Experience Of Female Genital Mutilation Research Articles

"A part of my life". A qualitative study about perceptions of female genital mutilation and experiences of healthcare among affected women residing in Sweden.

Female genital mutilation (FGM) is defined as all procedures involving partial or total removal of the external female genitalia, or other injuries to them for non-medical reasons. Due to migration, healthcare providers in high-income countries need to better understand the consequences of FGM. The aim of this study was to elucidate women's experiences of FGM, with particular focus on perceived health consequences and experiences of healthcare received in Sweden. A qualitative study was performed through face-to-face, semi-structured interviews with eight women who had experienced FGM in childhood, prior to immigration to Sweden. The transcribed narratives were analyzed using content analysis. Three main categories were identified : "Living with FGM", "Living with lifelong health consequences" and "Encounters with healthcare providers". The participants highlighted the motives behind FGM and their mothers' ambivalence in the decision process. Although the majority of participants had undergone FGM type 3, the most severe type of FGM, the lifelong health consequences were diverse. Poor knowledge about FGM, insulting attitude, and lack of sensitive care were experienced when seeking healthcare in Sweden. Our findings indicate that FGM is a complex matter causing a diversity in perceived health consequences in women affected. Increased knowledge and awareness about FGM among healthcare providers in Sweden is of utmost importance. Further, this subject needs to be addressed in the healthcare encounter in a professional way.

Women’s ability to negotiate safer sex with partners by contraceptive status among a nationally representative sample of married women in Nigeria

BackgroundExisting studies established that safer sex negotiation influences contraceptive use, and women who are able to negotiate safer sex were expected to be contraceptive users. However, it is not certain that all contraceptive users have the ability to negotiate safer sex. Likewise, there is no evidence that all non-users are not able to negotiate safer sex with partners. The study assesses the prevalence of women’s ability to negotiate safer sex and examines the determinants of women’s ability to negotiate safer sex among contraceptive users and non-users.MethodsThe comparative cross-sectional research design was adopted. Data were extracted from the 2018 Nigeria Demographic and Health Survey. The study analyzed a sample of 2,765 contraceptive users and 20,304 non-users. The outcome variable was women’s ability to negotiate safer sex with partners. The explanatory variables examined are eight socio-demographic characteristics (age, child marriage, education, parity, media exposure, religion, work status, and experience of female genital mutilation), six relational characteristics (healthcare autonomy, financial autonomy, household wealth quintile, partners’ education, ownership of assets, and type of marriage). Attitude to wife-beating, male controlling behavior, place of residence, and geo-political zone of residence were included as control variables. Multivariable regression models were estimated.ResultsFindings showed that 6.2% of women who were not able to negotiate safer sex were contraceptive users, while 15.9% of women who were able to negotiate safer sex were contraceptive users. Among non-users, the significant determinants were child marriage, education, parity, mass media exposure, religion, work status, healthcare autonomy, financial autonomy, household wealth, partner education, type of marriage, geo-political zone, attitude to wife-beating, and male controlling behavior. Regarding contraceptive users, the significant determinants were parity, religion, the experience of female genital mutilation, financial autonomy, partner education, type of marriage, and the geo-political zone of residence.ConclusionThe ability to negotiate safer sex differs among contraceptive users and non-users. Also, the determinants of the ability to negotiate safer sex differ among contraceptive users and non-users. While existing strategies may continue to focus on women not using contraceptives, new strategies promoting reproductive autonomy are required among contraceptive users.

Female genital mutilation (FGM) trauma and mental health support during the UK lockdown: exploring women’s experiences

