Abstract
Female genital mutilation (FGM) is a major public health problem, especially in developing countries. This was a prospective observational cohort study conducted over six months duration (1st July-31st December 2015) at Omdurman Maternity Hospital, Khartoum, Sudan, primarily to determine whether exposure to FGM/C (exposed Vs. non-exposed) and degree of exposure (type III Vs. type I) are associated with impaired sexual function or not?. As secondary objective, the study also investigated the association between FGM/C and postpartum complications (eg: difficulties in cervical examination, episiotomy wound infection, postpartum bleeding) by following the participants from the time of admission at the hospital, through vaginal delivery and until the 6th post-partum week. A total of 230 (subjected to FGM/C) and 190 (not subjected to FGM/C) women were approached. The clinical examinations evidenced that the majority (67.8%) had FGM type 3, while the remainder (32.2%) had type 1. The most common reported sexual complication was dyspareunia (76%). Bleeding following first attempt of sexual intercourse was reported in 35.2% followed by reduced sexual desire 62.6%, reduced sexual satisfaction 40.9% and need for surgery to release labial adhesions at first attempt of sexual intercourse 30.4%. With regard to FGM- related complications that occurred during labor 76.5% required an episiotomy, 61.7% experienced difficulties in cervical examination, 57.8% needed defibulations during second stage of labor, 26.5% complicated by episiotomy wound infection and 2.2% developed obstetric hemorrhage. In this study FGM/C was a significant factor increasing the risk of sexual complications. Interestingly when using logistic regression analysis the FGM-related complications were not significantly varied by FGM/C types. Our observations indicate that FGM/C is a serious public health problem and there should be an urgent intervention such as planned health education campaigns to end FGM/C practice.
Highlights
Female genital mutilation (FGM) is a major public health problem, especially in developing countries
This study investigated whether exposure to FGM/ C and degree of exposure are associated with impaired sexual function or not?
The finding of this study showed that the FGM is strongly associated with sexual and obstetric complications
Summary
Female genital mutilation (FGM) is a major public health problem, especially in developing countries. Female genital mutilation is a cultural and traditional procedure and it is considered as a violation of the human rights of girls and women because of its negative impact on women health [2, 3]. The procedure is outlawed in many countries [5, 6]. Female genital mutilation is highly prevalent in Sudan, it is reported in 83.3% among school girls and strongly associated with education [8], the current study is directed to investigate the health complications associated with FGM and it is expected to provide the health planners and stakeholders with fundamental data for the development of strategic plan such as health education and good partnership towards the elimination of this practice
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