P24 Study protocol: a critical communicative evaluation of maternal care pathways for FGM in lothian

Abstract

Background For expectant mothers with female genital mutilation (FGM), relevant care pathways are critical to a positive maternal care experience. Women with FGM may require a range of unique support, from mental health counselling to antenatal vaginal surgery.5 Challenged by evidence of substandard patient care, poor staff knowledge, and an increase in FGM-affected populations across Scotland, NHS Lothian established a specialist care team and training for FGM in 2015.1,3,4 This protocol presents an adaptation of the critical communicative methodology (CCM) to understand NHS staff and community views on the impact of these developments, and how the system can continue to improve. Objective To present a publicly led strategy for the evaluation of training and maternal care for women with FGM in Lothian. Methods CCM provides a useful tool for researchers to avoid the disadvantages of excluding the public from healthcare research and development.2 The method treats the contributions of researchers and the community equally, resulting in actionable and relevant evidence-based priorities for improvement. This protocol details our use of CCM’s approach to include relevant, diverse voices (the NHS Lothian FGM team, midwives, and new mothers) in every step of the research process. In-depth interviews partner researchers and individuals in an exploration of existing research evidence and their impressions of the new maternal strategy for FGM. Democratic discussion groups then analyze these views to determine recommendations for future maternal training and care for women with FGM. Ethical approval for this study was obtained from NHS South East Scotland. Conclusion This protocol should be of interest to those seeking to apply methods with an emphasis on social justice, which recognize the agency of the public to contribute to the healthcare strategies affecting their communities. References Baldeh F. Obstetric care in Scotland: The experience of women who have undergone Female Genital Mutilation (FGM) MSc edn, 2013. Queen Margaret University. Gomez J, Latorre A, Sanchez M, Flecha R. Metodologia Comunicativa Critica [Critical Communicative Research], 2006. Barcelona, Spain: Hipatia. Moxey JM, Jones LL. A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. BMJ Open2016;6(1):e009846. Scottish Refugee Council (SRC). Tackling female genital mutilation in Scotland: A Scottish model of intervention, 2014. [Online] Available at: http://www.scottishrefugeecouncil.org.uk/assets/0000/9061/FGM_Report_FINAL_A4portrait.pdf [Accessed 19 Sept. 2018]. World Health Organization (WHO). Health risks of Female Genital Mutilation (FGM), 2018. [online] Available at: http://www.who.int/reproductivehealth/topics/fgm/health_consequences_fgm/en/[Accessed 19 Sept. 2018].