L08 - FGM

Question 1

What is FGM?

Answer 1

Partial or complete removal of, or injury to, external female genitalia for non-medical reasons

Question 2

What are the reasons for the practice of FGM?

Answer 2

• Tradition / ? religious interpretation
• Social acceptability, community identity
• Rite of passage (in some cultures, girl not a woman until FGM performed)
• Hygiene
• Marriageability (some men don’t accept wives who have not had FGM)
• Preserving chastity
• Curbing female libido/sexual activity
• Ensuring sexual pleasure for men

Question 3

How is FGM classified?

Answer 3

• Type 1 – clitoridectomy -> partial or complete removal of clitoris and/or prepuce (clitoral hood)
• Type 2 – excision -> partial or total removal of clitoris & labia minora with or without excision of labia majora
• Type 3 – infibulation -> narrowing (stitching) of vaginal orifice with creation of covering seal by cutting & appositioning labia minora and/or majora with or without excision of clitoris
• Type 4 – all other harmful procedures to female genitalia for non-medical purposes e.g. stretching, pricking, burning, piercing, incising, scraping, cauterisation, intro of corrosive substances

Question 4

What are the immediate impacts of FGM?

Answer 4

• Haemorrhage
• Severe pain & shock
• Urinary retention
• Urinary, vaginal & uterine infections
• Trauma to adjacent tissues
• Transmission of blood borne viruses (HepB, HIV)
• Death
• Fracture of bones (holding down)

Question 5

What are the short term impacts of FGM?

Answer 5

• Delayed wound healing
• Scarring/keloid formation
• Pelvic infection
• Epidermoid cysts/abscesses
• Neuroma

Question 6

What are the long term impacts of FGM?

Answer 6

• Recurrent UTI
• Haematocolpos – impaired flow of menstrual blood & dysmenorrhoea
• Dysuria
• Dyspareunia
• Morbidity & mortality during pregnancy & childbirth
• PID/infertility
• Psycho-sexual & -social trauma
• Death

Question 7

What are the obstetric complications of FGM?

Answer 7

• Difficult vaginal examination & catheterisations
• Difficult scalp electrode placement/FBS
• Increased caesareans
• PPH (postpartum haemorrhage)
• Perineal tears
• Prolonged 2nd stage of labour
• Break down of episiotomy scars
• Sepsis
• Extended hospital stay

Question 8

What is the difference between mandatory recording and mandatory reporting?

Answer 8

• Mandatory recording in regard to adult women & matter for HCPs e.g. GPs
• Mandatory reporting required under Section 5B of FGM Act -> concerns U18s & matter for all regulated professions