PurposeThe purpose of this study is to report findings from interviews with seven African-heritage women attending a female genital mutilation (FGM) Clinic in the north of England, during the COVID-19 lockdown. The Clinic, established several years before the pandemic, provides specialist therapeutic support to women and girls from minority ethnic communities who are affected by harmful “traditional” practices, including FGM. The services provided by the Clinic include early interventions, peer support, community engagement and empowerment around FGM.Design/methodology/approachData was collected during an online focus group discussion with seven women who had received counselling for FGM, to gain insight into their lived experiences of therapeutic support during the pandemic.FindingsUsing Braun and Clarke (2006) six-step thematic analysis, four superordinate themes derived from the data: consistency and continuity; safety in shared experience and creativity; feeling heard, feeling stronger; and altruism and desire for change.Research limitations/implicationsIt is important to recognise some limitations within this study. It is based on one focus group discussion that involved seven participants, who had experienced FGM, were living in a targeted area and whose mental health had been further compromised by the COVID-19 pandemic.Practical implicationsThe findings of this study indicate that it is essential to consider participants’ experiences of receiving therapeutic support during the COVID-19 pandemic. It was observed that emotional stressors linked with participants’ experiences of FGM may be exacerbated by those related to COVID-19.Social implicationsThere is a need to conduct similar research, perhaps on an individual basis, that would reach a wider sample of women from ethnic minority populations who are survivors of FGM, including those from FGM practicing communities who have been hospitalised through their deteriorating mental health. This would add to the small but growing body of evidence, to provide a better understanding of the experiences of their mental health needs during the COVID-19 pandemic and perhaps better identify effective therapeutic interventions.Originality/valueThese themes provide an insight into these women’s experiences of the trauma associated with FGM and receiving mental health support during the pandemic.

Involving Men: The Multiple Meanings of Female Genital Mutilation in a Minority Migrant Context

ABSTRACT The paper explores the roles of men in the continuation/abandonment of female genital mutilation (FGM) in a migrant minority community in Sweden. The aim is to contribute to the under-researched area of men’s attitudes towards and experiences of FGM, using frameworks on engaging men, feminist theories on men and masculinity, and intersectionality. It is based on an inductive qualitative design for data collection, including a focus group discussion with 13 male Somali migrants in Sweden. The analysis shows a window of opportunity for involving minority migrant men in prevention and to challenge a minority migrant gender regime. The ambivalent attitudes expressed are based on a will to reflect on roles, a desire to adjust to conflicting social norms and institutional rules, and an interest in the legal, health and medical consequences of FGM. The paper concludes that successful interventions and involvement need to consider local activism, gendered dynamics, masculinities and empowerment; attempts to eradicate FGM will be more successful if they empower women and men.

A qualitative assessment of women\u2019s perspectives and experience of female genital mutilation in Iraqi Kurdistan Region

BackgroundFemale genital mutilation (FGM) is prevalent in Iraqi Kurdistan Region, but there is a lack of adequate knowledge about how the practice is perceived by the women population who are the direct victims of the practice. This study aimed to assess the knowledge, beliefs, and attitude of a sample of Kurdish women of FGM and identify the main enabling factors for performing this practice and the barriers to ending it.MethodsThis qualitative study was based on six focus groups involving a sample of 51 women. We used a topic guide to lead discussions, which included questions on women’s perspectives of different aspects of FGM such as the reasons for practicing it, the positive and negative consequences, the continuation of the practice and tackling this problem in the community. Content analysis was used for the qualitative analysis of the data.ResultsThe women had poor knowledge about different aspects of FGM particularly concerning the procedure and the consequences. The mutilated participants revealed the devastating experience of the pain and the psychological effects they have experienced. Reducing sexual desire, having halal (permissible by Allah) hands, and religious requirement were the main reasons for practicing FGM. Reduction in women’s sexual desire and the related social problems with the husband were the main problems identified to be associated with FGM. Most women did not support the continuation of FGM practice, but some women still think that FGM should be left to the people’s preference. The participants identified raising people’s awareness, active involvement of religious leaders in prevention efforts and the issuance and enforcement of legislation against FGM as the primary measures to reduce FGM practice.ConclusionPassing through FGM at childhood is an overwhelming experience with long-term effects for women. There is still a significant segment among the women population that do not oppose the continuations of FGM and need religious and scientific evidence against FGM. Some reasons for practicing FGM are deeply embedded in the culture and traditions, and there is a need for extensive efforts to raise the awareness of the population and change their thoughts and behavior about FGM.

