Circumcision Before Eighth Day
In a number of hospitals the custom has been estab lished that mothers and their babies are sent home on the fifth or sixth day after the baby’s birth. This situa tion affects the time and place of circumcision. Shall the child be circumcised at home on the eighth day, or shall we yield to the physicians preference to cir cumcise the child while it is yet in the hospital and therefore earlier than the eighth day?
Before going into the halachic side of the question, inquiry was made as to the actualities of the present situation with regard to hospital practice in this matter. Through the kindness of the administrative head of a well-known hospital, inquiries were instituted of obstetricians and from famous lying-in hospitals. From these inquiries it is evi dent that the shortened period of hospitalization is likely to continue and will undoubtedly affect the actual practice of circumcision.
It seems that as a national average the length of stay of the mother in the hospital is now four to five days, some hospitals permitting the mother to stay six to seven days. Many physicians agree that while it is valuable for the mother to become ambulatory a day or two after childbirth, it still would be best if she stayed at the hospital for about ten days. Nevertheless, the average stay is now four to five days. The chief reason for this is the crowded condition of the hospitals and perhaps also the fact that many hospital insurance plans for lying-in cases allow free hospitalization for only that length of time. Both these factors result in the fact that a mother leaves the hospital two or three days before the eighth day, on which a male child should be circumcised.
In general, doctors prefer to circumcise the child in the hospital rather than at home, or, if a mohel is used, to have him do the circumcision in the hospital under aseptic conditions. But nowadays the child cannot be circumcised in the hospital on the eighth day unless the mother takes it back to the hospital. Orthodox Jews will undoubtedly return to the earlier custom of circumcising the child at home on the eighth day (Milo Bizmano). This, of course, may be a step backward from the medical point of view, because sanitary conditions in the home cannot be as carefully watched as they have been in recent years in the hospital whenever the mohel circumcises. But for the sake of Milo Bizmano, which is an important enough mitzvah to set aside the laws of Sabbath work, Orthodox circumcisions will undoubtedly be moved back to the home.
What are our young parents likely to decide on their own accord? It is unlikely that they will decide for the sake of Milo Bizmano to have the child circumcised at home. They will undoubtedly prefer to have him circumcised by the obstetrician in the hospital, as is now a widespread custom. What shall we do about this most probable preference of the members of our congregations, which, because of the present conditions outlined above, will mean that most of the circumcisions will be before the eighth day?
Also in this regard, before answering the question from the halachic point of view the medical point of view was considered. There is no doubt that if there is a choice to be made between circumcision at home and circumcision in the hospital, physicians will overwhelmingly prefer hospital conditions. Moreover, is there any medical advantage in having the child circumcised before the eighth day? It seems that there is considerable medical opinion that it would be better to wait until the eighth day, as is required by Jewish law, because certain blood conditions that might make it desirable to postpone circumcision do not become clearly evident until the eighth day. Thus, if we wait until the eighth day, these dangerous conditions can be recognized and the circumcision postponed, as it should be.
Thus, common sense would require that we should not readily yield to the present new circumstances, but when a male child is born should endeavor to get the mother’s stay lengthened to eight or nine days to allow the child some time of healing. Under many circumstances in certain hospitals this will be possible. Whenever it is possible, both for the sake of the mother and because of tradition, we should endeavor to get the stay lengthened to nine days, and have the circumcision on the traditional eighth day.
However, in the increasing majority of cases where this is becoming impossible, what shall we do? As to having a surgeon operate instead of a mohel, there is no real objection in the law if he is a Jewish surgeon, and there is considerable opinion that even a Christian surgeon is also permissible. This matter of using a surgeon rather than a mohel is discussed later, in Responsum #24. The chief question that here concerns us is the validity of circumcision before the eighth day (Toch Sh’mono).
