L11: Female Genital Mutilation Flashcards
What is the definition of Female genital mutilation (FGM)
A term used by WHP make it clear that FGM is avid action of human rights, emphasise harmfulness of act
What is FGM distinct from
Male circumcision
Why are the following terms of female genital cutting, excision, genital cutting used by some people
People feel that mutilation stigmatises FGM affected communities
What term does WHO state that is should be avoided for use
Female circumcision
Why should female circumcision be avoided
It is felt to be misleading as it suggests a similarity to male circumcision
What is the definition of FGM
Partial or compete removal of or injury to female genitalia for NON-MEDICAL reasons
How many types of FGM is there
4 types
What differs from as you increase from type 1 to type 3
Amount of genital tissue cut increases
What is the type 3 FGM also called
Infibulation
What is type 1 also called
Clitoridectomy
What is type 1 FGM
Partial or total removal of the clitoral hood or clitorial glans
What is type 2 FGM also called
Excision
What is type 2 FGM
Partial or total removal of clitoral glans and inner labia or/and outer labia
What is type 3 also known as
Infilbulation
What is type 3 FGM
Partial or total removal of the clitoris glans and inner Labia or/and outer labia with inner or/and outer labia sewn together leaving a small hole
What is the small hole in type 3 for
Urination or sexual intercourse
What is type 4 FGM
Any other harmful procedure that involves piercing, scraping, burning, pricking
Which countries does FGM predominantly occur occur
Africa (most)
Eastern Europe
Latin America
What is happening to the prevalence of FGM
Declining very slowly (but not fast enough)
In the U.K. what are the 2 statistics sources we have for FGM
Census data from 2011
NHS digital from 2015+
What does NHS digital data rely on to date FGM
Healthcare professionals knowledge of FGM
FGM survivors that access healthcare services
What are the strength of census based estimates
- Good starting point
- record changes in population
- accessible for analysis
What are the weaknesses of census based estimates
- estimated
- too generalised
- only collected every 10 years
What are the strengths of NHS digital data
- accessible
- clean data
- enable service planning
What are the weaknesses of NHS digital data
- poor data recording
- statistics are experimental
- low reliability in some areas
Are there any health benefits of FGM
No
What are the categories of impact of FGM
Health
Psychological
Sexual
Economic
What are the immediate impacts of FGM to the female
Cut without Anaesthetic- pain Haemorrhage Acute urinary retention Urinary, vaginal infection Septicaemia Trauma Transmission of Hep b, HIV Death Bone fracture - due to being held down
What are the shorter term impacts of FGM on the female
Delayed wound healing Scarring Pelvic infection Epidermoid cysts Neuroma
What are the longer term impacts of FGM on females
Reproductive tract infection Impaired flow of menstrual Painful menstruation Painful urination Painful sex Childbirth Pelvic inflammatory disease Social trauma Mental health Increased risk of HIV Death
How can type 3 FGM be treated
Deinfibulation
What is type 3 deinfibulation
You release the vagina opening and suture the raw edges to prevent it healing back together
In what settings can de-infibulation be done
Outside pregnancy
Antepartum
Intra partum
What are the benefits of de-infibulation
Improved health
Wellbeing
Allow sexual intercourse
Allows childbirth
Describe how the FGM procedure is performed on females
1) circumsers use razors, scissors, broken glans, sharpened glass to cut
2) no anaesthetic
3) unsanitary condition
4) girl is held down
4) legs are bond for weeks after the procedure
What are the 6 categorical reasons for FGM
1) sociological and cultural reasons
2) psychosexual reasons
3) socio-economic factors
4) hygiene and feminity reasons
5) marriage ability
6) religious reasons
What are the sociological and cultural reasons for FGM
- historical and cultural tradition
- respect for elderly
- acceptance in community
- community identity
- gender inequality i.e male control
- myths about clitoris growing into a penis
- passage from childhood to woman hood
What are the psychosexual reasons
- control of woman’s sexuality
- preservation of her virginity before marriage
- increase male sexual pleasure as the hole is much tighter
- protect family honour
What are the socio-economic factors
Prerequisite for marriage and right to inherent
Income for cutters
What are the hygiene and feminity reasons for FGM
Cut is perceives as clean
Spiritual purity
Hygiene
Clitoris is seen as masculine so removal makes is feminity
What are the marriage ability reasons
Eligible for marriage
Mean want to marry cut woman
What are the religious reasons
Religious obligation but there is no evidence in books
When might a child be at risk of FGM
Child mother has had FGM Father from a FGM background Parent say they are taking her abroad Girl is withdrawal from FGM lessons Family thinks FGM is important
What should be done with a girl has had FGM
Documented in medical notes
Referral to social services
Under what act is FGM illegal in the U.K.
Serious crime act 2015
What are the offences of FGM
Committing FGM
Assisting a girl
Assisting a non U.K. person to mutilate overseas
Faulting to protect a girl at risk
What is mandatory recording
In regards to adult women, as HCP you record into the nhs data set and medical notes
What is mandatory reporting
As a result of serious crime act 2015 you have to report under 18s as all healthcare professionals
When do you have to directly report to the police
- girls under 18
- examination reveals she has had FGM
- girl discloses FGM
When you report to the police can you transfer the responsibility to another HCP
NO the duty is personal
When does mandatory reporting not apply
- woman over 18
- if you think a girl has FGM but she does not disclose it and no signs and symptoms are seen
- if it has been reported already
How do you report as a HCP
- call police by 101
- make a detailed record on it system
- alert senior manager and safeguarding lead
When should you report
As soon as possible by end of next working day
In FGM act 2003 what are the expectational cases for reporting
Up to 1 month with reasons of delay in reporting
What happens if you as a HCP fail to report
- failure to fitness to practise
- regulators consider your ability to practise safely
After post partum is it legal or illegal to suture to re-infinbulate after birth
Illegal
