FGM Flashcards
What is FGM?
All procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs for non-medical purposes.
FGM=F circumcision=F genital cutting=F genital surgery
What is type 1 FGM?
Excision of prepunce with or without part of entire of clitoris
What is type 2 FGM?
Excision of whole or part of labia minora or majora
What is type 3 FGM?
Excision of whole or part of external genitalia with narrowing of the vaginal opening = Infibulation
What is type 4 FGM?
Unclassified e.g. pricking, incising or piercing of clitoris; burning, corrosive substances, within or around cuts
Where did FGM originate?
Ancient Egypt
Which countries still practice FGM?
Africa, middle East, India, Malaysia, Indonesia
What are the possible reasons behind FGM?
Not religious. Tradition and social acceptability Rite of passage into womanhood Hygiene Marriageability and preserves purity Reduced female libido and sexual activity Increased pleasure for men
How is FGM traditionally carried out?
With unsterile equipment, homemade sutures and adhesives and leg binding to stop bleeding
How is FGM being medicalised?
HCP are making money by doing the procedure with the provision of antibiotics and pain relief so that they are more likely to use them than traditional circumcisers.
What does FGM violate?
Child protection issue
Violation of right to protection - children should have the opportunity to develop physically in a healthy way, receive adequate medical attention and be protected from all forms of violence, injury and abuse.
Why is FGM not being detected in the UK?
Child is unlikely to tell on their parent.
Instruments are being brought from abroad.
The event has usually already happened a long time ago by the time it comes to a HCP attention.
Who experiences FGM?
Girls from infancy to 15yrs
What is the issue with FGM?
It permanently alters and injures the genitalia for non-medical reasons with no health benefits, but carries a risk of death or poor QoL
What are the immediate implications of FGM?
Pain Haemorrhage Fractures from resisting Infection Urinary retention Shock - hypovolaemic or sepsis Death
What are the long term complications of FGM?
Dysmenorrhoea, dyspareunia, apareunia Coital lacerations Difficulty conceiving Genital fistula and labial fusion Keloids (fibrous tissue from abnormal healing) Sebaceous cysts Difficult gynae exams for smears Chronic pain REcurrent UTI and urinary obstruction Death PTSD
What is a genital fistula?
Fistula between the bladder and vagina when giving birth as the fetus gets stuck and tissue necroses
How does urinary obstruction lead to death?
Poor stream = hydronephritis and polynephritis = Chronic renal failure = death as most countries where FGM occurs do not have the facilities to treat and manage CRF.
What consequences does FGM have on a fetus?
Lower Apgar score More resuscitation required Low birth weight /IUGR Neural damage Increased risk of perinatal death
What is defibulation?
Reversal of circumcision from a type 3 FGM. Usually done during pregnancy at 20 weeks and requires an anterior episiotomy during labour.
What must happen before defibulation can occur?
Requires counselling, consent, anaesthesia and analgaesia with follow up and advice.
Cannot recircumcise after birth
What is acute FGM? What must happen if it is identified?
A recent circumcision that requires the response of any acute injury of stopping bleeding, antibiotics, analgesia and catheterisation. Must be well documented and notify police immediately with the help of a safeguarding team and social services
What is the traditional view of women who are circumcised?
They are uneducated housewives
What is the Law around genital mutilation?
1985 prohibition of female circumcision act states that it is illegal to:
- Excision, infibulation or mutilate any labia or clitoris of another person
- Aid, abet, counsel or persuade the act of another person
Results in 14yr prison sentence. Can be convicted if making plans for it to be carried out abroad.
In what situations can FGM be argued legal?
During labour and for an individuals comfort, confidence, body image and self esteem
What is the two major risk factors for FGM?
Country of origin
If FHx of FGM
Who can apply for an FGM protection order?
Anyone
