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Interventions for improving outcomes for pregnant women who have experienced genital cutting.

Cochrane Database Syst Rev. 2013 Feb 28;2:CD009872. doi: 10.1002/14651858.CD009872.pub2.

Interventions for improving outcomes for pregnant women who have experienced genital cutting.

Balogun OO, Hirayama F, Wariki WM, Koyanagi A, Mori R.

Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

BACKGROUND: Female genital cutting (FGC) refers to all procedures that involve the partial or total removal of the external female genitalia, or other injury to the female genital organs for cultural or other non-therapeutic reasons. There are no known medical benefits to FGC, and it can be potentially dangerous for the health and psychological well-being of women and girls who are subjected to the practice resulting in short- and long-term complications. Health problems of significance associated with FGC faced by most women are maternal and neonatal mortality and morbidity, the need for assisted delivery and psychological distress. Under good clinical guidelines for caring for women who have undergone genital cutting, interventions could provide holistic care that is culturally sensitive and non-judgemental to improve outcomes and overall quality of life of women. This review focuses on key interventions carried out to improve outcome and overall quality of life in pregnant women who have undergone FGC.

OBJECTIVES: To evaluate the impact of interventions to improve all outcomes in pregnant women or women planning a pregnancy who have undergone genital cutting. The comparison group consisted of those who have undergone FGC but have not received any intervention.

SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (31 December 2012) and organisations engaged in projects regarding FGC.

SELECTION CRITERIA: Randomised controlled trials (RCTs), cluster-randomised trials or quasi-RCTs with reported data comparing intervention outcomes among pregnant women or women planning a pregnancy who have undergone genital cutting compared with those who did not receive any intervention.

DATA COLLECTION AND ANALYSIS: We did not identify any RCTs, cluster-randomised trials or quasi-RCTs.

MAIN RESULTS: There are no included studies.

AUTHORS’ CONCLUSIONS: FGC research has focused mainly on observational studies to describe the social and cultural context of the practice, and we found no intervention trials conducted to improve outcomes for pregnant women presenting with complications of FGC. While RCTs will provide the most reliable evidence on the effectiveness of interventions, there remains the issue of what is considered ethically appropriate and the willingness of women to undergo randomisation on an issue that is enmeshed in cultural traditions and beliefs. Consequently, conducting such a study might be difficult.

This review can be accessed in this LINK