RANZCOG FGM guideline

Question 1

What is Type 1 FGM?

Answer 1

partial or total removal of the clitoris and or the prepuce

Question 2

what is type 2 FGM?

Answer 2

• partial or total removal of the clitoris + labia minora (+-/ excision of the labia majora)

Question 3

What is Type 3 FGM?

Answer 3

narrowing of the vaginal orifice with the creation of covering seal by cutting and apositioning the labia minor and majora with or without excision of the clitoris

Question 4

What is type 4 FGM?

Answer 4

all other harmful procedure to the female genitalia for non medical purposes
e.g. pricking, piercing, incising, scraping and cauterising

Question 5

Which women are at risk of FGM?

Answer 5

it is a largely geographical practise (rather than strictly religious - although it is associated with islamic religion)

• north east africa
• particularly Sudan and Somalia in NZ and Australia
• 80% of Somalian women will have had FGM

Question 6

What are the long term health consequences of FGM?

Answer 6

• impaired sexual function (pain etc)
• recurrent urinary tract infection
• recurrent vaginal infection
• subfertility
• menstrual problems
• local scar complications - keloid, dermal cysts
• chronic neuropathic pain
• difficult procedures e.g. IDC insertion, pap smears
• psychological - PTSD

Question 7

what is the procedure called to restore FGM?

Answer 7

de-infibulation
- minor surgical proceudre
- aim to separate the midline structure and re-approximate normal anatomy to restore sexual function/urinary function/vaginal examination/spec examinations
-

Question 8

What are the potential effects of FGM on pregnancy?

Answer 8

• difficulty with vaginal examinations
• difficulty with intra-partum procedures
• difficulty with catheterisation
• increased likelihood of perineal trauma
• increased likelihood of episiotomy requirement
• increased risk of C/S
• increased fear of childbirth