FGM Flashcards
What is FGM
Compromises all procedures that involve partial or total removal of the external female genitalia or other injury of the fetal Venetia l organs from non medical reasons
- illegal in uk
-Sever form of violence to women and girls
-Human rights violation
- Child abuse
Type 1
Partial or complete removal of the clitoris and/or the prepuce
Type 2
Partial or total removal of the clitoris and labia minors with or without the excision of the labia majora
Type 3
Infibulation - a narrowing of vaginal orifice by the creation of a covering seal by cutting and apposition of the labia minors and or the majora with or without excision of the labia
The 4
Other harmful procedure to the female genitalia, done for non medical purposes: pricking, piercing, incising, burning, scraping and cauterising for the purpose f tightening or narrowing the orifice
Why is it carried out
Cultural identity
Social compulsion
Rites of passage
Marriageability
Marital fidelity
Aesthetics
Prevalence rates
Most commonly seen in women and girls from Somalia,Eritrea, Mali, Sudan, Ethiopia, Sierra Leone and Nigeria
4.7% in some London boroughs
1.6% in Birmingham, Bristol, slough and Manchester
0.7% in Oxford
Language of fgm
Closed
Smooth
Cutting
Mutilation
Circumcision
Sunna, gudniin,Halalays, tahur,merges,khitan
The law
Illegal in the uk
Prohibition of femal circumision act 1985
Female genetically mutilation act 2003
Serious crimes act 2015
Illegal to carry out re- infibulation of the vagina
Illegal for uk nationals or permanent resident too carry out FG, abroad, or to aid, abet,counsel or procure the procedure eve if legal in those countries
Offence for those with parental responsibility to fail to protect a girl from the risk of FGM = up to 14 years in prison
Safeguarding and reporting
Use the DOH FGM assessment tool/document to help you make the decision whether the unborn female child is at risk
Consider the need for reporting
Use an interpreter
Reporting - red
Reasonable cause to suspect that a child/unborn is suffering or is likely to suffer, significant harm
Rating - immediate risk to baby and or siblings to include postnatal period, women id term 37/>40wks with new safeguarding concern, immediate referral to social care
Reporting - amber
A child/unborn whose health and development is likely to be significantly or further impaired without the provision of services
Rating: safeguarding concerns identified in pregnancy, no immediate risk of siblings, complete referral to social care within 1 week f identifying concern
Reporting - green
Information that identifies a previous or potential concern, but not identified as a current safeguarding these cases will need to be monitored with clear handover to health visiting team and other relevant services
Rating: complete A form referral for info only - not to be sent to social care within 1 week
Complications from FGM - immediate
Haemorrhage
Severe pain
Shock
Urine retention
Injury to adjacent tissues
Fractures or dislocation of pelvic/hip
Septicaemia
Death
Life long complications for FGM
Regular UTI/kidney infection
Prolonged and painful menstruation
Sexual dysfunction
Dyspareunia
Buildup of me se blood - infections
Acute/chronic pelvic infection
Infertility
Increased chance hep b, C and HIV
Obstructed birth
Antenatal considerations
Deinfibulation
A surgical procedure carried out to re open the vaginal intro it’s following type 2 FGM informed consent for defibulation in the antenatal period or 1sr/2nd stage of labour done with adequate pain relief
- scar tissue to be cut
- midline incision to expose the urethra
- haemostatic stutces after defibulation
Referral
If a woman retires intrapartum de-infibulation the midwife and obstruction caring for her should have completed training in de-infibulation or should be supervised appropriately
Ideally defibulation is performed at 20 weeks. Minor procedure that can be done with local or spinal anaestethic as required by the specialist FGM nominated consultant or midwife
Non disclosure of FGM - therefore alll midwives should be able to carry out an emergency defibulation
Additional needs in labour
Respectful sensitive and non judgemental care
Women with FGM have a higher incidence of -
- prolonged labour leading to an instrumental birth
- emergency c section
- PPH
Extended maternal hospital stay
- increased resuscitation of the baby
- perinatal death
- urinary retention and bladder trauma
- PTSD and flashback
