Female genital mutilation and female genital schistosomiasis-bourouwel, the worm: Traditional belief or medical explanation for a cruel practice?
Wacker J, Zida A, Sitz C, Schweinfurth D, Briegel J
Female genital mutilation (FGM), defined as the partial or total removal of the external female genitalia for ritual or religious reasons, is routinely practised by ethnic groups in more than 20 countries across the North African savannah as well as in Egypt, the southern part of the Arab peninsula, Malaysia and Indonesia. The total number of women mutilated has been estimated 100–140 million (WHO, 2008; cf. 85–115 million: Dehne et al., 1997). In Africa, three million young women are at risk to be circumcised annually (WHO, 2008).
Maternal infibulation and obstetrical outcome in Djibouti.
Minsart AF, N’guyen TS, Hadji RA, Caillet M.
The objective of the present study was to assess the relation between female genital mutilation and obstetric outcome in an East African urban clinic with a standardized care, taking into account medical and socioeconomic status. Methods This was a cohort study conducted in Djibouti between October 1, 2012 and April 30, 2014. Overall 643 mothers were interviewed and clinically assessed for the presence of female genital mutilation. The prevalence of obstetric complications by infibulation status was included in a multivariate stepwise regression model. Results Overall, 29 of 643 women did not have any form of mutilation (4.5%), as opposed to 238 of 643 women with infibulation (37.0%), 369 with type 2 (57.4%), and 7 with type 1 mutilation (1.1%).Women with a severe type of mutilation were more likely to have socio-economic and medical risk factors. After adjustment, the only outcome that was significantly related with infibulation was the presence of meconium-stained amniotic fluid with an odds ratio of 1.58 (1.10-2.27), p-value=0.014. Conclusions Infibulation was not related with excess perinatal morbidity in this setting with a very high prevalence of female genital mutilation, but future research should concentrate on the relation between infibulation and meconium.
Lancet. 2008 Mar 15;371(9616):879-81. doi: 10.1016/S0140-6736(08)60393-1.
Maternal deaths and vulnerable migrants.
Reaching Out Project, Medact, London N1 6HT, UK. firstname.lastname@example.org
Media coverage of the recent UK Confidential Enquiry into Maternal and Child Health (CEMACH) report focused on the risks associated with obesity, but largely ignored the findings about vulnerable migrants. Maternal mortality is six times higher for black African women and four times higher for black Caribbean women than for white women in the UK. Although some of the causes are understood, there are new factors that warrant further investigation.
Unsatisfactory arrangements for interpretation and lack of awareness of female genital cutting are documented in the report. Five women who were murdered by their partners had the abusive partner as their interpreter. For one woman, late identification of genital cutting led to an unnecessary caesarean section and may have directly contributed to her death. Migration from countries in which the practice is common has led to increased prevalence of genital cutting among pregnant women in the UK…
Being different and vulnerable: experiences of immigrant African women who have been circumcised and sought maternity care in Sweden.
Berggren V, Bergström S, Edberg AK. Karolinska Institute, Sweden.
The purpose of the study was to explore the encounters with the health care system in Sweden of women from Somalia, Eritrea, and Sudan who have been genitally cut. A qualitative study was performed through interviews with 22 women originally from Somalia, Sudan, and Eritrea who were living in Sweden. The women experienced being different and vulnerable, suffering from being abandoned and mutilated, and they felt exposed in the encounter with the Swedish health care personnel and tried to adapt to a new cultural context. The results of this study indicate a need for more individualized, culturally adjusted care and support and a need for systematic education about female genital cutting for Swedish health care workers.