FGM Flashcards

1
Q

What is FGM?

A

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

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2
Q

What is type 1 FGM?

A

Excision of prepunce with or without part of entire of clitoris

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3
Q

What is type 2 FGM?

A

Excision of whole or part of labia minora or majora

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4
Q

What is type 3 FGM?

A

Excision of whole or part of external genitalia with narrowing of the vaginal opening = Infibulation

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5
Q

What is type 4 FGM?

A

Unclassified e.g. pricking, incising or piercing of clitoris; burning, corrosive substances, within or around cuts

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6
Q

Where did FGM originate?

A

Ancient Egypt

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7
Q

Which countries still practice FGM?

A

Africa, middle East, India, Malaysia, Indonesia

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8
Q

What are the possible reasons behind FGM?

A
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
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9
Q

How is FGM traditionally carried out?

A

With unsterile equipment, homemade sutures and adhesives and leg binding to stop bleeding

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10
Q

How is FGM being medicalised?

A

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.

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11
Q

What does FGM violate?

A

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.

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12
Q

Why is FGM not being detected in the UK?

A

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.

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13
Q

Who experiences FGM?

A

Girls from infancy to 15yrs

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14
Q

What is the issue with FGM?

A

It permanently alters and injures the genitalia for non-medical reasons with no health benefits, but carries a risk of death or poor QoL

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15
Q

What are the immediate implications of FGM?

A
Pain
Haemorrhage
Fractures from resisting
Infection
Urinary retention
Shock - hypovolaemic or sepsis
Death
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16
Q

What are the long term complications of FGM?

A
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
17
Q

What is a genital fistula?

A

Fistula between the bladder and vagina when giving birth as the fetus gets stuck and tissue necroses

18
Q

How does urinary obstruction lead to death?

A

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.

19
Q

What consequences does FGM have on a fetus?

A
Lower Apgar score
More resuscitation required
Low birth weight /IUGR
Neural damage
Increased risk of perinatal death
20
Q

What is defibulation?

A

Reversal of circumcision from a type 3 FGM. Usually done during pregnancy at 20 weeks and requires an anterior episiotomy during labour.

21
Q

What must happen before defibulation can occur?

A

Requires counselling, consent, anaesthesia and analgaesia with follow up and advice.
Cannot recircumcise after birth

22
Q

What is acute FGM? What must happen if it is identified?

A

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

23
Q

What is the traditional view of women who are circumcised?

A

They are uneducated housewives

24
Q

What is the Law around genital mutilation?

A

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.

25
Q

In what situations can FGM be argued legal?

A

During labour and for an individuals comfort, confidence, body image and self esteem

26
Q

What is the two major risk factors for FGM?

A

Country of origin

If FHx of FGM

27
Q

Who can apply for an FGM protection order?

A

Anyone