L24 - FGM

Question 1

FGM - HUMAN RIGHTS VIOLATION

i) what is FGM?
ii) give four other names for FGM
iii) what does mutilation mean?
iv) give four ‘reasons’ for FGM

Answer 1

i) destructive operation where female genitals are partly or entirely removed
ii) female genital cutting, female circumcision, purification, excision
iii) removal of healthy tissue
iv) prepare for marriage, social convention, culture/religion, reduce libido, femininity

Question 2

EPIDEMIOLOGY

i) how many women are affected worldwide? how many in europe?
ii) why is there increasing FGM in europe?
iii) what are two problems in the medical sector that are not contributing to preventing FGM?

Answer 2

i) 200 million worldwide with 1 million in europe
ii) increasing due to increasing migration from FGM practicing countries

iii) ignorance - victims approached in an inadequate way
lack of training - not part of training for medical professionals

Question 3

WHO DOES FGM

i) who is it usually performed by?
ii) give two other people it could be performed by
iii) is anaethesia used?

Answer 3

i) professional circumsisers - women have a high reputation in their society
ii) can be done by healer, nurses or doctors
iii) no

Question 4

CLASSIFICATION

i) what is removed in type I? what is this known as? what is this aiming to achieve?
ii) what is removed in type II? what is this known as? what is also sometimes removed
iii) what % of FGM cases are either type I or II
iv) what is done in type 3? what is this known as?
v) what is done in type 4?
vi) which type is the most severe?

Answer 4

i) removal of clitoris aiming to remove sexual pleasure
= clitoroidectomy

ii) removal of clitoris and labia minora
- known as excision
- can also remove labia majora

iii) 80% is type 1 or 2
iv) type 3 - infibulation (sewing up)
v) type 4 - any other procedure for non medical purposes

Question 5

COMPLICATIONS OF FGM

i) give six immediate/short term complications
ii) give six long term complications
iii) name six complications in pregnancy/delivery

Answer 5

i) haemmorhage, pain, injury to adjacent tissues eg urethra, fractures, urinary retention, infection, HIV/hepatitis, sepsis, death
ii) recurrent UTI, painful menstruation, keloid scarring, infertility, complications in pregnancy, PTSD
iii) hard to carry out vaginal examinations, hard to induce labour with a pessary, hard to access uterus, interventions, prolonged labour due to obstruction, increase risk of severe tears, increased risk of caesarian

Question 6

MANAGEMENT OF FGM - NON PREGNANT

i) name three things that should be done if the child is under 18?
ii) what does the law say about children under 18s with FGM?
iii) what must initially be done in non pregnant women with FGM? (2)
iv) name three areas a person may be reffered to

Answer 6

i) call police, contact safeguarding lead, refer to social services
ii) FGM is illegal in the UK and there has been mandatory reporting since october 2015
iii) identify type of FGM and see if de-infibulation is indicated
iv) FGM service (psych, urogynae), test for HIV/Hep. psychological services

Question 7

DEINFIBULATION

i) when may this be offered? (2)
ii) which type of FGM would require this?
iii) what two things can stitching around the labia after the procedure help with? (2)

Answer 7

i) in pregnancy to allow birth, or before pregnancy (gynae procedure)
ii) type 3
iii) stop bleeding anf stops the labia healing back together

Question 8

MANAGEMENT IN PREGNANCY

i) what four things may be done antenatally?
ii) what may happen during pregnancy?
iii) name three things that may happen postnatally
iv) what is re-infundibulation? is this legal?

Answer 8

i) ask all women about FGM, refer for psych assessment, refer to safeguarding midwife, examine type of FGM
ii) deinfundibulation if required
iii) debrief, educate, safeguarding
iv) re-stitching the labia back up post tearing - illegal

Question 9

FGM AND THE LAW

i) is mutilation of any part of the female genitals legal or illegal?
ii) is aiding/counselling a girl to mutilate her own genitals legal or illegal?
iii) is it legal to aid/counsel a person who is not a UK national to mutilate?
iv) is FGM classes as child abuse?
v) when has FGM been illegal since in the UK?
vi) is it legal to arrange FGM abroad?
vii) can people who organise FGM face imprisonment

Answer 9

i) illegal
ii) illegal
iii) no
iv) yes
v) since 1985

Question 10

RAISING AWARENESS

i) what year does UNICEF want to end FGM by?
ii) how much less likely is a girl to be cut now than 30 years ago?
iii) where is it most important to educate?

Answer 10

i) 2030
ii) 1/3 less likely
iii) within communities to make change from a ground level