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Female genital mutilation: The abuse has to stop

Midwifery, 2014, 30, 277–278. DOI: http://dx.doi.org/10.1016/j.midw.2014.02.001

Female genital mutilation: The abuse has to stop

Bick D

ABSTRACT

Female genital mutilation (FGM) involves the partial or total removal of the female external genitalia or injury of the genitalia with no medical indication or resulting health benefit (World Health Organisation, 2008). It is a custom prevalent in sub-Saharan countries of Africa, with some countries including Egypt, the Sudan and Somalia estimated to have a FGM prevalence of around 90% (United Nations Children׳s Fund, 2013). More midwives and other health professionals in the UK and elsewhere are providing care and support for women who have sustained FGM as a consequence of increased migration from countries where FGM is practiced.

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Female genital mutilation: Knowledge, attitude and practices of Flemish midwives

Midwifery. 2014 Dec 8. pii: S0266-6138(14)00294-0. doi: 10.1016/j.midw.2014.11.012. [Epub ahead of print]

Female genital mutilation: Knowledge, attitude and practices of Flemish midwives.

Cappon S, L’Ecluse C, Clays E, Tency I, Leye E

ABSTRACT

BACKGROUND: health professionals in Belgium are confronted with female genital mutilation (FGM). To date, no survey to assess knowledge, attitudes and practices on FGM was conducted among midwives in the Northern region of Belgium. OBJECTIVE: the objective of this study was to assess the knowledge, attitude and practices of Flemish midwives regarding female genital mutilation (FGM). DESIGN: we used a quantitative design, using KAP study (semi-structured questionnaire). SETTING: labour wards, maternity wards and maternal intensive care units (MIC) in 56 hospitals in Flemish region of Belgium. PARTICIPANTS: 820 midwives, actively working in labour wards, maternity wards and maternal intensive care units (MIC). FINDINGS: 820 valid questionnaires (40.9%) were returned. More than 15% of the respondents were recently confronted with FGM. They were mostly faced with the psychological and sexual complications caused by FGM. Few respondents were aware of existing guidelines regarding FGM in their hospitals (3.5%). The results also showed that only 20.2% was aware of the exact content of the law. The majority of midwives condemned the harmful traditional practice: FGM was experienced as a form of violence against women or a violation of human rights. Only 25.9% declared that FGM forms a part of their midwifery program. The vast majority of respondents (92.5%) indicated a need for more information on the subject. KEY CONCLUSIONS: this study indicated that midwives in Flanders are confronted with FGM and its complications and highlighted the gaps in the knowledge of Flemish midwives regarding FGM. This may interfere with the provision of adequate care and prevention of FGM for the new-born daughter. IMPLICATIONS FOR PRACTICE: there is an important need for appropriate training of (student)midwives concerning FGM as well as for the development and dissemination of clear guidelines in Flemish hospitals.

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School nurses take lead on FGM.

Nurs Stand. 2014 Jul 1;28(43):22-3. doi: 10.7748/ns.28.43.22.s27.

School nurses take lead on FGM.

Trueland J.

ABSTRACT

Female genital mutilation is now recognised as an important public health issue in the UK, requiring action from nurses and midwives. School nurses in particular are being enlisted to identify and support girls at risk of FGM, and help teachers have the confidence to intervene. Every nurse needs to know how to support women living with the consequences of FGM.

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Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation: A review of global experience

Midwifery. 2014 Sep 6. pii: S0266-6138(14)00222-8. doi: 10.1016/j.midw.2014.08.012. [Epub ahead of print]

Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation: A review of global experience.

Dawson A, Turkmani S, Fray S, Nanayakkara S, Varol N, Homer C.

ABSTRACT

OBJECTIVE: to identify how midwives in low and middle income countries (LMIC) and high income countries (HIC) care for women with female genital mutilation (FGM), their perceived challenges and what professional development and workplace strategies might better support midwives to provide appropriate quality care.

DESIGN: an integrative review involving a narrative synthesis of the literature was undertaken to include peer reviewed research literature published between 2004 and 2014.

FINDINGS: 10 papers were included in the review, two from LMIC and eight from HIC. A lack of technical knowledge and limited cultural competency was identified, as well as socio-cultural challenges in the abandonment process of the practice, particularly in LMIC settings. Training in the area of FGM was limited. One study reported the outcomes of an education initiative that was found to be beneficial.

KEY CONCLUSIONS: professional education and training, a working environment supported by guidelines and responsive policy and community education, are necessary to enable midwives to improve the care of women with FGM and advocate against the practice.

IMPLICATIONS FOR PRACTICE: improved opportunities for midwives to learn about FGM and receive advice and support, alongside opportunities for collaborative practice in contexts that enable the effective reporting of FGM to authorities, may be beneficial and require further investigation.

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A multicentre study on knowledge and attitude of nurses in northern Nigeria concerning female genital mutilation

Eur J Contracept Reprod Health Care. 2014 Apr;19(2):134-40. doi: 10.3109/13625187.2014.885940. Epub 2014 Mar 6.

A multicentre study on knowledge and attitude of nurses in northern Nigeria concerning female genital mutilation.

Ashimi A, Aliyu L, Shittu M, Amole T.