‘I have a story to tell’: Researching migrant women’s experiences of female genital mutilation and gender-based violence in Ireland and Europe

This article presents insights and practical lessons learned from multiple studies the author has undertaken and participated in as principal or co-researcher and/or provided expert guidance to in Ireland and Europe. These studies primarily focus on gender-based violence (GBV) and female genital mutilation (FGM) and given their foci, have an implicit need for cognisance of child protection, legislation and onward referral procedures. The research issues of interest are often considered taboo, private, not to be discussed outside immediate family and shameful. There are multiple practical and logistical barriers, as well as language and psycho-social obstacles, to participating in, and undertaking, research on these issues. The article discusses the approaches and routes taken to recruit women affected and impacted by the issues of FGM and GBV for research studies. The responsibility on researchers to present research study findings in a sensitive manner which does not add stigma to marginalised and vulnerable groups, but that enables policy makers to utilise the research for legislative and practical purposes, is also discussed.Keywords: gender-based violence (GBV); female genital mutilation (FGM); migration; ethics; stigma; research design

Female genital mutilation: An exploratory study of teachers' knowledge and experiences

Objectives: Female genital mutilation (FGM) is prevalent in the United Kingdom (UK) but there is a dearth of evidence on teachers' understandings of the practice. This study explored primary school teachers' knowledge and experiences of FGM. Methods: A grounded theory study, using semi-structured interviews was conducted with 11 primary school teachers, from the North West of England. Data analysis adhered to the principles of grounded theory. Findings: Three themes were generated: fear, cultural subjectivity and teaching culture. Despite teachers wanting to ‘do the right thing’ their lack of confidence and perception that they needed authorisation to intervene prevented them from doing so. Conclusions: This study has provided insight into teachers' perceptions of their role in relation to FGM. Supportive professional guidelines aimed at those working in schools could provide the confidence needed to tackle issues related to FGM.

Married women’s negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

ObjectiveMarried women’s ability to negotiate for safer sex is important for HIV prevention in sub-Saharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women’s sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. MethodsWe analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. ResultsWe found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR=0.87; p<.05) and that they can ask for condom use during sexual intercourse (OR=0.62; p<.001) than their counterparts who had not undergone genital mutilation, while controlling for theoretically relevant variables. ConclusionOur findings indicate that the experience of female genital mutilation may influence married women’s ability to negotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage.

O28 Experience of female genital mutilation (FGM) in a sexual health clinic

IntroductionAfter recommendations from the Intercollegiate Guidelines in 2013, our sexual health clinic introduced a diagnostic code and mandatory proforma to identify, record and report FGM.MethodsRetrospective case note review of all patients coded FGM.ResultsAll patients presenting were over 18. There were 210 FGM patients; 30/210 Type 1 (clitoridectomy); 40/210 Type 2 (excision); 35/210 Type 3 (infibulation); 79/210 Type 4; 26/210 unclassified. 71 had consensual FGM as adults; of whom 69 were Type 4 (typically genital piercing), 2 were Type 1.In FGM performed under 18 years old (139); average age of cutting was 6 years. Countries involved; Somalia 67% (93/139), Sierra Leone 7% (9/139), Eritrea, Nigeria and Ethiopia 4% (6/139) respectively. 14% (19/139) reported complications.12% (17/139) had prior reversal. 4% (6/139) expressed interest in reversal. 98% (136/139) knew FGM is illegal in the UK.Abstract O28 Table 1Associations if FGM performed under 18 years old or over 18 years old.AssociationFGM types 1–4 &lt;18yrsFGM type 1–4 &gt;18yrsP valuePelvic pain/PID17% (23/139)6% (4/71)0.0289HIV/Hepatitis B/C11% (15/139)3% (2/71)0.0596There was no significant difference in the rates of bacterial STI’s between both groups.DiscussionOur proforma assists in identifying and accurately recording information regarding FGM. No women required referral to police or social services. Some were signposted for surgical intervention. An increased incidence of pelvic pain was noted in those whose FGM was performed as children, with no reflected increase in bacterial STI’s. An increased prevalence of blood borne viruses was also noted. Most women reported negative attitudes to FGM. Sexual health clinics are well placed to assist in awareness, risk assessment and education surrounding FGM.

