FGM

Question 1

Definition

Answer 1

The practice of injuring or removing part or all of the labia, clitoris, and other parts of the female genitals for reasons that are not part of medical treatment

OR
All procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons

Question 2

Type 1

Answer 2

Partial or total removal of the clitoris and/or the prepuce (clitoridectomyy)

Question 3

Type 2

Answer 3

Partial or total removal of the clitoris and the labia minors, with or without excision of the labia majora

Question 4

Type 3

Answer 4

Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minors and or the labia majora, with or without excision of the clitoris (infibulation)

Question 5

Type 4

Answer 5

All other harmful procedures to the female genitalia for non-medical purposes (pricking, piercing, incising, scraping, cauterising)

Question 6

Consequences of FGM

Answer 6

Impaired sexual function (apareunia, dyspareunia, anorgasmia, reduced sexual pleasure)
Urinary tract: recurrent UTI, prolonged voiding time, difficulty obtaining MSU
Recurrent vaginal infections
Infertility
Menstraul problems: haetocolpos, retained menstraul clots, dysmenorrhoea
Local scar complications: keloid, sermons cysts
Chronic neuropathic pain
Trouble getting Pap smear or catheter in
Psychological: PTSD, anxiety, depression

Question 7

Pregnancy associated issues with FGM

Answer 7

Difficulty with vaginal exam in pregnancy and labour
Difficulty with intrapartum procedures (ARM, FSE)
Difficulty catheterizing
Increased risk severe perineal trauma or vaginal lac
Increased likelihood episiotomy
Increased risk of Caesarean section
Fear of childbirth

Low income countries- increased risk of perinatal death

Question 8

When to offer antenatal deinfibulation

Answer 8

2nd trimester

When adequate vaginal exam is unlikely to be possible

Question 9

Deinfibulation

Answer 9

Incision anterior Ly enough to allow visualization of the external urethral meat is but not far enough to injure the buried clitoris or clitoral stump (high potential for heavy bleeding)

Question 10

Justifying perpetuation of the practice

Answer 10

Social obligation
Tradition & Culture
Gender Roles
Religion
Rite of Passage
Virginity, chastity & marriage
Economics
Aesthetics & hygiene

Question 11

Right violated by FGM

Answer 11

Rights of the child
Right to life
Right to be free of torture or other cruel treatment
Right to equality and non-discrimination on the basis of gender

Question 12

If concerns around FGM potential to a baby

Answer 12

1. talk to parents about attitudes and intentions
2. Advice illegal -21 yrs prison
3. Provide literature on complications and consequences of FGM
4. Refer parents to early childhood health Centre and note risk of FGM to baby
5. Encourage parents to speak to GP and community leaders who do not support FGM
6. Complete mandatory report to department of family and community services