The use of intrapartum defibulation in women with female genital mutilation

Abstract

Objective To assess the use of intrapartum de®bulation for women who have had female genital mutilation.Design A retrospective case analysis. Setting King Abdulaziz University Hospital, a teaching hospital in Jeddah, Saudi Arabia.Sample Two hundred and thirty-three Sudanese and 92 Somali women who were delivered at the hospital between January 1996 and December 1999.Methods The outcome of labour of women with female genital mutilation who needed intrapartum de®bulation were compared with the outcome of labour of women without female genital mutilation who did not need intrapartum de®bulation.Results One hundred and ®fty-eight (48.6%) women had in®bulation and needed intrapartum de®bulation to deliver vaginally, 116 women (35.7%) did not have in®bulation and gave birth vaginally without de®bulation, and 51 (15.7%) women were delivered by caesarean section. There were no statistically signi®cant differences, between women who underwent intrapartum de®bulation and those who did not, in the duration of labour, rates of episiotomy and vaginal laceration, APGAR scores, blood loss and maternal stay in hospital. The surgical technique of intrapartum de®bulation was easy and no intraoperative complications occurred. Conclusions Intrapartum de®bulation is simple and safe, but sensitivity to the cultural issues involved is essential. In the longer term, continuing efforts should be directed towards abandoning female genital mutilation altogether.

Defibulation During Vaginal Delivery for Women With Type III Female Genital Mutilation

“…An interesting finding is the lack of significant statistical differences in the first and second stages of labor between women with defibulation and women without defibulation. This is in agreement with other studies 10,21 and suggests that with timely defibulation during delivery, the duration of labor of women with female genital mutilation or cutting should not be different than women without female genital mutilation or cutting. An earlier study from Saudi Arabia showed significant prolongation in the second stage of labor between women with female genital mutilation or cutting and women without it.…”

“…Defibulation was done as described previously. 10 After examination of the scar (Fig. 3), urinary catheterization is done.…”

“…7,8 Despite the numbers of women with female genital mutilation or cutting, there are few published reports on defibulation before pregnancy, antenatally, or during vaginal delivery. In our center, based on the local prevailing standards of care 5,9 and a previous published study from our center, 10 we follow a policy of routine defibulation during vaginal delivery for women with type III female genital mutilation or cutting. The objective of this study was to assess our routine practice of defibulation during vaginal delivery for pregnant immigrant women who have undergone type III female genital mutilation or cutting.…”

“They Get a C-Section . . . They Gonna Die”: Somali Women’s Fears of Obstetrical Interventions in the United States

“…Women in our study did note that "cutting" is often needed for vaginal delivery but did not mention other peripartum complications from female circumcision (Chalmers & Hashi, 2000;Vangen et al, 2004;Vangen, Stoltenberg, Johansen, Sundby, & Stray-Pedersen, 2002). There is some controversy, as other reports in the literature do not find the same complications when intrapartum defibulation is performed by knowledgeable health professionals (Essen, Sjoberg, Gudmundsson, Ostergren, & Lindqvist, 2005;Rouzi, Aljhadali, Amarin, & Abduljabbar, 2001).…”

Weibliche Genitalbeschneidung

“…Eine Studie aus Saudi-Arabien zeigt, dass zwischen infibulierten Frauen, die intrapartal deinfibuliert wurden, und unbeschnittenen Frauen kein signifikanter Unterschied hinsichtlich Apgar-Score, Blutverlust und Krankenhausaufenthalt besteht [18]. Nach Hakig [19] fällt der Apgar-Score in den ersten 10 Minuten bei Kindern unbeschnittenen Frauen günstiger aus als bei denen von beschnittenen Frauen, jedoch zeigt sich in beiden Gruppen eine gleiche Verteilung perinataler Todesfälle.…”