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Archives Blog Original research

Female genital mutilation: an injury, physical and mental harm.

J Psychosom Obstet Gynaecol. 2008 Dec;29(4):225-9.

Female genital mutilation: an injury, physical and mental harm.  

Utz-Billing I, Kentenich H.

Department of Gynaecology and Obstetrics, DRK-Hospital Westend, Berlin, Germany.  isabell.utz@drk-kliniken-berlin.de

This article gives an overview over the huge topic of ‘female genital mutilation’ (FGM). FGM means non-therapeutic, partial or complete removal or injury of each of the external female genitals. It concerns about 130 million women around the world. FGM is performed in about 30 countries, most of which are located in Africa. Four types of FGM are distinguished: type I stands for the removal of the clitoral foreskin, type II means the removal of the clitoris with partial or total excision of the labia minora. Type III is the extreme type of FGM. Not only the clitoris but also the labia minora and majora were removed. The orificium vaginae is sewn up, leaving only a small opening for urine or menstruation blood. Other types like pricking, piercing of clitoris or vulva, scraping of the vagina, etc. were defined as type IV of FGM. The mentioned reasons for FGM are: encouragement of the patriarchal family system, method for birth control, guarantee of moral behaviour and faithfulness to the husband, protection of women from suspicions and disgrace, initiation ritual, symbol of feminity and beauty, hygienic, health and economic advantages. Acute physical consequences of FGM include bleeding, wound infections, sepsis, shock, micturition problems and fractures. Chronic physical problems like anemia, infections of the urinary tract, incontinence, infertility, pain, menstruation problems and dyspareunia are frequent. Women also have a higher risk for HIV infections. During pregnancy and  delivery, examinations and vaginal application of medicine are more difficult. Women have a higher risk for a prolonged delivery, wound infections, a postpartum blood loss of more than 500 mL, perineal tears, a resuscitation of the infant and an inpatient perinatal death. Mental consequences after FGM include the feelings  of incompleteness, fear, inferiority and suppression. Women report chronic irritability and nightmares. They have a higher risk for psychiatric and psychosomatic diseases. FGM carried out by doctors, nurses or midwives is also called medicalisation of FGM and is definitely unacceptable. Regarding human rights, FGM refuses women the right of freedom from bodily harm. Specific laws that ban FGM exist in many countries in Europe, Africa, USA, Canada, New Zealand  and Australia.

This article can be accessed in this LINK

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Archives Blog Review

The consequences of female circumcision for health and sexuality: an update on the evidence.

Cult Health Sex. 2005 Sep-Oct;7(5):443-61.

The consequences of female circumcision for health and sexuality: an update on the evidence.

Makhlouf Obermeyer C.

Department of Population and International Health, Harvard University, Boston, MA 02115, USA. coberm@hsph.harvard.edu

Abstract

This systematic review of published sources between 1997 and 2005 shows that female circumcision is associated with some health consequences but that no statistically significant associations are documented for a number of health conditions. This is in part a result of the difficulty of designing studies on the more extensive operations (infibulation). The findings of the analysis can be summarized as follows: statistically higher risks are documented for some but not all types of infections; the evidence regarding urinary symptoms is inconclusive; the evidence on obstetric and gynecological complications is mixed: increased risks have been reported for some complications of labour and delivery but not others, and for some symptoms such as abdominal pain and discharge, but not others such as infertility or increased mortality of mother or infant. Concerning sexuality, most of the existing studies suffer from conceptual and methodological shortcomings, and the available evidence does not support the hypotheses that circumcision destroys sexual function or precludes enjoyment of sexual relations. This review highlights the difficulties of research on the health and sexuality consequences of FGC, underscores the importance of distinguishing between more and less extensive operations, and emphasizes the need to go beyond simple inventories of physical harm or frequencies of sexual acts.

This article can be purchased in this LINK

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Archives Blog Original research

Health consequences of female genital mutilation/cutting in the Gambia, evidence into action.

Reprod Health. 2011 Oct 3;8:26.

Health consequences of female genital mutilation/cutting in the Gambia, evidence into action.

Kaplan A, Hechavarría S, Martín M, Bonhoure I.

Cátedra de Transferencia del Conocimiento/Parc de Recerca UAB-Santander, Departamento de Antropología Social y Cultural, Universitat Autònoma de Barcelona, Barcelona, Spain. adriana.kaplan@uab.cat

ABSTRACT

BACKGROUND:

Female Genital Mutilation/Cutting (FGM/C) is a harmful traditional practice with severe health complications, deeply rooted in many Sub-Saharan African countries. In The Gambia, the prevalence of FGM/C is 78.3% in women aged between 15 and 49 years. The objective of this study is to perform a first evaluation of the magnitude of the health consequences of FGM/C in The Gambia.

METHODS:

Data were collected on types of FGM/C and health consequences of each type of FGM/C from 871 female patients who consulted for any problem requiring a medical gynaecologic examination and who had undergone FGM/C in The Gambia.

RESULTS:

The prevalence of patients with different types of FGM/C were: type I, 66.2%; type II, 26.3%; and type III, 7.5%. Complications due to FGM/C were found in 299 of the 871 patients (34.3%). Even type I, the form of FGM/C of least anatomical extent, presented complications in 1 of 5 girls and women examined.

CONCLUSION:

This study shows that FGM/C is still practiced in all the six regions of The Gambia, the most common form being type I, followed by type II. All forms of FGM/C, including type I, produce significantly high percentages of complications, especially infections.

This article is open source in LINK