It is often assumed that female genital mutilation is an issue specific to areas of Africa and the Middle East, however this practice is likely to be affecting 66,000 women in the UK at this moment in time.
Female genital mutilation (FGM) can come in many different forms and the type of mutilation practiced varies across different cultures.This procedure can involve the partial or total removal of the clitoris and/or the labia. Another more extreme form of mutilation is infibulation, which is the narrowing of the vaginal orifice through the stitching up of the labia, which leaves a very small opening for sex, urination, menstruation and childbirth- sometimes as small as a matchstick head.
FGM takes place for a number of different social, religious and cultural reasons, sometimes referred to as female circumcision. Some communities believe that it protects the woman’s sexual purity and some see it as a rite of passage through adulthood and marriage. It is also thought that uncircumcised women can be infertile or unclean, for example, meat cooked by a woman who has a clitoris may not be considered halal in some Muslim communities.
There are thought to be 125 million girls and women alive today that have undergone female genital mutilation, with Unicef predicting a further 30 million will be at risk in the coming decade. This practice is more widespread in African, Middle Eastern and Asian communities, and is almost universal in Somalia, Guinea, Djibouti and Egypt. However, FGM does not only affect these areas of the world, it also has a huge impact on women and girls living in the UK.
FGM is prohibited in the UK under the Female Genital Mutilation Act of 2003, however it often occurs illegally or when young girls are sent to relatives overseas. A recent report by the Royal College of Obstetricians and Gynaecologists has estimated that as many as 23,000 British girls are at risk of being subjected to this procedure every year. However, because FGM is associated with such high cultural sensitivities, it is often under-reported in the healthcare sector due to reluctance to speak out against it.
A lack of awareness about FGM and its prevalence in the UK has hindered healthcare professionals in detecting women that have undergone FGM or children that are at risk. Therefore campaigners encourage the routine questioning of patients in order to identify victims or potential victims, with nurses encouraged to pay particular attention to women that originate from a country where FGM is common practice.
There are several dangers to health involved in FGM, especially when it is performed in its most extreme form, infibulation. The procedure usually takes place without anaesthetic, using blunt, non-sterile equipment which can lead to infections and even haemorrhaging. Females subjected to this procedure often suffer long term physical complications such as problems with passing urine and menstrual fluid, urinary tract infections, infertility and problems with giving birth.
Many women also experience long term psychological effects. Health professionals who have listened to the experiences of these women reported that their patients recounted the trauma of it as if they would never forget the pain endured. During examination, women have been known to have flashbacks to their mutilation and often experience psychological distress. Therefore healthcare professionals are encouraged to take a sensitive, empathetic approach, avoiding judgement when examining a victim or when questioning them about their ordeal.
Raising awareness, educating staff and ensuring that FGM is a mandatory part of training for all healthcare professionals is essential, as ensuring they are informed about these sensitive issues will help them to give patients the care, support and medical attention they may need.
Click here to access free Home Office training designed to help professionals identify and assist girls who are at risk of FGM.
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