In general, the halachic point of view is that it is not valid to have it earlier, for if it were possible to do so, why violate the Sabbath? However, there is considerable opinion that tends to accept the validity of circumcision before the eighth day. Thus, Asher ben Yehiel (to b. Sabbath, chap. 19) discusses whether a child who is circumcised before the eighth day needs on the eighth day the taking of the drop of blood of the covenant (Hatofas Dam Bris), as is done when the child is born circumcised, or when a Gentile who has already been circumcised is converted. He decides that a child circumcised earlier than the eighth day does not need the drop of blood taken, thus indicating that such early circumcision is to be deemed valid. Nathaniel Weil (in Korban Nesanel, ad loc.) also defends this viewpoint, refuting Sabbathai Cohen (Shach) and defending Isserles on this question, and ends by saying: “The law is, that it is not necessary to take the drop of blood [on the eighth day] of the child who is circumcised earlier than the eighth day.”
Isserles on this question seems to hold two contradictory opinions. In Yore Deah 262 : 1, he simply says that if the child is circumcised earlier than the eighth day, the duty of circumcision has been accomplished. But in 264 : 1, discussing the question of who may circumcise (Jew or Gentile or woman, etc.), he says that when a child needs to be circumcised earlier than the eighth day because of danger, a Jew or a Gentile may do the circumcising, since this (earlier circumcision) is not really the mitzvah of circumcision. But Moses Rifkes says (in “B’er Hagola”) that this latter statement (“that it is not the fulfillment of the commandment”) refers merely to the question of whether or not a Jew be required to do the circumcising, and that this early circumcision is actually (as Isserles stated earlier in 262 : 1) a fulfillment of the commandment. Aryeh Lev, of Metz (in “Sha’agas Aryeh” #52) discusses the question of a child who at the command of a doctor was circum-cised before the eighth day. He sides with Sabbathai Cohen that this is not the fulfillment of the commandment, yet the question itself and his discussion of it indicate that such early circumcision was a fairly frequent practice. It is clear that there is a considerable weight of authority that gives legal status to the pre-eighth-day circumcision at the command of a doctor, and in the present case it is clear that the doctors so desire it.
It often happens in the law, when certain liberal opinions are noted but are not followed, that these liberal opinions are nevertheless regarded as important “to rely upon in time of need.” That is to say, if circumstances arise when it is necessary to make a permissive decision, these liberal opinions will become useful. It is in this way that we must regard those opinions which concede the legality of circumcision before the eighth day. They are contrary to general Jewish practice. But in case this hos pital practice of sending mothers home early becomes permanent, and in case the parents insist upon the circumcision being performed in the hospital before the mother goes home, then we may have to face the fact.
Yet there is no need to surrender too soon. As long as possible, we must insist upon the importance of the traditional eighth day. For the present we should resist the tendency to convert the fifth day into the regular circumcision day.
It therefore would be advisable for a rabbi not to participate in the fifth-day circumcision. The father, however, is indispensable at the circumcision. The duty to circumcise is in the first instance incumbent on the father himself, and the mohel is only his agent (Sheliach); therefore the father must stand at the side of the mohel to indicate that the mohel is only acting as his agent. Besides, tradition assigns one of the blessings to be recited by the father. Therefore let the father and some other relatives be present at this early circumcision and let the father name his child, as is provided for in the Union Home Prayerbook.
Since we will thus give the early circumcision partial, but not complete, religious sanction, it would be advisable that the father be called up to the Torah a week or so afterward, and the child named in the presence of the congregation, as we already do with girl children.
In conclusion, it is clear that we are facing a situation which is at present beyond our power to change basically. Where we can modify it, we should. Whenever possible, we should urge that the mother be permitted to stay beyond the eighth day so that the circumcision can occur at the proper time in the hospital, or perhaps the parents may be willing to return to the hospital on the eighth day.
Where that is impossible, the father should be present at the early circumcision, and within a week or so the child should be formally named by the rabbi in the presence of the congregation, or on the eighth day at a regular circumcision-naming ceremony.