The woman is wearing a hat. The man is spearing the baby's forehead with a carving fork (not a "devil's pitchfork") reminscent of the Shi'ite custom during the festival of Ashura. The book is unidentifiable. The baby's genitals remain covered. It is his toes that are being cut off. He is being held down in a device reminiscent of a Circumstraint (TM) used for American traditional (pseudo-medical) circumcisions. Remember the boy who cried "Wolf!"
from the article: Jewish groups slam Norwegian paper over gory circumcision cartoon