FGM

Question 1

Incidence of FGM/C?

Answer 1

100-140 million women world wide

Question 2

Types of FGM/C?

Answer 2

*Type I
-Total Clitoridectomy

*Type II
-Excision of labia minora and or majora

*Type III
-Infibulation- cutting and sewing labia minora to narrow vaginal opening.

*Type IV
-Piercing or cauterisation of vulva

Question 3

How would you manage a patient requesting FGM/C for their child?

Answer 3

*Seek information- respectful & empathetic inquiry into cultural practices, understanding of risks.

*Patient safety maintenance

*Inform with compassion- FGM/C is illegal in Australia and is a reportable criminal offence, also illegal to remove a person internationally to perform FGM/C.

*Escalate to appropriate senior colleague.

*Support patient with MDT referrals including to social work and psychology.
DDRRR

Question 4

How would you manage a woman in ANC planning delivery with FGM/C?

Answer 4

*Seek information with Culturally sensitive and compassionate care approach

• Patient safety maintenance- check for FDV, external pressures, personal concern, reassure of confidentiality.

*Inform: Modes of delivery discussion including offering de-infibulation if desired (inform that re-infibulation will not be possible as it is a criminal offence). Vaginal vs c/s options.

*Escalation to SR/Obstetrician

*Supportive care including referrals to psych and social work, community based support programs for FGM/C affected persons.

*DDRRR

Question 5

What are some Complications of FGM/C?

Answer 5

*Immediate:
-Severe pain
-Shock
-Haemorrhage
-Tetanus
-Sepsis
-Urine retention
-Open sores in genital region
-Injury to nearby genital tissue

*Long term:
-Dysuria
-Implantation cysts
-Dyspareunia
-Recurrent UTI’s
-Recurrent vaginal infections
-Dysmenorrhea
-PID
-Infertility
-Difficulty in pregnancy and child birth
-Psychological and Psychosexual morbidity