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      Health consequences of female genital mutilation/cutting in the Gambia, evidence into action

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          Abstract

          Background

          Female Genital Mutilation/Cutting (FGM/C) is a harmful traditional practice with severe health complications, deeply rooted in many Sub-Saharan African countries. In The Gambia, the prevalence of FGM/C is 78.3% in women aged between 15 and 49 years. The objective of this study is to perform a first evaluation of the magnitude of the health consequences of FGM/C in The Gambia.

          Methods

          Data were collected on types of FGM/C and health consequences of each type of FGM/C from 871 female patients who consulted for any problem requiring a medical gynaecologic examination and who had undergone FGM/C in The Gambia.

          Results

          The prevalence of patients with different types of FGM/C were: type I, 66.2%; type II, 26.3%; and type III, 7.5%. Complications due to FGM/C were found in 299 of the 871 patients (34.3%). Even type I, the form of FGM/C of least anatomical extent, presented complications in 1 of 5 girls and women examined.

          Conclusion

          This study shows that FGM/C is still practiced in all the six regions of The Gambia, the most common form being type I, followed by type II. All forms of FGM/C, including type I, produce significantly high percentages of complications, especially infections.

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          Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries.

          Emily Banks, Olav Meirik, Tim Farley … (2006)
          Reliable evidence about the effect of female genital mutilation (FGM) on obstetric outcome is scarce. This study examines the effect of different types of FGM on obstetric outcome. 28 393 women attending for singleton delivery between November, 2001, and March, 2003, at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal, and Sudan were examined before delivery to ascertain whether or not they had undergone FGM, and were classified according to the WHO system: FGM I, removal of the prepuce or clitoris, or both; FGM II, removal of clitoris and labia minora; and FGM III, removal of part or all of the external genitalia with stitching or narrowing of the vaginal opening. Prospective information on demographic, health, and reproductive factors was gathered. Participants and their infants were followed up until maternal discharge from hospital. Compared with women without FGM, the adjusted relative risks of certain obstetric complications were, in women with FGM I, II, and III, respectively: caesarean section 1.03 (95% CI 0.88-1.21), 1.29 (1.09-1.52), 1.31 (1.01-1.70); postpartum haemorrhage 1.03 (0.87-1.21), 1.21 (1.01-1.43), 1.69 (1.34-2.12); extended maternal hospital stay 1.15 (0.97-1.35), 1.51 (1.29-1.76), 1.98 (1.54-2.54); infant resuscitation 1.11 (0.95-1.28), 1.28 (1.10-1.49), 1.66 (1.31-2.10), stillbirth or early neonatal death 1.15 (0.94-1.41), 1.32 (1.08-1.62), 1.55 (1.12-2.16), and low birthweight 0.94 (0.82-1.07), 1.03 (0.89-1.18), 0.91 (0.74-1.11). Parity did not significantly affect these relative risks. FGM is estimated to lead to an extra one to two perinatal deaths per 100 deliveries. Women with FGM are significantly more likely than those without FGM to have adverse obstetric outcomes. Risks seem to be greater with more extensive FGM.
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            Posttraumatic stress disorder and memory problems after female genital mutilation.

            Alice Behrendt, Steffen Moritz (2005)
            This pilot study investigated the mental health status of women after genital mutilation. Although experts have assumed that circumcised women are more prone to developing psychiatric illnesses than the general population, there has been little research to confirm this claim. It was predicted that female genital mutilation is associated with a high rate of posttraumatic stress disorder (PTSD). The psychological impact of female genital mutilation was assessed in 23 circumcised Senegalese women in Dakar. Twenty-four uncircumcised Senegalese women served as comparison subjects. A neuropsychiatric interview and further questionnaires were used to assess traumatization and psychiatric illnesses. The circumcised women showed a significantly higher prevalence of PTSD (30.4%) and other psychiatric syndromes (47.9%) than the uncircumcised women. PTSD was accompanied by memory problems. Within the circumcised group, a mental health problem exists that may furnish the first evidence of the severe psychological consequences of female genital mutilation.
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              Sexual function in women with female genital mutilation.

              Sharifa Alsibiani, Abdulrahim Rouzi (2010)
              To compare the sexual function of women with female genital mutilation (FGM) to women without FGM. A prospective case-control study. A tertiary referral university hospital. One hundred and thirty sexually active women with FGM and 130 sexually active women without FGM in Jeddah, Saudi Arabia. Women with and without FGM were asked to answer the Arabic-translated version of the female sexual function index (FSFI) questionnaire. The individual domain scores for pain, arousal, lubrication, orgasm, satisfaction, pain, and overall score of the FSFI were calculated. The two groups were comparable in demographic characteristics. There were no statistically significant differences between the two groups in mean desire score (+/- standard deviation) or pain score. However, there were statistically significant differences between the two groups in their scores for arousal, lubrication, orgasm, and satisfaction as well as the overall score. Sexual function in women with FGM is adversely altered. This adds to the well-known health consequences of FGM. Efforts to document and explain these complications should be encouraged so that FGM can be abandoned. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Reprod Health
                Title: Reproductive Health
                Publisher: BioMed Central
                ISSN (Electronic): 1742-4755
                Publication date Collection: 2011
                Publication date (Electronic): 3 October 2011
                Volume: 8
                Page: 26
                Affiliations
                [1 ]Cátedra de Transferencia del Conocimiento/Parc de Recerca UAB-Santander, Departamento de Antropología Social y Cultural, Universitat Autònoma de Barcelona, Barcelona, Spain
                [2 ]Grupo Interdisciplinar para la Prevención y el Estudio de las Prácticas Tradicionales Perjudiciales (GIPE/PTP), Departamento de Antropología Social y Cultural, Facultad de Letras y Psicología, Universitat Autònoma de Barcelona, Barcelona, Spain
                [3 ]NGO Wassu Gambia Kafo, Fajara F Section, Banjul, The Gambia
                [4 ]Cuban Medical Mission in The Gambia, Banjul, The Gambia
                [5 ]Community Based Medical Program, Ministry of Health and Social Welfare, Banjul, The Gambia
                [6 ]Facultad de Ciencias Médicas Manuel Fajardo. Universidad Médica de la Habana, La Habana, Cuba
                [7 ]Grups de Recerca d'Amèrica i África Llatines (GRAAL), Unitat de Bioestadistíca. Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
                Article
                Publisher ID: 1742-4755-8-26
                DOI: 10.1186/1742-4755-8-26
                PMC ID: 3195700
                PubMed ID: 21967670
                SO-VID: ccd021e3-ba38-4c99-a6a9-45f5616c8868
                Copyright © Copyright ©2011 Kaplan et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 July 2011
                Date accepted : 3 October 2011
                Categories
                Subject: Research

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: africa,gambia,female genital mutilation/cutting,sexual and reproductive health
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: africa, gambia, female genital mutilation/cutting, sexual and reproductive health

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