Female Genital Cutting: Impact on Women's Health

Abstract

More than 130 million women worldwide have undergone female genital cutting (FGC). FGC is practiced in parts of Africa and Asia, in societies with various cultures and religions. Reasons for the continuing practice of FGC include rite of passage, preserving chastity, ensuring marriageability, religion, hygiene, improving fertility, and enhancing sexual pleasure for men. The World Health Organization has classified FGC into four types depending on the extent of tissue removed. Immediate complications include hemorrhage, infection, sepsis, and death. Long-term complications include pain, scarring, urinary issues, and poor obstetric and neonatal outcomes. Efforts are being made nationally and internationally to eradicate this practice. In December 2012, the UN General Assembly accepted a resolution on the elimination of FGC. Although it is illegal to perform FGC in the United States, women from countries where the practice occurs have been and are still immigrating here. Many enter as refugees from war-torn, famine-stricken, or politically unstable countries. They bring along with them their cultural pride, health complications, and fears of being judged when visiting a health provider. A deeper understanding of the history, cultural beliefs, medical complications, and methods of surgical reconstruction is necessary to provide culturally and linguistically competent care to this unique group of women.

Keywords

female genital cutting - mutilation - circumcision

• References

• 1 World Health Organization. Female genital mutilation. A joint WHO/UNICEF/UNFPA statement. Geneva: WHO; 1997
• 2 Jones WK, Smith J, Kieke Jr B, Wilcox L. Female genital mutilation. Female circumcision. Who is at risk in the U.S.?. Public Health Rep 1997; 112 (5) 368-377
• 3 Brigham and Women's Hospital. African Women's Health Center. http://www.brighamandwomens.org/Departments_and_Services/obgyn/services/africanwomenscenter/research.aspx . Accessed January 31, 2014
• 4 World Health Organization. http://www.who.int/mediacentre/factsheets/fs241/en/index.html . Accessed on November 12, 2014
• 5 American College of Obstetricians and Gynecologists. Female Genital Cutting: Clinical Management of Circumcised Women. 2nd ed. Washington, DC: ACOG; 2008
• 6 United Nations Children's Fund. Female Genital Mutilation/Cutting: A Statistical Overview and Exploration of the Dynamics of Change. New York, NY. UNICEF; 2013. Available at: http://www.unicef.org/media/files/FGCM_Lo_res.pdf . Accessed on November 13, 2014
• 7 Cook RJ, Dickens BM, Fathalla MF. Female genital cutting (mutilation/circumcision): ethical and legal dimensions. Int J Gynaecol Obstet 2002; 79 (3) 281-287
• 8 Herieka E, Dhar J. Female genital mutilation in the Sudan: survey of the attitude of Khartoum university students towards this practice. Sex Transm Infect 2003; 79 (3) 220-223
• 9 Nour NM. Female genital cutting: clinical and cultural guidelines. Obstet Gynecol Surv 2004; 59 (4) 272-279
• 10 Banks E, Meirik O, Farley T, Akande O, Bathija H, Ali M. WHO study group on female genital mutilation and obstetric outcome. Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. Lancet 2006; 367 (9525) 1835-1841
• 11 Nour NM. Urinary calculus associated with female genital cutting. Obstet Gynecol 2006; 107 (2, Pt 2) 521-523
• 12 Thabet SM, Thabet AS. Defective sexuality and female circumcision: the cause and the possible management. J Obstet Gynaecol Res 2003; 29 (1) 12-19
• 13 Chalmers B, Hashi KO. 432 Somali women's birth experiences in Canada after earlier female genital mutilation. Birth 2000; 27 (4) 227-234
• 14 Lightfoot-Klein H, Shaw E. Special needs of ritually circumcised women patients. J Obstet Gynecol Neonatal Nurs 1991; 20 (2) 102-107
• 15 Stewart H, Morison L, White R. Determinants of coital frequency among married women in Central African Republic: the role of female genital cutting. J Biosoc Sci 2002; 34 (4) 525-539
• 16 Okonofu FE, Larsen U, Oronsaye F, Snow RC, Slanger TE. The association between female genital cutting and correlates of sexual and gynaecological morbidity in Edo State, Nigeria. BJOG 2002; 109 (10) 1089-1096
• 17 Nour NM, Michels KB, Bryant AE. Defibulation to treat female genital cutting: effect on symptoms and sexual function. Obstet Gynecol 2006; 108 (1) 55-60