History Of Female Genital Mutilation Research Articles

Six aspects of female genital mutilation education (SAFE) model: findings from a qualitative study

ObjectivesRecent figures show that over 200 million women and girls, globally, live with the consequences of female genital mutilation (FGM). Complex debilitating physical, psychological and social problems result from the...

(011) Exploring Pretending Orgasm and Sexual Satisfaction Among Egyptian Women: A Cross-Sectional Survey Study

Abstract Introduction Research on sexual satisfaction, especially orgasm, has focused on North American and Western contexts. Studies show women frequently pretend during PVI to end activity or avoid consequences. Reasons vary from emotional communication to mate deception, not always related to sexual dysfunctions. Sociosexuality may influence behaviors, with casual sex individuals less likely to fake orgasms for positive feedback. Limited research on non-Western societies, especially Egypt, prompted this study to explore prevalence and reasons for pretending orgasm among Egyptian women, investigating correlations with sexual orientation, sexual violence history, dysfunction, and family size. Objective 1. Prevalence of faking orgasm in Egyptian adults. 2. Reasons for faking orgasm in Egyptian women. 3. Correlations with sexual orientation, violence history, dysfunction, and family size. 4. Insights into sexual scripts in Egyptian society. Methods This cross-sectional survey investigates reasons for faking orgasm in Egyptian women. A convenience sample of women aged 18 and above was recruited through social media, community centers, and universities. Data collection occurred between [December 2020] and [February 2021], with participants providing informed consent for the online survey. The survey includes 51 questions on pretending orgasm and a structured interview for demographic information. Participants rated reasons on a Likert scale, and quantitative data will be analyzed using descriptive and inferential statistics to identify prevailing motives. Results In the survey of 626 Egyptian women: •38.6% (242 women) reported pretending orgasm during sexual encounters. •Common reasons for pretending included: wanting to end sexual activity (55.9%–350 women), avoiding negative consequences (66.6%–417 women), and pleasing their partner (55.9%–350 women). •Sociosexuality played a role, with 38.3% (240 women) of those interested in casual sex less likely to fake orgasms for positive feedback. •96.2% (602 women) identified as heterosexual, 1% (6 women) as homosexual, and 2.9% (18 women) as bisexual. •85.2% (534 women) were married, 6.4% (40 women) divorced, 2.6% (16 women) separated, and 5.7% (36 women) in a relationship. •91.8% (575 women) belonged to small families, and 8.2% (51 women) to big families. •14.1% (88 women) had multiple sexual partners, and 16.5% (103 women) suffered from psychological dysfunction. •43.2% (271 women) engaged in sexual relationships more than once a week, 26.9% (168 women) once a week, and 17.6% (110 women) once a month. •32.6% (204 women) were sexually satisfied, 9.6% (60 women) were not satisfied, and 7% (44 women) were neutral. •45.5% (285 women) had a history of sexual harassment, and 27.6% (173 women) had a history of Female Genital Mutilation (FMG). Conclusions The study reveals a prevalent practice of pretending orgasm among Egyptian women (38.6%). Reasons for pretending vary, with a significant percentage aiming to end sexual activity (55.9%), avoid negative consequences (66.6%), and please partners (55.9%). Sociosexuality plays a role, with 38.3% of those interested in casual sex less likely to fake orgasms for positive feedback. Findings emphasize open communication for sexual satisfaction and relationship well-being. Limitations include self-report bias and limited generalizability. Future research should explore diverse contexts and long-term effects on relationship satisfaction. Addressing complexities is vital for healthy relationships among Egyptian women. Disclosure No.

Pronostic obstétrical et néonatal des patientes ayant un antécédent de mutilation génitale féminine

ObjectiveFemale genital mutilation (FGM) covers all procedures involving partial or total removal of the external genitalia for non-therapeutic purposes. The period of pregnancy and childbirth is probably more at risk of complications for these women. The main aim of this study was to compare obstetrical, maternal and neonatal outcomes in patients with a history of female genital mutilation with patients without such a history. MethodsAll deliveries taking place between January 2005 and June 2022 at Besançon University Hospital in patients with a history of FGM were included. This group was compared with a randomly selected group of deliveries of patients with no history of FGM. A total of 87 deliveries with a history of FGM were included and compared with 696 deliveries with no history of FGM. ResultsThere were significantly more instrumental deliveries (27.6% vs. 17.5%, P=0.01), more caesarean sections (23% vs. 14.1%, P=0.01), more episiotomies (9.2% vs. 0.7%, P<0.01), more first-degree perineal tears (30.8% vs. 20.8%, P=0.02), second-degree (13.9% vs. 5.3%, P<0, 01), third-degree (3.1% vs. 0.2%, P=0.02), more anterior perineal tears (23.1% vs. 2.5%, P<0.01), increased duration of pushing efforts (13 min vs. 10 min, P=0.05) and greater blood loss (297 cc vs. 165 cc, P<0.01) in the group with a history of FGM. There was no statistically significant difference in neonatal outcome. ConclusionThe obstetrical prognosis of patients with a history of FGM is significantly poorer. Neonatal prognosis remains unchanged.

Risk of obstetric anal sphincter tear among primiparous women with a history of female genital mutilation, giving birth in Sweden.

Female genital mutilation (FGM) includes a range of procedures involving partial or total removal of the external female genitalia. It is a harmful procedure that violates human rights of girls and women. FGM has been associated with obstetric anal sphincter injury (OASI), among other adverse obstetric complications. However, the obstetric outcomes in high-income countries are not clear. The aim of this study was to compare the risk of OASI among primiparous women, with and without a history of FGM, giving birth in Sweden. A population-based cohort-study based on data from the Swedish Medical Birth Register during the period 2014-2018. The study included primiparous women with singleton term pregnancies. We compared the risk, using multivariable logistic regression, of our main outcome OASI between women with a diagnosis of FGM and women without a diagnosis of FGM. Secondary outcomes included episiotomy and instrumental vaginal delivery. A total of 239,486 primiparous women with a term singleton pregnancy were identified. We included 1,444 women with a diagnosis of FGM and 186,294 women without a diagnosis of FGM in our analysis. The overall rate of OASI was 3% in our study population. By using multivariable logistic regression analysis, we found that women with a diagnosis of FGM had a significantly increased odds ratio (OR) of OASI (OR 2.69, 95%CI: 2.14-3.37) compared to women without a diagnosis of FGM. We also found an association between FGM and instrumental delivery as well as the use of episiotomy. Women with a history of FGM have an almost tripled risk of OASI in comparison with women without FGM, when giving birth in a Swedish setting. Increased knowledge and awareness regarding FGM, and its potential health implications is crucial in order to minimise the risk of OASI among women with FGM giving birth in high-income countries. A limitation in our study is the lack of information about the specific types of FGM.

Female genital mutilation and skilled birth attendance among women in sub-Saharan Africa

BackgroundThere is evidence that women who have had their genitals cut suffer substantial difficulties during and/or after childbirth, including the need for a caesarean section, an episiotomy, an extended hospital stay, post-partum bleeding, and maternal fatalities. Whether or not women in sub-Saharan Africa who have undergone female genital mutilation utilize the services of skilled birth attendants during childbirth is unknown. Hence, we examined the association between female genital mutilation and skilled birth attendance in sub-Saharan Africa.MethodsThe data for this study were compiled from 10 sub-Saharan African countries’ most recent Demographic and Health Surveys. In the end, we looked at 57,994 women between the ages of 15 and 49. The association between female genital mutilation and skilled birth attendance was investigated using both fixed and random effects models.ResultsFemale genital mutilation and skilled birth attendance were found to be prevalent in 68.8% and 58.5% of women in sub-Saharan Africa, respectively. Women with a history of female genital mutilation had reduced odds of using skilled birth attendance (aOR = 0.91, 95% CI = 0.86–0.96) than those who had not been circumcised. In Ethiopia, Guinea, Liberia, Kenya, Nigeria, Senegal, and Togo, women with female genital mutilation had reduced odds of having a trained delivery attendant compared to women in Burkina Faso.ConclusionThis study shed light on the link between female genital mutilation and skilled birth attendance among sub-Saharan African women. The study's findings provide relevant information to government agencies dealing with gender, children, and social protection, allowing them to design specific interventions to prevent female genital mutilation, which is linked to non-use of skilled birth attendance. Also, health education which focuses on childbearing women and their partners are necessary in enhancing awareness about the significance of skilled birth attendance and the health consequences of female genital mutilation.

Effects of clitoral reconstruction for female genital mutilation on perinatal outcomes: A retrospective case-control study

ObjectivesTo investigate the perinatal outcomes of women with a history of female genital mutilation (FGM) who underwent clitoral reconstruction (CR) compared with women with FGM who did not undergo CR. Material and methodsRetrospective case-control study at Angers University Hospital, between 2005 and 2017. Inclusion criteria: pregnant women >18 years who underwent CR after FGM. Only the first subsequent delivery after CR was included. Each woman with CR was matched for age, ethnicity, FGM type, parity, and gestational age at the time of delivery with two women with FGM who did not undergo CR during the same period of time. At birth, the main outcomes were the need for episiotomy and having an intact perineum after delivery. Results84 women were included (28 in the CR group; 56 in the control group). In the CR group, patients required significantly fewer episiotomies (5/17[29.4 %]) compared to the control group (28/44[63.6 %], p = 0.02), even after excluding operative vaginal deliveries (2/13[15.4 %] vs 21/36[58.3], p < 0.01). CR reduces the risk of episiotomy (aOR = 0.15, 95 %CI [0.04−0.56]; p < 0.01) after adjusting on the infant weight and the need for instrumental delivery.In the CR group, 47 % of the patients had an intact perineum after delivery, compared to 20.4 % in the control group (p = 0.04). CR increases the odds of having an intact perineum at birth by 3.46 times (CI95 %[1.04–11.49]; p = 0.04). ConclusionCR after FGM increases the chances of having an intact perineum after delivery by 3.46 times and reduces the risk of episiotomy by 0.15 times compared to women with FGM who did not underwent CR.

Seroprevalence of hepatitis B surface antigen and associated risk factors among pregnant women in Gandhi Memorial Hospital, Addis Ababa

Hepatitis B is the world’s most common serious liver infection caused by Hepatitis B virus (HBV). Rate of vertical transmission is very high from infected mother to baby and has adverse effect on both. A cross-sectional study involving a total of 384 pregnant women attending Gandhi Memorial Hospital in Addis Ababa from April to June 2017 was conducted to determine the seroprevalence and risk factors of HBV among the clients. A structured questionnaire was used to collect socio-demographic data and information regarding possible risk factors for HBV infection and screening was performed by emmuno-chromatographic method using advanced quality one step hepatitis B surface antigen (HBsAg) test card. The seroprevalence of HBsAg among the participants was 2.3%, which is a moderate prevalence according to the WHO classification. HBsAg positivity was significantly associated to age (P=0.020) and ethnic group (P=0.023). About 67% of the HBsAg positive participants belonged to the Gurage ethnic group. No significant association was found between HBsAg positivity and other variables such as marital status (P=1.00), history of multiple sexual partners (P=0.740), history of blood donation (P=1.00), history of tattooing (P=0.070), and history of female genital mutilation (P=0.188). Further study should be conducted to identify the reasons for the highest prevalence of the HBsAg among women from Gurage ethnic group. Key words: Chronic hepatitis, pregnancy, hepatitis B virus, vertical transmission.

18: Reconstruction after female genital mutilation

The primary objective of this video is to demonstrate the surgical management of a case of female genital mutilation (FGM). FGM includes all procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs for non-medical reasons. A review of clitoral anatomy and the classification scheme of FGM will also be addressed. A 44 year-old female with a history of FGM as an infant presented with dyspareunia. She experienced FGM at age 18 months as part of a traditional rite of passage for females in North Sudan. She described undergoing excision of a portion of the external vulva and then having the remainder of the two labia sewn together (infibulation). Her dyspareunia was characterized by pain with penetration as well as pain during and after intercourse. She denied any urinary or menstrual complaints. On exam, she was found to have fusion of her labia minora leaving her with an introitus of approximately two centimeters. The clitoris was neither visualized nor palpable. The urethra was not visualized. Surgical management included reconstruction of the external genitalia with placement of an autologous vaginal epithelial graft. Reconstruction was accomplished via separation of the fused labia in order to create a larger introitus. At this point of the procedure, it was clear there was no intact clitoris. A vaginal graft was placed at the level of the medial mucosal defect resulting from defibulation. The postoperative course at one month was notable for slight lateral deviation of the patient’s urine stream but no other issues. Evaluation and management of patients who have undergone FGM requires a thorough understanding of clitoral anatomy. Definitive diagnosis can only be made during surgical exploration. Providers must discuss possible outcomes of surgery with regard to functional and cosmetic outcomes with patients.

The experience of maternity care for migrant women living with female genital mutilation: A qualitative synthesis.

Increasing numbers of childbearing women with a history of female genital mutilation (FGM) are accessing maternity services in high-income countries across the world. For many of these women, their first contact with the health services in their host country is when they are pregnant. While the clinical consequences of certain categories of FGM are well documented, how high-risk maternity services - designed to mitigate the obstetric consequences of FGM - impact upon women's experience of childbearing is less clear. Using a meta-synthesis approach, this paper synthesizes 12 qualitative research papers, conducted in 5 high-income countries, to explore how migrant women with a history of FGM experience maternity care in their host countries. One over-arching theme and four discrete subthemes of migrant women's experience of the maternity services in their host country were identified: feelings of alienation; fatalism and divine providence, positive and negative feelings about maternity care, different understandings of the birthing process, and feelings about FGM. The findings illustrate that migrant women with a history of FGM frequently encounter negative attitudes when accessing the maternity services in their host countries. Women's experiences suggest a concerning absence of sensitive and empathetic care; a more woman-centered approach is recommended.

Re: Tackling female genital mutilation in the UK

As a result of the diaspora of communities that practise female genital mutilation, many more women are now living with genital mutilation in the United Kingdom, and many more girls are at risk. The campaign to end the practice in the UK has been spearheaded by committed and experienced activists (www. forwarduk.org.uk, www.equalitynow.org with wide institutional endorsement), as reflected in recent intercollegiate recommendations for dealing with the problem. The document results from collaboration between the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of Nursing, Equality Now, and the Unite union. It merges key points from several existing guidelines into a single paper that reiterates the core message: female genital mutilation is a form of child abuse. It points to the importance of data collection and sharing between relevant agencies for effective action. It stipulates appropriate professional care for girls and young women affected by the practice. For the recommendations to be implemented (we hope urgently), a strategic implementation plan with a tight time frame is needed. Disappointingly, this gap remains unfilled. It has been suggested that female genital mutilation should be part of the mandatory training in child protection for NHS staff, implementation has been inconsistent. Being born into a community that practises genital mutilation is themost important risk factor for girls, so pregnancy presents an opportunity for prevention. However, this remains unexplored. Most pregnant women receive antenatal care in the UK, but maternity staff need knowledge and skills to identify genital mutilation. Thus far there has been little impetus for methodical research on attitudes, knowledge, skills, and confidence among maternity staff in relation to this practice. Even if there is a stronger drive to improve training, there is no evidence base on which effective training methods can be formulated. Currently, whether a pregnant woman is asked about genital mutilation—and what to do if it is identified—depend entirely on the awareness and confidence of the booking midwife. It is therefore not surprising that this practice is under-detected in pregnant women and that follow-up action is haphazard. This failure can be remedied by including routine questions about the practice in a minimum maternity dataset for every pregnant woman, regardless of ethnicity or country of origin. However, currently no designated codes, diagnostic or procedural, can record or identify female genital mutilation from NHS activity data. An international classification of diseases code for a history of female genital mutilation and an Office of Population Censuses and Surveys code for deinfibulation should be introduced without delay. Care providers need to know what to do when female genital mutilation is identified and the intercollegiate document is inconsistent with regard to this. It states that “all girls and women presenting with female genital mutilation within the NHS should be referred to the police and support services.” Yet it also recommends considering referral of pregnant women who have undergone the practice to the police “with the woman’s consent.” Individual practitioners continue to be responsible for deciding whether to refer, with no criteria to help them weigh up each situation. Half of women would have undergone genital mutilation under 5 years of age and might not remember the details. It is neither helpful nor fair to expect maternity staff to guess which families are likely to practise female genital mutilation. Routine referral of all identified women to designated social services personnel could provide an opportunity for preventive education. The service pathway should also include psychological care for women who report serious or enduring distress in relation to the practice. This would require investment. There is no guidance for the police and social services on follow-up action. For example, for how long should an unaffected girl who remains at risk be followed up, how often, and by whom?Or, if information is to be collected on all women with genital mutilation where no crime has been committed, who should have stewardship of the information? These major decisions should not be left to the discretion of individual practitioners or services. Criminal prosecution is considered central to prevention, and the UK has been compared unfavourably to France, where identification of female genital mutilation in children has resulted in more than 100 prosecutions since 1979. Without a single prosecution in the UK, the people who procure or perform female genital mutilation remain unpunished and girls remain

50: Pelvic organ prolapse surgery in the setting of female genital mutilation

To provide an overview of female genital mutilation (FGM). To demonstrate the approach to prolapse repair in a patient with a history of female genital mutilation. A 72-year-old East Indian female with a history of type III FGM presented with stage III pelvic organ prolapse. The patient had previously been managed with a pessary, but then began to have obstructive voiding symptoms secondary to scarring from FGM and worsening of her pelvic organ prolapse. The decision was then made to proceed with surgical management with colpocleisis. On examination, the labia were noted to be completely fused down to the posterior vagina with the prolapse protruding through a small opening near the posterior fourchette. A unique surgical approach was taken, first performing a labial defibulation with partial vulvectomy. This released the prolapse from within the scarred vagina, which then demonstrated complete procidentia. The colpocleisis, posterior repair, perineorraphy were then completed. Her postoperative course was uncomplicated and the patient no longer has symptoms of prolapse or obstructive voiding. Our case demonstrates a unique patient in which pelvic organ prolapse occurred in the setting of FGM and no such case is currently documented in the literature. In evaluating patients with FGM, gynecologists must consider the long-term consequences of FGM and identify when it is appropriate to proceed with surgical management. Given the distortion in anatomy, referral to a specialist such as a Female Pelvic Medicine and Reconstructive Surgeon may be necessary.

Obstetric Complications Due to Female Genital Mutilation (FGM) at N’Djamena Mother and Child Hospital (Chad)

Background: Female genital mutilation (FGM) or female circumcision is all procedures involving partial or total removal of the external female genital organ or other injuries to the female genital organ whether for cultural or any other non-therapeutic reasons. Female genital mutilation causes numerous complications. Four in such cases multiplies obstetric complications. The aim of this study was to identify obstetric complications due to FGM. Patients and Material: We conducted a comparative prospective case-control study for three months, from January 1st to March 31st, 2014 in the maternity of N’Djamena Mother and Child. It focused on identifying neonatal and/or maternal complications during childbirth due to FGM. The study population consisted of pregnant women at term admitted for delivery labor. All parturients had to present the same sociodemographic and clinical profiles. A history of FGM was the main distinguishing criterion. Results: During the study period, we recorded 312 births to women with genital mutilation, among 1905 deliveries, representing a prevalence of 16.4%. One hundred ninety-one cases of circumcised women responding to the inclusion criteria were selected. Most of these women were between the ages of 20 and 29. The extreme age group was 15 and 39 (with a mean of 24.5 years). FGM was significant in age group over 20 years (Khi2 = 10.8; OR = 2.6 [1.4 - 4.9]; P = 0.001). The type II of FGM which removed a part of the clitoris and the adjacent labia minora represented 64.40% patients in the group of women with FGM. Perinea laceration was the frequent maternal complication among parturient with FGM (Khi2 = 9.8; OR = 2.2 [1.4 to 3.6]; P = 0.0007). FGM type III was associated with a high proportion of maternal complication (Khi2 = 11.2; OR = 7.3 [1.97 - 31.6]; P = 0.0001). Still births were significantly higher in the group of parturient with FGM (11.5%, P = 0.015). Conclusion: Female genital mutilation is a common cultural practice in our country; it contributes to worsening maternal and fetal complications.

Female Genital Mutilation in a Young Refugee: A Case Report and Review

Female genital mutilation (FGM) is a widespread practice affecting up to 140 mil-lion girls and women worldwide (World Health Organization, 2008a). A substantial advocacy literature reports long-term psychological consequences of FGM, but there is little in the psychiatric literature to document this (Behrendt & Moritz, 2005). Within the broader psychiatric literature on refugee mental health, there are debates about the general validity of psychiatric diagnoses in refugee communities, including somatic disorders and posttraumatic stress disorder (Summerfield, 2008). We present the case of a young woman with a history of FGM, who was repeatedly hospitalized for gastrointestinal complaints of unclear etiology and discuss how her case illustrates the diagnostic and cultural complexity of the psychosocial consequences of FGM and political asylum-seeking.

Female genital mutilation--experience of The Royal Women's Hospital, Melbourne.

This study was performed to improve our knowledge and understanding of the needs of women affected by female genital mutilation. We looked at the types of complications of these practices which present to a large metropolitan women's hospital in order to determine how we can appropriately treat and support affected women. This was an observational study of women from countries with a high prevalence of female genital mutilation who presented to the Royal Women's Hospital between October, 1995 and January, 1997. Fifty-one patients with a past history of female genital mutilation who were attending the hospital for antenatal or gynaecological care consented to participate in the study. We found that 77.6% of women identified as having had female genital mutilation had undergone infibulation. More than 85% of the women in our study reported a complication of the procedure. The major complications were dyspareunia, apareunia and urinary tract infections; 29.4% of these women required surgery to facilitate intercourse. In our study group there was no difference in Caesarean section rates between the women who had previously delivered in Australia compared with those who had delivered in Africa. Women who have had a female genital mutilation procedure have specific needs for their care which present challenges to both their general practitioners and obstetrician/gynaecologists. These women have significant complications related to their procedure including social and psychosexual problems which require sympathetic management.

Ending Footbinding and Infibulation: A Convention Account

This paper explores the close similarities between Chinese footbinding and female genital mutilation and categorizes each custom as universal where practiced persistent practiced by those opposed to it a way to control sexual access to females considered necessary for proper marriage and family honor sanctioned by tradition an ethnic marker spread by contagious diffusion exaggerated over time related to status supported and transmitted by women performed on young girls generally not initiation rites believed to promote health and fertility considered aesthetically pleasing considered an enhancement to male pleasure during intercourse and related to female slavery. After noting these characteristics the paper defends these assertions by tracing the history of female footbinding in China and defining and tracing the history of female genital mutilation in Africa. The authors conclusion that each practice is a self-enforcing convention (as defined by Shelling in 1960 and Lewis in 1969) is presented through a discussion of the convention hypothesis and game theory illustrated through coordination problems. This theory illustrates how people can be stuck in an inferior equilibrium which is maintained by what people believe about each other (daughters will be forced to undergo genital mutilation if people believe this is necessary to attract a husband). Such a convention is self-enforcing and in these cases the enforcement is derived by a desire for paternity confidence by a history of imperial female slavery and by belief traps. The mechanism necessary to allow escape from an inferior convention is then covered and it is recommended that efforts to end female genital mutilation adopt the successful tactics which eradicated footbinding in China in one generation. Quick convention change can be achieved by an education campaign by use of adverse international public opinion and by forming associations of parents who pledge not to submit their daughters to genital mutilation and not to let their sons marry mutilated women.

Female genital mutilation in Britain

The practice of female genital mutilation predates the founding of both Christianity and Islam. Though largely confined among Muslims, the operation is also practiced in some Christian communities in Africa such that female genital mutilation takes place in various forms in more than twenty African countries, Oman, Yemen, the United Arab Emirates, and by some Muslims in Malaysia and Indonesia. In recent decades, ethnic groups which practice female genital mutilation have immigrated to Britain. The main groups are from Eritrea, Ethiopia, Somalia, and Yemen. In their own countries, an estimated 80% of women have had the operation. Female genital mutilation has been illegal in Britain since 1985, but it is practiced illegally or children are sent abroad to undergo the operation typically at age 7-9 years. It is a form of child abuse which poses special problems. The authors review the history of female genital mutilation and describe its medical complications. Assuming that the size of the population in Britain of ethnic groups which practice or favor female genital mutilation remains more or less unchanged, adaptation and acculturation will probably cause the practice to die out within a few generations. Meanwhile, there is much to be done. A conspiracy of silence exists in medical circles as well as widespread ignorance. Moreover, none of a number of well-known obstetric and pediatric textbooks mentions female genital mutilation, while the National Society for the Prevention of Cruelty to Children has neither information nor instructional material. It is high time that the problem was more widely and openly discussed.