other professional caregivers" regarding the procedure known as metzitzah b’peh.

Describing the plan as "a giant step leading to a ban" on the procedure, the hot-line message asked callers to leave the names of any health professional making "negative statements … against our mesorah [tradition]" and specifics about what was said, where and when.

The information will be used to prepare for "future action," the message said, raising the possibility of protests and pressure on specific caregivers.

Efforts to reach Rabbi S.F. Zimmerman of Monsey, identified in the ad as a recipient of contributions to the group, went unanswered. But sources in the Satmar chasidic community of Williamsburg in Brooklyn said the group was tied to the Central Rabbinical Congress of the United States and Canada, a Satmar rabbinic organization that has taken a lead in opposing city plans.

The same group met with Mayor Michael Bloomberg at Gracie Mansion to protest the plan in an exchange on Jan. 5.

City officials described their plans, first announced more than a month ago, as unchanged despite the moves. They disavow any intent to seek a ban.

"The details of our community outreach are still being finalized," said Health Department spokesman Andrew Tucker, "but the plan remains to distribute [information about metzitzah b’peh] to parents of newborns in hospitals. We expect this to begin over the next several weeks."

The information sheets, to be distributed at hospitals used heavily by the Orthodox community, alert parents of male newborns to risks the Health Department has found in the practice.

The procedure, in which the mohel orally sucks blood from the site of the genital cut, has been blamed for transmitting several cases of life-threatening genital herpes to newborns. Type 1 herpes is a common virus carried by the majority of adults with no harm, but it can cause brain damage or death if passed to newborns, who have little immunity.

The department has identified seven such cases since 1988, including five in the last two years. They include one child who died and two who suffered significant brain damage.

David Zwiebel, executive vice president of Agudath Israel, an Orthodox umbrella group, estimates some 2,500 metzitzah b’peh procedures are performed annually in the five boroughs.

Even within the Orthodox community, the practice is far from universal. Modern Orthodox communities and some ultra-traditional groups use alternative procedures that avoid direct oral-to-genital contact. But other Orthodox leaders insist the practice is an absolute requirement of religious law.

Comments this week from some Orthodox leaders indicated the department’s plan to put its information and warning directly into the hands of new mothers was being seen as a threat, or attempted end run, around the authority of leading rabbis: a broader, more fundamental issue in Orthodox sectors where these rabbis are looked to as unquestioned, and exclusive, sources of guidance.

Zwiebel noted the information sheet the city plans to distribute advises parents to consult their mohel and pediatrician about the procedure.

"It probably would have been more respectful to have said ‘consult your rabbi,’ " he said. "It’s almost as if the Health Department didn’t want to encourage people to speak to their rabbi and figure out with him their traditional regulations."

Rabbis in the communities where the practice is mandated have been unswayed thus far by the Health Department’s research data.

Interviews with several parents from these communities underlined this rabbinic-centered worldview and the hurdle it will pose for the Health Department.

"Of course my sons had metzitzah b’peh," said Surie Hirsch, 27, a Satmar chasid and mother of sons aged 4 and 2.

Hirsch said nothing she has heard about the recent controversy over the procedure would make her decide differently today.

"Our rabbis have been looking into it quite sufficiently," she said. "They’ve been protecting us beautifully, so far. I don’t believe for a moment we’d be doing this if I felt I was putting my sons at risk. If there’s going to be any reason to believe it’s actually dangerous, then I believe our rabbis will come forth and stop it."

Yisroel, 31, a Skverer chasid who would give only his first name, agreed.

"I have two sons, 6 and 4, both of whom had metzitzah b’peh," he said. "I didn’t see any problem with it then, and I would without hesitation have it performed again if I were to have another son."

Yisroel noted that Health Commissioner Thomas Frieden issued his warning against metzitzah b’peh on Dec 15 while a Satmar rabbinic court, or bet din, was still considering the issue.

With the city’s agreement, the Central Rabbinical Congress of the United States and Canada was to rule on the case of a mohel the department judged to have passed herpes to at least three infants in recent months via metzitzah b’peh.

The Health Department had agreed to let the religious court handle the problem by a mutually agreed upon deadline of Dec.1, but the rabbinic court missed the deadline. In the meantime, the city discovered two more recent cases.

"I, and many in the community, felt they should have given the bet din more time," Yisroel said. "It seemed like the commissioner was all too happy to declare that the bet din hadn’t produced any timely conclusions, so that they could take it into their own hands."

"For haredim," said Yisroel, using a common Hebrew term for Orthodox Jews who reject secular values, "the general principle of conservatism is often just as important as the letter of the law. … The general principle of conservatism does not allow changing a longstanding practice."

This is not to say the Health Department will be unable to influence some, particularly those Orthodox who have feet in both the secular world and their own communities.

Sarah (who asked that her real name not be used because of family considerations), 24, who gave birth last month, is a graduate of Brandeis University, as is her husband, and they consider themselves Modern Orthodox. After reading a story about metzitzah b’peh in The Jewish Week in October (a practice she had never heard of until then) Sarah resolved to find a mohel who would use one of the common alternatives to oral suction endorsed by many rabbis.

But to do so, she had to stand up to heavy pressure from some of her in-laws with ties to the Bobover chasidic community.

"My mother-in-law was unhappy," Sarah said, "and my grandmother-in-law was very unhappy. She said she didn’t want to invite her relatives. She said the brit was not kosher. She was embarrassed. We got angry."

Ultimately, Sarah said, her mother-in-law and grandmother-in-law attended the brit.

But she said that among those from the yeshiva world of Flatbush, where she lives, it is very rare for women to play any role in planning a brit, which is seen as the new father’s business.

Sarah suggested city officials would be wise to keep this in mind when targeting their message.

"Once the information is there, it will spark discussion, which will influence the rabbis," she predicted. "I don’t think it will take a long time for them to change."

Larry Cohler-Esses is editor at large. Debra Nussbaum Cohen is a staff writer.