Surgical management of female genital mutilation-related morbidity: A scoping review

Chappell, Ava G.; Sood, Rachita; Hu, Andrew; Folsom, Susan; Wafford, Q. Eileen; Bowen, Diana K.; Post, Lori A.; Jordan, Sumanas W.

doi:10.1016/j.bjps.2021.05.022

Cited by 5 publications

(8 citation statements)

References 64 publications

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“…2 A scoping review of surgical interventions for female genital mutilation/cutting–related morbidity confirmed that the majority of female genital mutilation/cutting care is delivered by obstetrics and gynecology providers. 3 However, procedures such as clitoral reconstruction, scar excision, neuroma treatment, and functional and aesthetic reconstruction fall within the scope and expertise of plastic surgeons. 4…”

mentioning

confidence: 99%

Plastic Surgeon Familiarity with Female Genital Mutilation and Cutting in the United States

Chappell

Ascha

Sood

et al. 2022

Plastic &Amp; Reconstructive Surgery

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confidence: 99%

Plastic Surgeon Familiarity with Female Genital Mutilation and Cutting in the United States

Chappell

Ascha

Sood

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…Summary of key features. The template also drew upon elements from the Template for Intervention Description and Replication (TIDieR) framework ( 53 ) as well as key information identified from analysis of core sources ( 27 – 29 , 31 , 33 , 48 ), experiential knowledge of JA, (an FGM/C specialist service lead), the research team and PPI.…”

Section: Methodsmentioning

confidence: 99%

“…In previous evidence reviews authors have distinguished FGM/C interventions for pregnant and non-pregnant women. Chappel ( 31 ) identified deinfibulation, cyst excision, clitoral and vulvar reconstruction, urological reconstruction, peripartum procedures, labial adhesion release, and reinfibulation as surgical interventions for FGM/C-related morbidity for non-pregnant women. In contrast, Balogun ( 32 ) examined maternal care interventions and identified:- deinfibulation; assisted delivery; infection and cyst treatment; psychological counselling; and health focused anti-FGM/C education.…”

Section: Introductionmentioning

confidence: 99%

Examining the key features of specialist health service provision for women with Female Genital Mutilation/Cutting (FGM/C) in the Global North: a scoping review

Albert,

Wells,

Spiby

et al. 2024

Front. Glob. Womens Health

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BackgroundHealth care for women with Female Genital Mutilation/Cutting (FGM/C) in the Global North is often described as sub-optimal and focused on maternity care. Specialist FGM/C services have emerged with little empirical evidence informing service provision. The objective of this scoping review is to identify the key features of FGM/C specialist care.MethodsThe review was conducted in accordance with JBI methodology. Participants: organisations that provide specialist FGM/C care. Concept: components of specialist services. Context: high-income OECD countries. Eligibility criteria included primary research studies of any design from 2012 to 2022, providing a comprehensive description of specialist services. Seven bibliographic databases were searched (MEDLINE, EMBASE, CINAHL, Web of Science, SCOPUS, Cochrane Library and MIC). The components of “specialist” (as opposed to “generalist”) services were defined and then applied to an analysis of FGM/C specialist care. FGM/C specialist provision was categorised into primary (essential) and secondary features. Data were extracted and analysed descriptively through charting in tables and narrative summary.ResultsTwenty-five papers described 20 unique specialist services across eleven high income countries. Primary features used to identify FGM/C specialist care were:—(i) Named as a Specialist service/clinic: 11/20 (55%); (ii) Identified expert lead: 13/20, (65%), either Midwives, Gynaecologists, Urologist, or Plastic Surgeons; (iii) Offering Specialist Interventions: surgical (i.e., reconstruction and/or deinfibulation) and/or psychological (i.e., trauma and/or sexual counselling); and (iv) Providing multidisciplinary care: 14/20 (70%). Eleven services (in Spain, Sweden, Switzerland, Germany, Italy, Netherlands, France, Belgium, and USA) provided reconstruction surgery, often integrated with psychosexual support. No services in UK, Norway, and Australia offered this. Six services (30%) provided trauma therapy only; 25% sexual and trauma therapy; 15% sexual therapy only; 30% did not provide counselling. Secondary features of specialist care were subdivided into (a) context of care and (b) the content of care. The context related to concepts such as provision of interpreters, cost of care, community engagement and whether theoretical underpinnings were described. Content referred to the model of care, whether safeguarding assessments were undertaken, and health education/information is provided.ConclusionOverall, the features and composition of FGM/C specialist services varied considerably between, and sometimes within, countries. Global guidelines advocate that specialist care should include access to deinfibulation, mental health support, sexual counselling, and education and information. The review found that these were rarely all available. In some high-income countries women cannot access reconstruction surgery and notably, few services for non-pregnant women mentioned safeguarding. Furthermore, services for pregnant women rarely integrated trauma therapy or psychosexual support. The review highlights a need for counselling (both trauma and psychosexual) and culturally-appropriate sensitive safeguarding assessments to be embedded into care provision for non-pregnant as well as pregnant women. Further research is needed to extract the features of specialist services into a comprehensive framework which can be used to examine, compare, and evaluate FGM/C clinical specialist care to determine which clinical features deliver the best outcomes. Currently a geographical lottery appears to exist, not only within the UK, but also across the Global North.

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“…The practice of FGM/C often results in well documented short- and long-term sequelae that can negatively impact on women's reproductive health and quality of life [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. Moreover, it is not possible to fully recover from the associated psychological trauma and health-related complications [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of type III female genital mutilation on obstetric outcomes: A systematic review and meta-analysis

Bonavina,

Spinillo,

Sotiriadis

et al. 2024

Heliyon

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Surgical management of female genital mutilation-related morbidity: A scoping review

Cited by 5 publications

References 64 publications

Plastic Surgeon Familiarity with Female Genital Mutilation and Cutting in the United States

Plastic Surgeon Familiarity with Female Genital Mutilation and Cutting in the United States

Examining the key features of specialist health service provision for women with Female Genital Mutilation/Cutting (FGM/C) in the Global North: a scoping review

Effect of type III female genital mutilation on obstetric outcomes: A systematic review and meta-analysis

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