Female genital mutilation among mothers and daughters in Harar, eastern Ethiopia

ObjectiveTo assess the practice of female genital mutilation (FGM) among mothers and daughters, and to investigate sociodemographic factors influencing the practice of FGM in Harar, Ethiopia. MethodsA community-based cross-sectional study was conducted among women aged 15 years or older who had at least one living daughter younger than 12 years via the Harar Health and Demographic Surveillance System 2013. Data were collected through face-to-face interviews. The practice of FGM was compared between mothers and their daughters. Whether the daughter had undergone FGM was included as an outcome variable in bivariate and multivariate analyses. ResultsAmong 842 mothers, 669 (79.5%) reported that they had undergone FGM themselves, and 160 (19.0%) that their daughter had undergone FGM. Traditional practitioners were said to be the major performers of FGM by 151 (94.4%) mothers. Mothers whose daughter was mutilated mentioned social acceptance (144 [90.0%] women) and better marriage prospects (96 [60.0%]) as the major benefits. Genital mutilation of daughters was significantly associated with maternal age, education to grade 1–4, and FGM experience. Amhara ethnic origin was significantly associated with a reduced likelihood of FGM among daughters. ConclusionOver one generation, the incidence of FGM has reduced. Increasing advocacy against FGM and enforcement of law should be emphasized.

A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England

ObjectivesTo explore how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. We explored women's perceptions of deinfibulation, caesarean section and vaginal delivery;...

Women's Work Choices in Kenya: The Role of Social Institutions and Household Gender Attitudes

ABSTRACTThis study considers the factors that influence women's work behavior in Kenya. In particular, it examines whether gender attitudes and certain types of social institution influence the probability of employment or type of employment for women. Using data from the Demographic and Health Survey of 2008–9, it finds that religion and ethnicity are significant determinants of women's employment in Kenya. While personal experience of female genital mutilation is insignificant, spousal age and education differences, as well as marital status (which reflect attitudes both in women's natal and marital families), are significant determinants of women's employment choices.

Slow progress in ending female genital mutilation

was just seven years old when I was cut, says Leyla Hussein, a British woman of Somali origin. first thing I heard was my sister screaming. Then it was my turn. Four women held me down while they cut my clitoris. I felt every single The pain was so intense--I blacked out. Hussein's experience of female genital mutilation (FGM) is fairly typical. The ancient rite of passage in many African and some Middle Eastern countries in which part or all of the genitals are cut off with razors or knives--often without anaesthetic--is supposed to make girls clean and pure, and ready for marriage. The grim reality is that an estimated 125 million women and girls living today have undergone some form of FGM --many of them suffer severe emotional and physical consequences. FGM is classified into four forms ranging from partial or total removal of the clitoris, the outer or inner vaginal lips to narrowing the vaginal opening by partially sealing it up. In countries such as Djibouti, Egypt and Somalia more than 90% of girls undergo some form of FGM, some of them before they are old enough to walk. [ILLUSTRATION OMITTED] The fight to end FGM is now global, with international agencies such as the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) at the helm, and has strong support from governments, such as that of the United Kingdom and nongovernmental organizations (NGOs). But for women like Hussein, now a London-based psychotherapist and anti-FGM campaigner, progress has been too slow. A few countries have seen rates of FGM fall. In Kenya, these rates in women aged 15 to 49 years fell from 38% in 1998 to 26% in 2008; in the Central African Republic, rates fell from 43% in 1994 to 24% in 2010. Yet most other African countries have seen rates stay stable or fall only marginally. Unless decisive action is taken to stop the the United Nations Population Fund (UNFPA) projects that 86 million girls between 15 and 19 years will be subjected to FGM by 2030. FGM has no health benefits and often leaves women with lifelong physical and emotional trauma, there is a human rights justification to end the says Dr Joar Svanemyr, from the Department of Reproductive Health and Research at WHO, but he adds, we have solid research evidence to show that FGM has devastating health effects. These include painful menstrual periods and intercourse, urinary problems, and birth complications. According to Dr Nafissatou Diop, FGM expert at UNFPA, FGM leaves a damning legacy, as deaths among babies during and immediately after birth are higher for those born to mothers who have been cut. International pressure to end FGM has been mounting since 1997, when the WHO, UNICEF and UNFPA issued a joint statement calling on governments to ban the practice. This commitment was renewed in 2008 and, in 2012, the UN General Assembly passed a resolution to step up efforts towards the elimination of FGM. Since 2008, nearly 10 000 communities in 15 countries, representing about 8 million people, have renounced the practice, says Diop. While public declarations do not guarantee changes in actual behaviour, they have important symbolic value. A report on FGM released in July last year by UNICEF, entitled Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change, provides critical insight into the underlying cultural beliefs. It presents data showing that in many countries where FGM is practised most men and women think the practice should end. So what explains its continuity? According to United Kingdom-based campaigner Hussein, who has talked extensively to men and women from communities where the practice is maintained, some women say they agree to the practice to ensure they are marriageable while men think it is the women who want it. …

