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Obstetric management of women with female genital mutilation

^1. James Paget University Hospital NHS Healthcare Trust Gorleston, Great Yarmouth, Norfolk, NR31 6LA, UK Email: mumtaz.rashid{at}jpaget.nhs.uk (corresponding author)
^2. Imperial College School of Medicine London, SW7 2AZ, UK

Key content:

• Female genital mutilation is the partial or total removal of the female genitalia for non-medical reasons.
  
• The practice is illegal in the United Kingdom.
  
• It is estimated that one woman dies every 10 minutes from the sequelae of the procedure.
  
• Healthcare professionals require adequate training in the clinical management of women with this condition and they also need to demonstrate great cultural sensitivity.
  
• In types III and IV the narrowed vaginal opening is likely to cause obstetric problems.
  
• Defibulation prepregnancy is the most desirable option, failing which it may be carried out antenatally or during early labour (less desirable options).
  

Learning objectives:

• To know about the practice of female genital mutilation, different types of mutilation procedures and associated medical complications.
  
• To learn about the obstetric complications and childbirth experience of women with the condition in the developed world.
  
• To understand how delivery of obstetric services in the UK for women with genital mutilation could be improved.
  
• To understand the ethical and child protection issues associated with the practice.
  

Ethical issues:

• Female genital mutilation is a violation of universal human rights.
  
• The procedure is regarded as a form of child abuse but not given the same recognition on the grounds that it is carried out with the best intentions for the future welfare of the child.
  
• Is it right to impose a Western concept of justice, which outlaws female genital mutilation, on a society where the practice is widely accepted?
  

Please cite this article as: Rashid M, Rashid MH. Obstetric management of women with female genital mutilation. The Obstetrician & Gynaecologist 2007;9:95–101.

Keywords defibulation / female genital mutilation / infibulation