ABSTRACT

Objective To determine the knowledge and attitude of nurses in northern Nigeria concerning female genital mutilation (FGM). Methods Cross-sectional study in which 350 nurses working in three tertiary health institutions in northern Nigeria were assessed, using a self-administered questionnaire, with regard to their knowledge of, and attitude to, FGM.

Results Two hundred and sixty-five respondents (76%) were female, 190 (54%) were married. Most (249; 71%) were Muslims, and 228 (65%), of Hausa/Fulani ethnicity. Their ages ranged from 18-60 years with a mean of 29.3 ± 8.9. Among the respondents, 318 (91%) had heard of FGM; of these 127 (40%) knew no particular type of FGM. Only 155 (49%) could identify ‘Angurya’ and ‘Gishiri’ cuts as forms of FGM. Two hundred and forty-five (77%), 231 (73%) and 200 (63%), respectively, identified haemorrhage; risk of HIV, hepatitis, and tetanus; and painful sexual intercourse as possible complications of FGM. Thirteen (4%) would perform it and also would have it done on their daughters.

Conclusion The nurses studied had a high level of awareness of FGM and a good general knowledge of complications associated with FGM. However, only half knew what ‘Angurya’ and ‘Gishiri’ cuts were. A few would perform FGM.

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Increasing certified nurse-midwives’ confidence in managing the obstetric care of women with female genital mutilation/cutting.

J Midwifery Womens Health. 2013 Jul;58(4):451-6. doi: 10.1111/j.1542-2011.2012.00262.x.

Increasing certified nurse-midwives’ confidence in managing the obstetric care of women with female genital mutilation/cutting.

Jacoby SD, Smith A.

INTRODUCTION: In response to an increase in the number of women who immigrate to the United States from countries that practice female genital mutilation/cutting (FGM/C; infibulation), US clinicians can expand their knowledge and increase confidence in caring for women who have experienced infibulation. This article describes a comprehensive education program on FGM/C and the results of a pilot study that examined its effect on midwives’ confidence in caring for women with infibulation.

METHODS: An education program was developed that included didactic information, case studies, a cultural roundtable, and a hands-on skills laboratory of deinfibulation and repair. Eleven certified nurse-midwives (CNMs) participated in this pilot study. Participants completed a measure-of-confidence survey tool before and after the education intervention.

RESULTS: Participants reported increased confidence in their ability to provide culturally competent care to immigrant women with infibulation when comparisons of preeducation and posteducation survey confidence logs were completed.

DISCUSSION: Following the education program and the knowledge gained from it, these midwives were more confident about their ability to perform anterior episiotomy and to deliver necessary care to women with FGM/C in a culturally competent context. This education program should be expanded as more women who have experienced infibulation immigrate to the United States.

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The Impact of Female Genital Cutting on First Delivery in Southwest Nigeria

Stud Fam Plann. 2002 June 33(2):173–184

The Impact of Female Genital Cutting on First Delivery in Southwest Nigeria

Slanger TE, Snow RC, Okonofua FE

ABSTRACT

To date, data linking obstetric morbidity to female genital cutting in populations with less severe types of cutting have been limited to case reports and speculation. In this cross-sectional study, 1,107 women at three hospitals in Edo State, Nigeria, reported on their first-delivery experiences. Fifty-six percent of the sample had undergone genital cutting. Although univariate analyses suggest that genital cutting is associated with delivery complications and procedures, multivariate analyses controlling for sociodemographic factors and delivery setting show no difference between cut and noncut women’s likelihood of reporting first-delivery complications or procedures. Whereas a clinical association between genital cutting and obstetric morbidity may occur in populations that have undergone more severe forms of cutting, in this setting, apparent associations between cutting and obstetric morbidity appear to reflect confounding by social class and by the conditions under which delivery takes place.

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The encounters that rupture the myth: contradictions in midwives´descriptions and explanations of circumcised women immigrants´sexuality

Health Care Women Int. 2004 25(8): 743-760. 10.1080/07399330490475593

The encounters that rupture the myth: contradictions in midwives´descriptions and explanations of circumcised women immigrants´sexuality

Leval A, Widmark C, Tishelman C, Ahlberg BM

ABSTRACT

The purpose of the study was to analyze how Swedish midwives (n = 26) discuss sexuality in circumcised African women patients. In focus groups and interviews, discussions concentrated on care provided to circumcised women, training received for this care, and midwives’ perceptions of female circumcision. An analytic expansion was performed for discussions pertaining to sexuality and gender roles. Results from the analysis show the following: (1) ethnocentric projections of sexuality; (2) a knowledge paradox regarding circumcision and sexuality; (3) the view of the powerless circumcised women; and (4) the fact that maternity wards function as meeting places between gender and culture where the encounters with men allow masculine hegemonic norms to be ruptured. We conclude that an increased understanding of cultural epistemology is needed to ensure quality care. The encounters that take place in obstetrical care situations can provide a space where gender and culture as prescribed norms can be questioned.

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Female genital mutilation: a global and local concern.

Pract Midwife. 2010 Apr;13(4):12-4.

Female genital mutilation: a global and local concern.

Momoh C.

Guy’s and St. Thomas’s NHS Foundation Trust.

No LINK is available to view this article online.

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More current issues for midwives.

J Fam Health Care. 2010;20(5):166-8, 170-3.

More current issues for midwives.

Edmondson L.

There is no available abstract for this article.

No LINK is available to view this article online.