Female genital mutilation in rural Ghana, West Africa

Abstract

In northern Ghana interviews were conducted with 195 women attending a rural prenatal clinic and a local practitioner of female genital mutilation (FGM) to determine the prevalence of FGM the age at FGM reasons for practicing FGM and longterm complications. A physical examination was also conducted on 12 women who had undergone FGM to determine the extent and type of FGM present. 76 (39%) women had undergone FGM. The examined women had either Type I FGM (excision of the clitoral prepuce) or Type II FGM (removal of the clitoris the crura and varying amounts of the labia minora). The age of 76% of the FGM women ranged from early childhood to 12 years. Reasons for having FGM performed included: parental and peer pressure (45%); unsure (37%); cultural or religious beliefs (15%); superstition (3%). Obstetrical complications with first vaginal delivery were lacerations or hemorrhage (26%) and episiotomy (8%). 13% of the FGM women compared to 5% of the uncircumcised women suffered from persistent pain or difficulty during intercourse. 12% could not achieve an orgasm and 5% had postcoital bleeding. None of the uncircumcised women experienced sexual dysfunction. Prenatal counseling on the hazards of FGM reduced the intention of all 195 women to have their female children circumcised to only 1%; yet 4.5% considered FGM as having a traditional value. These findings and working with the local FGM practitioners are leading to more appropriate educational efforts to curb FGM in northern Ghana.