Risk assessment for antenatal depression among women who have undergone female genital mutilation or cutting: Are we missing the mark?

Abstract

Background Although prohibited by specific legislation in Australia, patterns of global migration underscore the importance for local clinicians to recognise and manage potential complications associated with female genital mutilation/cutting (FGM/C). The incidence of antenatal depression in Australia is 10% and may be higher among those with a history of FGM/C (RANZCOG 2 statement: Perinatal Anxiety and Depression, 2012). The phenomenon of cultural embedding could represent a protective factor against an increase in mental health problems among these women. Aim To determine whether women who have undergone FGM/C are at greater risk of depression in the antenatal period as defined by the Edinburgh Postnatal Depression Scale (EPDS). Materials and Methods A multicentre retrospective case‐control study was performed. Participants who had delivered at either of two hospitals, had migrated from FGM/C‐prevalent countries and who had undergone FGM/C were assessed and compared with the control group, case‐matched by language and religion. Results Eighty‐nine cases were included with an equal number of matched controls. No significant difference in the EPDS score was demonstrated when analysed as a continuous variable (P = 0.41) or as a categorical variable with a cut‐off score of 12 (P = 0.12). There was no difference in the number of women who identified as having thoughts of self‐harm between the two groups. Conclusion There was no identified increase in the risk of antenatal depression among women who have undergone FGM/C from high‐prevalence countries. Consideration must be given to the utility of the EPDS in this population, as well as factors such as cultural embedding.

Economic burden of female genital mutilation in 27 high-prevalence countries

“…Healthcare utilisation associated with FGM was based on a review and meta-analysis of the literature on clinical complications associated with FGM 19–109. All complications for which a significant association with FGM was found, and for which corresponding interventions could be identified, were included in the healthcare utilisation calculations.…”

The Perception of African Immigrant Women Living in Spain Regarding the Persistence of FGM

“…Among the major short-term physical consequences are haemorrhage, infection and shock [23]. In the long term, women present with clitoral neuroma [22], epidermal cysts [24], fistulas [25], bladder dysfunction [21,26], sexual dysfunction, pelvic pain and obstetrical trauma [27]. FGM leads to a higher risk of prenatal mortality both for the mother and foetus [4,27].…”