Perceptions and experiences of female genital mutilation after immigration to Sweden: An explorative study

AimThe aim of this study is to explore how women from part of the world where female genital mutilation (FGM) is normative perceive and experience FGM after immigrating to Sweden. MethodInterviews were conducted with eight women from Djibouti, Eritrea, Ethiopia and Somalia. The data were analyzed using qualitative content analysis. ResultsThe women’s feelings were ambivalent: though they opposed FGM, on the one hand, because of its negative effects on health, they acknowledged the practice’s positive cultural aspects on the other hand. The themes that emerged from the interviews are the role of FGM in ensuring virginity and protecting a family’s honor, its role in avoiding shame and enhancing purity, social pressure experienced after immigration, an understanding of FGM as a symbol of the country of origin, and support for changing the tradition. ConclusionThese findings indicate that women originating from communities where FGM is normative live in a context in which the practice is viewed as an important aspect of life even after immigration. More research concerning this complex and deeply rooted cultural issue is recommended.

Asking For Trouble: Ethics, Agenda and Personal Storytelling in a Women's FGM Health Project

This article reflects upon a project that was run in partnership between the author and an Australian health agency in 2010. Nine women's stories, of their personal experiences of Female Genital Mutilation (FGM), were told for an educational CD aimed at developing a cultural competency around the issue. I facilitated the women's storytelling and recorded these testimonies. Throughout this process I discovered that the design of the project and the agenda of creating the CD often conflicted with the complex requirements of the participant group. As a result, this project is used as a point of reflection for the ethics of personal storytelling and a discussion regarding the friction between agenda and need.

Experiences from pregnancy and childbirth related to female genital mutilation among Eritrean immigrant women in Sweden

Objective to explore Eritrean immigrant women's experiences of female genital mutilation (FGM) during pregnancy, childbirth and the postpartum period. Design qualitative study using an ethnographic approach. Data were collected via tape-recorded interviews. Setting interviews in the Eritrean women's homes located in and around Uppsala, Sweden. Participants 15 voluntary Eritrean immigrant women. Data collection and analysis Semi-structured interview and open-ended questions were used. The interviews were tape-recorded, transcribed verbatim and then analysed. Findings six themes of experiences of FGM among Eritrean women during pregnancy and childbirth were identified. They are (1) fear and anxiety; (2) extreme pain and long-term complications; (3) health-care professionals’ knowledge of circumcision and health-care system; (4) support from family, relatives and friends; (5) de-infibulation; and (6) decision against female circumcision of daughters. Key conclusion and implications for practice the Eritrean women had experiences of FGM and had suffered from its complications during pregnancy, childbirth and the postpartum period. Midwives and obstetricians should have competence in managing women with FGM, and they need increased understanding of cultural epistemology in order to be able to provide quality care to these women. At antenatal centres, circumcised women should be advised to de-infibulate before pregnancy. Special courses about anatomical differences should be offered to these women and their husbands. It is also important to inform them about Swedish law, which prohibits all forms of FGM.

Female genital mutilation in the context of migration: experience of African women with the Swiss health care system

