New York is preparing to reconsider its ruling about oral suction circumcision, a tradition that has been linked to deadly cases of infant herpes, in an effort to resolve a dispute with the city’s ultra-Orthodox Jewish community. Officials from the city’s board of health agreed this week to open a public discussion about a proposal that would rescind a rule requiring consent forms for the procedure, in what has been an attempt by Mayor Bill de Blasio to balance public health prerogatives with concerns about freedom of religion.

De Blasio’s administration has been trying to waive a rule instituted by his predecessor that required parents to sign a consent form before the ritual, which involves the circumciser, or mohel, using his mouth to suck blood away from the circumcision wound. The city’s health commissioner, Mary Travis Bassett, said that while the original rule was “well-meaning,” it had a polarizing effect and had become difficult to implement.

“In retrospect the current requirement has mandated that education about medical risks of directorial suction be given at the wrong time in the wrong place and by the wrong person,” Bassett said, in comments reported by WCBS New York.

De Blasio had pledged to rescind the consent regulation during his mayoral campaign, and members of his administration have spent months in talks with ultra-Orthodox leaders on a suitable compromise. The community raised fierce objections to the rule when it was introduced by former Mayor Michael Bloomberg, accusing the city of infringing on their religious freedom.

Circumcisions that involve oral suction are common among some branches of ultra-Orthodox Judaism. More than 3,000 babies are circumcised each year in New York using the method, also known as metzitzah b’peh in Hebrew, according to city health official estimates. The practice came under scrutiny after a newborn boy died from contracting herpes from the ritual in 2012, leading to Bloomberg’s decision to introduce consent forms that would inform parents of the risks of the procedure.

Since 2000, New York’s health department has linked oral suction circumcision to 17 cases of infant herpes, including two deaths. Health organizations, including the American Academy of Pediatrics, have also cautioned parents about the ritual, warning that it significantly raises the risks of herpes infections among infants.

There is little evidence, however, that the city’s consent form rule has been successful in reducing the rate of infections. Not only were the forms rarely used, but the number of herpes infections linked to oral suction circumcisions jumped last year, the New York Times reported. Ultra-Orthodox leaders have argued that the city’s implementation of regulations around the practice disregarded the concerns of the community, but some have indicated that they are more hopeful about de Blasio’s approach to the issue.

“It is to Mayor de Blasio’s eternal credit that he recognized how profoundly offensive the regulation was to our community,” said Rabbi David Zwiebel, leader of an ultra-Orthodox group that sued the city over the consent rule, in comments to the Times. The health department has now begun to circulate brochures about the risks of the procedure at hospitals and pediatricians' offices so that parents can receive information through their doctors before the circumcision ritual.