While most ritual circumcisers, known as mohelim, no longer use oral contact to pull blood away from the circumcision incision — they use gauze or sterile glass pipettes instead — the practice has been strongly defended by ultra-Orthodox Jewish rabbis who believe the practice is both safe and faithful to Talmudic codes. More than 200 ultra-Orthodox rabbis have ordered their adherents not to comply with the regulation.

“This process is being created without a shred of evidence,” said Rabbi William Handler, one of a few ultra-Orthodox Jews who gathered outside the meeting in protest. “The city is lying, and slandering compassionate rabbis.”

In an effort to educate parents, the city will now require ritual circumcisers to inform parents in writing if they will use direct oral contact during the circumcision, and must receive their written consent. The consent form states that the health department advises against the procedure because of the possibility of herpes transmission, which may cause brain damage or death. The mohelim must keep that permission document for one year.

Failure to comply may result in warning letters or fines to the mohelim. Enforcement, though, will be based on investigation of specific complaints and herpes cases, not spot checks or raids, and there are no mandatory punishments, said Dr. Jay K. Varma, the city’s deputy commissioner for disease control.

Orthodox groups, including Agudath Israel of America and the Central Rabbinical Congress, have announced that they plan to sue the city to block the regulation, which is scheduled to go into effect 30 days from official publication of the rule.