Factors promoting and hindering the practice of female genital mutilation/cutting (FGM/C)

Factors promoting and hindering the practice of female genital mutilation/cutting (FGM/C)

Female genital mutilation/cutting (FGM/C) is a traditional practice that involves "the partial or total removal of the female external genitalia or other injury to the female genital organs for cultural or other non-therapeutic reasons." The current WHO classification describes four types of FGM/C: Type I, clitoridectomy, involves partial or total removal of the clitoris and/or the prepuce. Type II, excision, involves partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. Type III, infibulation, involves narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris. Type IV, other, involves all other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping, and cauterization. More info →
Psychological, social and sexual consequences of female genital mutilation/cutting (FGM/C)

Psychological, social and sexual consequences of female genital mutilation/cutting (FGM/C)

Report from Kunnskapssenteret (Norwegian Knowledge Centre for the Health Services) No 13–2010 Systematic review Background: In November 2008, the Norwegian Knowledge Centre for Violence and Traumatic Stress Studies (NKVTS) commissioned the Norwegian Knowledge Centre for the Health Services (NOKC) to conduct a systematic review about the consequences of female genital mutilation/cutting (FGM/C). The review would answer the question: What are the psychological, social and sexual consequences of FGM/C? More info →
Obstetric consequences of female genital mutilation/cutting (FGM/C)

Obstetric consequences of female genital mutilation/cutting (FGM/C)

Background: Female genital mutilation/cutting (FGM/C) is a traditional practice that involves the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. This systematic review aimed to fi ll a gap in synthesized evidence of the obstetric sequelae of FGM/C. We included 44 primary studies, 28 of which compared groups of women with FGM/C to women with no or different types of genital modifi cations. More info →
Gynecological consequences of female genital mutilation/cutting (FGM/C)

Gynecological consequences of female genital mutilation/cutting (FGM/C)

The traditional practice of female genital mutilation or cutting (FGM/C) covers a range of procedures (clitoridectomy, excision, infi bulation, and other) performed on the genitals of females of different ages. This systematic review aimed to summarize empirical quantitative research describing the gynecological consequences of FGM/C on girls and women. We included 136 primary studies, 42 of which compared groups of women who had been subjected to FGM/C with women who had no or different types of genital alterations. The main finding is that FGM/C has harmful consequences for a woman’s gynecological health. We found that: • Women with FGM/C seem to be more likely than women without FGM/C to experience urinary tract infection, bacterial vaginosis, and pain during intercourse. • There seems to be a trend for women with FGM/C to be more likely than women without FGM/C to experience: burning/painful urination, problems with menstruation, vaginal discharge and vaginal itching. • There seems to be no clear trend for either a greater or lower risk of HIV and sexually transmitted infections among women who have undergone FGM/C. • There were insuffi cient data for us to conclude whether the risk of other gynecological complications (tissue damage, vaginal adhesions and obstructions, cysts, infertility) is different among women with FGM/C compared to women without FGM/C, and whether various FGM/C types differentially affect the risk of other gynecological complications (except regarding urinary tract infection). This systematic review found that sufficient evidence exist to concludethat women who have undergone FGM/C suffer a greater risk of gynecological complications than women who have not undergone the procedure. There were no indications of gynecological benefi ts of FGM/C. Rather, there is a real chance of under-reporting of many of the health issues covered in this systematic review. More info →
Immediate health consequences of female genital mutilation/cutting (FGM/C)

Immediate health consequences of female genital mutilation/cutting (FGM/C)

Background: Female genital mutilation/cutting (FGM/C) has been performed in various forms for millennia and involves the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. In this systematic review we addressed harm occurring during the cutting or alteration modifi cation process and the short-term period. • We included 56 observational studies that documented immediate complications. There were 14 studies in which two or more groups of girls and women with different types of FGM/C were compared with regards to the occurrence of one or more acute complications. There are three main fi ndings: • The most common immediate FGM/C complications were pain, excessive bleeding, swelling, problems with wound healing, urine retention. • The girls and women undergoing FGM/C often suffered more than one immediate complication. • There were few differences in risk of immediate complications among different types of FGM/C, but there might be a greater risk of immediate complications for women with FGM/C type III (infi bulation) compared to types I-II. • There was evidence of underreporting of complications. However, the fi ndings show that the FGM/C procedure unequivocally causes immediate, and typically several, health complications during the FGM/C procedure and the short-term period. Each of the most common complications occurred in more than one of every ten girls and women who undergo FGM/C. The participants in these studies had FGM/C types I through IV, thus immediate complications such as bleeding and swelling occur in setting with all forms of FGM/C. Even FGM/C type I and type IV ’nick’, the forms of FGM/C with least anatomical extent, presented immediate complications. The results document that multiple immediate and quite serious complications can result from FGM/C. These results should be viewed in light of long-term complications, such as obstetric and gynecological problems, and protection of human rights. More info →
Effectiveness of interventions designed to reduce.

Effectiveness of interventions designed to reduce.

In November 2008, the Norwegian Knowledge Centre for Violence and Traumatic Stress Studies commissioned the Norwegian Knowledge Centre for the Health Services to do a systematic review about the effectiveness of interventions to prevent female genital mutilation/cutting (FGM/C). The review would answer the question: What is the effectiveness of interventions designed to reduce the prevalence of female genital mutilation/cutting compared to no or any other intervention? Method: We searched systematically for relevant literature in international scientifi c databases, in databases of international organisations that are engaged in projects concerning FGM/C, and in reference lists of relevant reviews and included studies. We selected studies according to prespecifi ed criteria and appraised the methodological quality using checklists. We summarized the results using tables and calculated effect estimates in outcomes for which pre- and post scores for both intervention and comparison groups were reported. Results: We included and summarized results from six controlled before-after-studies. All studies were set in Africa and compared an intervention with no intervention. There was great variation in prevalence, ethnicity, religion, and education among these settings. All studies were judged to have weak methodological quality and the quality of the evidence was low. Conclusion: There is a paucity of high quality evidence regarding the effectiveness of interventions to prevent FGM/C and the evidence base is insuffi cient to draw solid conclusions. While fi rst generation anti-FGM/C intervention studies are informative, there is an urgent need for additional studies. Such second generation studies should be randomized or at a minimum secure similar distribution of prognostic factors in the intervention and comparison groups; long term to ensure viability and reliable assessment of changes in prevalence; take into account regional, ethnic and socio demographic variation in the practice of FGM/C; focus on prevalence – assessed by physical examinations – behaviours, and intentions; and they should be cross disciplinary, if possible through international collaborative initiatives. More info →
Effectiveness of interventions designed to reduce the prevalence of female genital mutilation/cutting

Effectiveness of interventions designed to reduce the prevalence of female genital mutilation/cutting

Background: In November 2008, the Norwegian Knowledge Centre for Violence and Traumatic Stress Studies commissioned the Norwegian Knowledge Centre for the Health Services to do a systematic review about the effectiveness of interventions to prevent female genital mutilation/cutting (FGM/C). The review would answer the question: What is the effectiveness of interventions designed to reduce the prevalence of female genital mutilation/cutting compared to no or any other intervention? More info →