Circumcision, the surgical removal of the foreskin around the penis, is becoming less common, according to recent statistics from the Centers for Disease Control (CDC). What was once a standard hospital procedure has now become an elective choice that many parents are choosing to forgo.

One reason for the decline may be the changing recommendations from organizations like the American Academy of Pediatrics (AAP).

The academy's position is that despite offering some health benefits, the decision to circumcise or not is a personal one: “…[T]he final decision should still be left to parents to make in the context of their religious, ethical and cultural beliefs.”

Not surprisingly, this policy means that doctors no longer expect or routinely advise parents to have their infant sons circumcised.

The biggest change was in the rate of circumcision in the West. There rates fell by about 37%, from 63.9% in 1979 to 40.2% in 2010.

The new CDC report details how the rates have fluctuated from 1979 to 2010. Circumcision rates fell across the U.S. by about 10%. This number is based on data on all newborn boys circumcised in hospitals, but does not include circumcisions in other venues — for example, as part of religion ceremonies — or later in life.

The change in rates varied by region, as well. In the Northeast in 1994, 69.7% of infant boys were circumcised. By 2007 that number had dropped to 60.7%. The Midwest and the South both showed similar fluctuations, with rates increasing to 1998 and then falling off through 2010.

The biggest change was in the rate of circumcision in the West. There rates fell by about 37%, from 63.9% in 1979 to 40.2% in 2010. The biggest drop came in the 1980s, when only 31.4% of infant boys were circumcised, after which they began to rebound slightly.

The study made no attempt to look at what social factors may have affected the rates, so it is impossible to know for certain why these changes occurred.

Circumcision rates both nationally and regionally seemed to follow the AAP’s recommendations, which have changed over the years. In the 1970s, the AAP said there was no evidence to recommend the procedure, but in 1989, they decided that there were some health benefits (mainly reduced risks of contracting HIV, sexually transmitted diseases, and of developing urinary tract infections).

In 1999, however, the position shifted again, and it was concluded that the benefits did not outweigh the surgical risks — infection, possible mutilation, inflammation, and pain — enough for the procedure to be recommended.

While the AAP still doesn’t recommend that it be done routinely, in August of last year the academy did say that based on a review of the evidence, “the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision.”

Circumcision is associated with a reduced risk of urinary tract infection in infants, genital herpes, human papillomavirus (HPV), penile cancer, HIV, and cervical cancer rates in women (which is often caused by the HPV virus).

If you’re expecting a son and are on the fence about whether to have the procedure done, read up on the risks and benefits and discuss the issues with your partner and your doctor.