Female genital mutilation/cutting in The Gambia: long-term health consequences and complications during delivery and for the newborn

Abstract

BackgroundFemale genital mutilation/cutting (FGM/C) is a harmful traditional practice deeply rooted in 28 Sub-Saharan African countries. Its prevalence in The Gambia is 76.3%. The objective of this study was to gain precise information on the long-term health consequences of FGM/C in The Gambia as well as on its impact on delivery and on the health of the newborns.MethodsData were collected from 588 female patients examined for antenatal care or delivery in hospitals and health centers of the Western Health Region, The Gambia. The information collected, both through a questionnaire and medical examination, included sociodemographic factors, the presence or not of FGM/C, the types of FGM/C practiced, the long-term health consequences of FGM/C, complications during delivery and for the newborn. Odds ratios, their 95% confidence intervals, and P values were calculated.ResultsThe prevalence of patients who had undergone FGM/C was 75.6% (type I: 75.6%; type II: 24.4%). Women with type I and II FGM/C had a significantly higher prevalence of long-term health problems (eg, dysmenorrhea, vulvar or vaginal pain), problems related to anomalous healing (eg, fibrosis, keloid, synechia), and sexual dysfunction. Women with FGM/C were also much more likely to suffer complications during delivery (perineal tear, obstructed labor, episiotomy, cesarean, stillbirth) and complications associated with anomalous healing after FGM/C. Similarly, newborns were found to be more likely to suffer complications such as fetal distress and caput of the fetal head.ConclusionThis study shows that FGM/C is associated with a variety of long-term health consequences, that women with FGM/C are four times more likely to suffer complications during delivery, and the newborn is four times more likely to have health complications if the parturient has undergone FGM/C. These results highlight for the first time the magnitude of consequences during delivery and for the newborn, associated with FGM/C in The Gambia.

Prevalence of Female Genital Mutilation and its Association with Birth Complications among Women Attending Delivery Service in Nigist Eleni Mohammed General Hospital, Hossana, Southern Nations, Nationalities and Peoples' Region, Ethiopia

“…The study findings in Kersa district (Ethiopia) (92.3%), Djibouti (93%), and Somalia (98%) was greater than the findings of this study. On the other hand, the study findings in Nigeria (34%), Gambia (75.6%), Mauritania (77%), Sierra Leone (81.2%), and Eritrea (89%) was slightly less than the findings of this study [8,[12][13][14][15][16]. These differences might be due to religious, ethnicity and cultural differences across the countries.…”

What Works and What Does Not: A Discussion of Popular Approaches for the Abandonment of Female Genital Mutilation

“…In its crudest form, it can include delivering factual and didactic messages around the physical complications of FGM by local health providers, community facilitators, or NGO staff [7]. In its broadest form, it includes local knowledge and personal sharing and reflection coupled with the provision of health care services for complications of FGM [16]. …”

Understanding the motivations of health-care providers in performing female genital mutilation: an integrative review of the literature

“…Immediate risks of FGM include intense pain, haemorrhage (excessive bleeding), shock, difficult urination and infection [5]. In the long term, FGM can also give rise to reproductive health problems, such as dyspareunia (difficulty having sexual intercourse), complications during childbirth and even neonatal death, particularly among women who have been infibulated [6, 7]. Moreover, psychological health problems such as anxiety, depression and post-traumatic stress disorder are associated with this practice [8, 9].…”