by Tayyabal Riaz
Research finds health professionals need to understand the despicable practice even more in order to provide adequate care for victims
More than 125 million girls are subjected to Female Genital Mutilation, and at least 3 million are at ongoing risk. Girls who undergo the procedure are at a higher risk of infertility, infection as well as ongoing bleeding.
FGM comprises all procedures involving partial or total removal of the external genitalia for non-therapeutic reasons. It violates the human rights of women and girls, has no health benefits and can have significant, negative, psychological and health outcomes.
The International Journal of Obstetrics and Gynaecology (BJOG) calls for extra training of staff to deal with women who have undergone FGM. BJOG raises a flag on the lack of skills and confidence of healthcare providers when dealing with issues such as defibulation outside labour, clitoris reconstruction and post-partum care. BJOG states that a significant improvement in healthcare for women, who have undergone FGM, is urgently required to ensure adequate medical treatment.
Whilst, campaigns are run in order to battle this issue, the numbers inflicted with this have not seen a significant decrease. Laws and regulations against the practice have pushed people to carry out such procedures in areas that are not regulated well, creating a ‘black market’ for FGM. This poses an even greater risk as tools are unsanitary and procedures are performed by less experienced professionals, in unhygienic conditions.
The study reviewed the available literature about the clinical care of women with FGM and identified four areas with significant evidence gaps, and controversy regarding optimal management. These include;
• Obstetric outcomes and post-partum care
• Defibulation (surgical opening of the labia) outside of pregnancy or labour
• Clitoral reconstruction
• Training, skills and confidence of healthcare providers
Previous studies conducted in Africa have suggested that FGM is associated with an increased risk of obstetric complications, such as caesarean section, post-partum haemorrhage, episiotomy and low birth weight. However, studies performed in Western settings suggest that a high standard of obstetric care can reduce such risks.
The study highlights that obstetric outcomes should be evaluated for age, socio-economic status, reproductive history, and health affecting a pregnancy, in addition to FGM type. Future research should also take into account the quality and utilisation of healthcare services.
Tracing back the practices is not only tedious, but also borderline impossible. The practice is often misunderstood for cultural or religious, when it is solely about male dominance over females. More awareness and clarification of such issues is still needed to battle a cultural practice so deeply embedded in their countries.