Female genital mutilation

Question 1

What is FGM?

Answer 1

Surgically changing the genitals of a female for non-medical reasons
Cultural practice

Question 2

When does FGM occur?

Answer 2

Girls before puberty

Question 3

Which countries commonly practice FGM?

Answer 3

African countries - Somalia, Ethiopia, Sudan and Eritrea

Question 4

Name the act that talks about FGM

Answer 4

Female genital mutilation act 2003

Question 5

What does the FGM act 2003 say about FGM

Answer 5

Illegal
Safe guarding issue
Child abuse
Legal requirement for HCPs to report this to the police

Question 6

List and describe the 4 types of FGM

Answer 6

Type 1 - removal of part or all of the clitoris

Type 2 - Removal of part or all of the clitoris and labia minora. Labia majora may be removed

Type 3 - narrowing or closing the vaginal orifice (infundibulation)

Type 4 - All other unnecessary procedures to the female genitalia

Question 7

What are the two main risk factors of FGM

Answer 7

Being from a community that practise FGM

Having relatives affected by FGM

Question 8

List the immediate complications of FGM

Answer 8

Pain
Bleeding
Infection
Swelling
Urinary retention
Urethral damage and incontience

Question 9

List the long term complications of FGM

Answer 9

Vaginal infections - BV
Pelvic infections
Uriary tract infections
Dysmenorrhoea
Sexual dysfunction and dyspareunia
Infertility and pregnancy related complication
Significant psychological issues and depression
Reduction in engagement with healthcare and screening

Question 10

Describe the management of FGM

Answer 10

Educate patients and relatives that FGM is illegal in the UK
Discuss the health consequences of FGM

Mandatory to report all cases of FGM <18 to police

Other services - social services and safeguarding, paediatrics, specialist gynaecology or FGM services, counselling

In patients >18, there needs to be careful consideration about whether to report cases to the police or social services. Risk assessment includes considering whether the patient has female relatives at risk or if an unborn child of a pregnant woman affected by FGM is at risk

De-infibulation surgical procedure - to correct the narrowing or closure of the vaginal orifice, improve symptoms and try to restore normal function

Question 11

Is re-infibulation allowed?

Answer 11

No

Illegal