J Matern Fetal Neonatal Med. 2011 Jun;24(6):833-6. Epub 2010 Dec 1.
Female circumcision: obstetrical and psychological sequelae continues unabated in
the 21st century.
Chibber R, El-Saleh E, El Harmi J.
Department of Obstetrics and Gynaecology, College Of Medicine Kuwait
University/King Faisal University Dammam, Safat 13110, Kuwait.
OBJECTIVES: To assess the incidence of female circumcision/female genital cutting
(FGC) among pregnant women and describe the obstetrical and psychological
sequelae of female circumcision.
METHOD: Four thousand eight hundred pregnant women over a 4-year period were
assessed for female circumcision. Odd ration (OR) and 95% confidence interval
(CI) were calculated to measure association between female circumcision, maternal
morbidity, and birth outcome. Variables included prolonged maternal
hospitalization, low birth weight, prolonged labor, obstructed labor, cesarean
section, and fetal outcome. Assessment measures to determine cognitive and
emotional effects included the Mini international Neuro-psychiatric interview and
Rey memory test.
RESULTS: The prevalence of female circumcision was 38%; women who were
circumcised were more likely have extended hospital stay. There was a positive
association between such women and prolonged labor, cesarean section, post-partum
hemorrhage, early neonatal death, and hepatitis C infection. Psychiatric sequelae
included: 80% continued to have flashbacks to the FGC event; 58% had a
psychiatric disorder (affective disorder); 38% had other anxiety disorders, and
30% had post-traumatic stress disorder.
CONCLUSION: Female circumcision is associated with adverse materno-fetal outcome
and psychiatric sequelae. Many will need psychiatric as well as gynecological