Female Genital Mutilation
Female Genital Mutilation (FGM) is a reproductive health issue for many wmen. In the UK, it is estimated that up to 24,000 girls under the age of 15 are at risk of female circumcision. In line with the government guideline launch to support front-line professional such as teachers, health professionals, police officers and social workers to prevent and tackle FGM.
Forms of FGM
There are four main types of FGM:
- Type 1 (clitoridectomy) – removing part or all of the clitoris.
- Type 2 (excision) – removing part or all of the clitoris and the inner labia (lips that surround the vagina), with or without removal of the labia majora (larger outer lips).
- Type 3 (infibulation) – narrowing of the vaginal opening by creating a seal, formed by cutting and repositioning the labia.
- Type 4 - Other harmful procedures to the female genitals, including pricking, piercing, cutting, scraping or burning the area.
FGM is often performed by traditional circumcisers or cutters who do not have any medical training. However, in some countries it may be done by a medical professional.
Anaesthetics and antiseptics aren't generally used, and FGM is often carried out using knives, scissors, scalpels, pieces of glass or razor blades.
FGM often happens against a girl's will without her consent and girls may have to be forcibly restrained.
Effects of FGM
There are no health benefits to FGM and it can cause serious harm, including:
- constant pain
- pain and/or difficulty having sex
- repeated infections, which can lead to infertility
- bleeding, cysts and abscesses
- problems passing urine or incontinence
- depression, flashbacks and self-harm
- problems during labour and childbirth, which can be life-threatening for mother and baby
Some girls die from blood loss or infection as a direct result of the procedure.
FGM & Sex
FGM can make it difficult and painful to have sex. It can also result in reduced sexual desire and a lack of pleasurable sensation.
Talk to your GP or another healthcare professional if you have sexual problems that you feel may be due to FGM, as they can refer you to a special therapist who can help.
FGM & Pregnancy
Some women with FGM may find it difficult to become pregnant, and those who do conceive can have problems in childbirth.
If you're expecting a baby, your midwife should ask you at your antenatal appointment if you've had FGM. It's important to tell your midwife if you think this has happened to you, so they can arrange appropriate care for you and you baby.
FGM & Mental Health
FGM can be an extremely traumatic experience that can cause emotional difficulties throughout life, including;
- flashbacks to the time of the cutting
- nightmares and other sleep problems
In some cases, women may not remember having the FGM at all, especially if it was performed when they were an infant.
Talk to your GP or another healthcare professional if you're experiencing emotional or mental health problems that may be a result of FGM. Help and support is available.
Treatment for FGM (deinfibulation)
Surgery can be performed to open up the vagina, if necessary. This is called deinfibulation.
It's sometimes known as a "reversal" although this name is misleading, as the procedure doesn’t replace any removed tissue, and will not undo the damage caused. However, it can help many problems caused by FGM.
Surgery may be recommended for:
- women who are unable to have sex or have difficulty passing urineas a result of FGM
- pregnant women at risk of problems during labour or delivery as a result of FGM
Deinfibulation should be carried out before getting pregnant, if possible. It can be done in pregnancy or labour if necessary, but ideally should be done before the last two months of pregnancy. The surgery involves making a cut (incision) to open the scar tissue over the entrance to the vagina.
It's usually performed under local anaesthetic in a clinic and you won't normally need to stay overnight. A small number of women need either a general anaesthetic or spinal anaesthetic (injection in the back), which may involve a short stay in hospital.
How SHINE Can Help
SHINE initiated training sessions in order to explain the complex issues around Female Genital Mutilation. SHINE would also be keen to help professionals so that they can identify the signs that girls and women may be at risk or who are dealing with the consequences of FGM. SHINE also work to encourage groups to support and to protect girls and women at risk.SHINE have had a number of trainings sessions for male and female African groups.
A helpline, specialising in responses to female genital mutilation (FGM) has been set up by the NSPCC, supported by the Metropolitan Police, and in association with a number of voluntary and professional groups, including FGM charities.
The Female Genital Mutilation Helpline was launched in June 2013 as a UK-wide service. It will operate 24/7, and will be staffed by specially trained child protection helpline counsellors who can offer advice, information, and assistance to members of the public and to professionals. Counsellors will also be able to make referrals, as appropriate, to statutory agencies and other services.
The helpline can be contacted on: 0800 028 3550
This simple eight-page booklet about FGM is aimed at young people aged 9 and above.
It includes information about:
- what FGM is
- why it's often kept secret
- what harm FGM does to girls and women
- who to talk to about it.
For use in primary schools by teachers and other professionals delivering sex and relationships education. To read more and download your free copies, see here: http://www.fpa.org.uk/sites/default/files/my-body-my-rules-female-genital-mutilation-information.pdf
In Newcastle there are multi agency guidance and the FGM mandatory reporting procedural information. The links to these documents are below: