INTRODUCTION
Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.
This practice is mostly carried out by traditional circumcisers, who often play other central roles in communities, such as attending childbirths and under septic conditions. In many settings, health care providers perform FGM due to the erroneous belief that the procedure is safer when medicalized.
WHO strongly urges health professionals not to perform such procedures.
FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also infringes on a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.
KEY FACTS
*Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.
*The procedure has no health benefits for girls and women.
*The procedure can cause severe bleeding and problems urinating, and later cysts, infections, as well as complications in childbirth and increased risk of newborn deaths.
*More than 200 million girls and women alive today have been cut in 27 countries in Africa, the Middle East and Asia where FGM is concentrated (UNICEF, 2016)
It is believed that some men in these areas subject their partners to FGM to ‘tighten’ the vagina for their increased sexual pleasure or to increase the aesthetics of the external genitalia otherwise known as the vulva.
*FGM is highest in Somalia and Guinea and highest among cultures and religions that permit child marriage in each 27 African countries where it is practiced.
* In Guinea, all Fulani women responding to a survey in 2012 said they had experienced FGM, against 12 percent of the Fulani in Chad, while in Nigeria the Fulani are the only large ethnic group in the country that does not to practise it.
*FGM is highest among girls in the 14-19 age bracket.
*FGM is mostly carried out on young girls between infancy and age 15.
*FGM is a violation of the human rights of girls and women.
IS IT RELIGIOUS?
FGM’s origins in northeastern Africa are pre-Islamic, but the practice became associated with Islam because of their focus on female chastity and seclusion. There is no mention of it in the Quran and it is despised by core Islamists.
There is no mention of FGM in the Bible. In fact, Christian missionaries in Africa were among the first to object to FGM, but Christian communities in Africa do practise it and they do for inherent cultural rather than religious reasons.
CLASSIFICATIONS OF FGM
Female genital mutilation is classified into 4 major types.
Type 1: Often referred to as clitoridectomy , this is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
Type 2: Often referred to as excision , is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva ).
Type 3: Often referred to as infibulation, is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy).
Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.
COMPLICATIONS OF FGM
FGM may place women at higher risk of problems during pregnancy and childbirth, which are more common with the more extensive FGM procedures.
women may try to make childbirth easier by eating less during pregnancy to reduce the baby’s size.
women with vesicovaginal or rectovaginal fistulae, it is difficult to obtain clear urine samples as part of prenatal care, making the diagnosis of conditions such as pre-eclampsia harder. Cervical evaluation during labour may be impeded and labour prolonged or obstructed. Third-degree laceration (tears), anal-sphincter damage and emergency caesarean section are more common in infibulated women.
Neonatal mortality is increased. The WHO estimated in 2006 that an additional 10–20 babies die per 1,000 deliveries as a result of FGM. The estimate was based on a study conducted on 28,393 women attending delivery wards at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan.
Immediate Complications Include:
1) Severe pain
2) Excessive bleeding (haemorrhage)
3) Genital tissue swelling/genital oedema
4) Fever
5) Infections e.g., tetanus (from the use of crude and unsterilized sharps/instruments)
6) Urinary problems
7) Wound healing problems
8) Trauma/injury to surrounding genital tissue
9) Shock (from pain or bleeding)
10) Possible death.
Long-term Consequences May Include:
1) Urinary problems (painful urination, urinary tract infections);
2) Vaginal problems (discharge, itching, bacterial vaginosis and other infections);
3) Menstrual problems (painful menstruations, difficulty in passing menstrual blood, etc.);
4) Scar tissue and keloid formation.
5) Sexual problems (painful intercourse, decreased satisfaction, etc.).
6) Increased risk of childbirth complications (difficult delivery, excessive bleeding, caesarean section, need to resuscitate the baby, etc.) and newborn deaths;
7) Need for later surgeries: for example, the FGM procedure that seals or narrows a vaginal opening (type 3) needs to be cut open later to allow for sexual intercourse and childbirth (deinfibulation). Sometimes genital tissue is stitched again several times, including after childbirth, hence the woman goes through repeated opening and closing procedures, further increasing both immediate and long-term risks;
8) Serious and long lasting psychological problems (depression, anxiety, post-traumatic stress disorder, low self-esteem, etc.).
Ukabuilu Chuks