Female Genital Mutilation Flashcards
what is female genital mutilation?
Female Genital Mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for cultural or non-medical reasons
what are the types of FGM?
Type 1 – Clitoridectomy: partial or total removal of the clitoris and, in very rare cases, only the prepuce
Type 2 – Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora
Type 3 – Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris. Sometimes referred to as Pharaonic circumcision. (most radical and gives problems with child birth)
Type 4 – Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterising the genital area.
what is De-infibulation?
De-infibulation (sometimes known as or referred to as deinfibulation or defibulation or FGM reversal): The surgical procedure to open up the closed vagina of FGM type 3
De-infibulation, or FGM reversal, is perhaps most likely to come up in maternity or sexual health clinics but may also be raised in support work elsewhere
Women with type 3 FGM will be offered deinfibulation. This should be carried out between 20 and 36 weeks however, some women may prefer to have it done when they are in labour as they are already in pain. In this instance it should be done during first stage
what is Re-infibulation?
Re-infibulation (sometimes known as or referred to as reinfibulation or re-suturing): The re-stitching of FGM type 3 to re-close the vagina again after childbirth
Re-infibulation is illegal in the UK as it constitutes FGM
Just because a woman has been de-infibulated prior to the birth of her baby does not mean that she does not need to be examined in subsequent pregnancies or that the subject does not need to be raised when she returns for booking
what are the preffered terms for FMG?
The legislation refers to Female Genital Mutilation, and strategic and policy work should use this term
FGM is also known as cutting, and sometimes referred to as female circumcision. These terms are likely to be more recognisable to women in communities and are often used whilst inquiring about this health issue
Whenever possible information should be given about the term Female Genital Mutilation and about the law in Scotland which protects girls and women
what are some justifications for FGM?
The main reason now given for carrying out FGM is social acceptance or, conversely, fear of social exclusion.
Preservation of virginity and chastity
Religion, in the mistaken belief that it is a religious requirement
Social acceptance
Fear of social exclusion
To ensure the girl is marriageable or to improve marriage prospect
Hygiene and cleanliness
Increasing sexual pleasure for the male
Family honour
Enhancing fertility
what is the prevelance of FGM in Africa?
Nationality is usually seen as a main indicator of potential risk of FGM, however it is more accurate to say that FGM is carried out by ethnic groups rather than by nationalities
Highlight that not every woman from an FGM practicing community will have had FGM and not every woman who has been cut will support the practice, ethnicity is one indicator of potential risk there are other factors to consider, including educational and socio-economical background, age and in some communities, religion
what is the prevelance of FGM around the world?
As a result of immigration and refugee movements, FGM is now potentially being practiced by ethnic minority populations in other parts of the world as is illustrated above
what are the short term impacts of FGM?
severe pain and shock
infection
injury to adjacent tissues
sprains, dislocations, broken bones or internal injuries from being restrained
immediate fatal haemorrhaging
infection by blood borne virus
what are the long term impacts of FGM?
These are possible impacts – not all women will experience all of these. Some women have no health issues associated with the FGM
urine retention and difficulties in menstruation
uterus, vaginal and pelvic infections
cysts and neuromas
complications in pregnancy and childbirth
increased risk of fistula
on-going impact of trauma / PTSD
sexual dysfunction
Negative impacts can include additional psycho-sexual and psychological issues and also social consequences such as estrangement from parents/family, and relationship or marriage breakdown
F.G.M.and the Law:
FGM has been an offence in the UK since 1985.
Prohibition of Female Genital Mutilation (Scotland) Act 2005
what is the law?
Offence of female genital mutilation
(1) A person who performs an action mentioned in subsection
(2) in relation to the whole or any part of the labia majora, labia minora, prepuce of the clitoris, clitoris or vagina of another person is guilty of an offence.
(2) Those actions are:
- excising it;
- infibulating it; or
- otherwise mutilating it
As noted earlier it is an offence in the UK to re-infibulate a woman following childbirth
3) Aiding and abetting female genital mutilation
A person who aids, abets, counsels, procures or incites:
- a person to commit an offence under section 1;
- another person to perform an action mentioned in section 1(2) in relation to the whole or any part of that other person’s own labia majora, labia minora, prepuce of the clitoris, clitoris or vagina; or
- a person who is not a United Kingdom national or permanent United Kingdom resident to do a relevant act of genital mutilation outside the United Kingdom, commits an offence
what are the key risk factors of FGM?
Mother has had F.G.M.
The girl should be viewed as at increased risk if:
- an older sister or cousins have undergone FGM
- the mother (and/or father) has requested re-infibulation following delivery
- the parents express views which show that they value the practice
- The girl is withdrawn from all teaching classes on Personal, Social or Health Education
The level of integration within UK society is also significant. It is believed that communities less integrated into British society are more likely to carry out FGM
what is the National Guidance for Child Protection in Scotland (2014)?
Female genital mutilation should always be seen as a cause of significant harm and normal child protection procedures should be invoked
Where a child or young person within a family has already been subjected to female genital mutilation, consideration must be given to other female siblings or close relatives who may also be at risk
Local guidelines should be in place to ensure a coordinated response from all agencies and highlight the issue for all staff who may come into contact with children who are at risk from female genital mutilation
Finally…
- You can make a difference
- Be sensitive, non judgemental
- Be confident in asking, straight forward questions, simple language
- Be mindful the woman may not view FGM as abuse
- Be clear that FGM is illegal and that the law can be used to help families here in the UK