In contrast to other European countries, the Swiss health care system does not deal with the specific needs of women with female genital mutilation (FGM) in a consistent manner, though migrants from countries where FGM is commonly practised are living in Switzerland. For this study, the interaction of women who had undergone FGM, with the Swiss health services was analysed both from the perspective of the women concerned and that of health care professionals (doctors and midwives). The methods used were mainly qualitative, including focus group discussions with 29 women from Somalia and Eritrea and telephone interviews with 37 health care professionals. It is estimated that some 6000 girls and women with FGM could be living in Switzerland. The fact that health care providers rarely see such patients and the absence of professional guidelines give rise to misunderstandings. Counselling of the women is often inadequate, and there is a striking lack of communication about FGM between health care providers and users, as well as within the women's communities. As a surprising finding, reinfibulation is carried out in Switzerland when requested by the patient. This study shows that at present the specific gynaecological and obstetric health care needs of migrant women who have undergone FGM are not adequately addressed in the Swiss health system. The situation could be easily improved by taking into consideration the fairly simple measures suggested by the women and the health care providers taking part in this study. Due to international migration, female genital mutilation (FGM) has become an issue of increasing concern in host countries such as Switzerland. Objectives of this study were to analyze how immigrant women with FGM experience gynaecological/obstetrical care in the Swiss health care system, and to investigate if gynaecologists/obstetricians and midwives treat and counsel FGM related complications adequately. Specific health care needs of women with FGM should--and easily could--be better considered by the Swiss health care system. Recommended measures include capacity building and professional guidelines on FGM for health care providers; and access to culturally appropriate information and self-help groups for the communities concerned.

Management of female genital mutilation in Djibouti: the Peltier General hospital experience.

Female genital mutilation (FGM) is still performed on 98% of Djiboutian women. Infibulation (FGM type 3) is the most widely used method of FGM in Djibouti. Even though this operation is mutilating, illegal and sometimes results in death, it is still practiced at approximately the same rate as in the past. Mass immigration of African women to Europe, Canada, Australia and the United States in the past decade has brought the problems of FGM to these countries. Female genital mutilation is a problem unfamiliar to most Western obstetrician-gynecologists. A tight infibulation can be a high risk for the mother and fetus if not handled by a skilled operator. It can lead to an unnecessary cesarean section as a result of the fear of handling infibulated women. Therefore, Western physicians need to be informed. The aim of this article was to share our experience of FGM. It will focus on FGM in Djibouti, its types, epidemiology and health consequences. It will present the management of obstetric and gynecologic complications and discuss medico-legal and health service measures to combat these dangerous and unnecessary practices

Management of female genital mutilation in Djibouti: the Peltier General hospital experience

Female genital mutilation (FGM) is still performed on 98% of Djiboutian women. Infibulation (FGM type 3) is the most widely used method of FGM in Djibouti. Even though this operation is mutilating, illegal and sometimes results in death, it is still practiced at approximately the same rate as in the past. Mass immigration of African women to Europe, Canada, Australia and the United States in the past decade has brought the problems of FGM to these countries. Female genital mutilation is a problem unfamiliar to most Western obstetrician-gynecologists. A tight infibulation can be a high risk for the mother and fetus if not handled by a skilled operator. It can lead to an unnecessary cesarean section as a result of the fear of handling infibulated women. Therefore, Western physicians need to be informed. The aim of this article was to share our experience of FGM. It will focus on FGM in Djibouti, its types, epidemiology and health consequences. It will present the management of obstetric and gynecologic complications and discuss medico-legal and health service measures to combat these dangerous and unnecessary practices

The practice of female genital mutilation in Upper Egypt

Objective: To study the prevalence of and reasons for female genital mutilation in an Egyptian village population. Methods: A survey of all 819 households in an Upper Egyptian village near Assiut was conducted in 1992. The mothers of 1732 girls under 20 years of age were interviewed to obtain information about their daughters. When possible, fathers and grandparents were also interviewed. Results: Respectively, 62%, 36.6% and 1.1% were girls who had undergone female genital mutilation (FGM), were to undergo the procedure and were not to have the operation. A total of 67% of the fathers of girls who had undergone FGM and 92% of their mothers were illiterate. FGM was performed most often when girls were 5–9 years old. Almost all procedures (97.5%) were performed by dayas; 1.3% were performed by barbers. A razor was used in 80.7% of the cases, and a knife in 18.5%; in less than 1% (0.7%) of the procedures were medical instruments used. The most prevalent reason for FGM was that it followed customs and traditions (77%). Serious bleeding (5.7%) and pain (3%) were the most commonly reported complications of the procedure. Conclusions: The study raises a number of questions about the experience of FGM by young girls, the reasons for maintaining this practice and the kinds of interventions which might be effective in eliminating it.