‫بسم هللا الرحمان الرحيم‬

Sudan International University

Faculty of Medicine

Female genital mutilation (FGM)

"A proposal submitted for the degree of MBBS in medicine and surgery"
Submitted by:

1 Razan Sabil Mohammed Osman

2 Maha Haider
3 Mahasin Ahmed
4 Malaz Salah
Supervisor:

Introduction:

Female circumcision , the partial or total cutting away of the external genitalia, has been
practiced for centuries in parts of Africa, generally as one element of a rite of passage
preparing young girls for womanhood and marriage . Often performed without anesthetic
under septic conditions by lay practitioners with little or no knowledge of human
anatomy or medicine , female circumcision can cause death or permenant health
problems as well as severe pain. Depsite these grave risks , its practitioners look on it
as an integral part of their cultural and ethnic identity and some perceive it as a
religious obligation.

FGM can cause long-term problems with sex , childbirth and mental health, its very
painful and can seriously harm the health of women and girls.

ClassifIcation of FGM

There are 4 main types of FGM :

Type 1 Clitrodectomy; Which is removing part or all of the clitoris .

Type 2 Excision: Removing part or all of the clitoris and the inner labia (the lips that
surround the vagina) with or without removal of the labia majora (the larger outer lips).

Type 3 Infibulation: Narrowing of the vaginal opening through the creation of a covering seal.
The seal is formed by cutting and repositioning the labia minora or the labia majora ,
sometimes through stitching with or without removal of the clitoral prepuce or clitoral hood and
glans (type 1 FGM)

Type 4 : This includes all of the harmful procedures to the female genitalia for non medical
purposes eg: pricking, piercing, incising , scraoung and cauterizing te genital area.

Immediate Complicatons include:

Severe pain

Excessive bleeding (hemorrhage)

Genital tissue swelling

Fever

Infections eg: tetanus

Urinay problems

Wound healing problems

Injury to the surroundings

Shock

Death

LONG-TERM COMPLICATIONS CAN INCLUD

Urinary problems (painful urination & uinary tract infection)

Vaginal problems (discharge , itching , bacterial vaginosis)

Menstrual problems ( painful menstruation , difficulty in passing menstrual blood)

Scar tissue and keloid

Sexual problems (pain during intercourse & dcreased satisfaction )

Psychological problems ( depression , anxiety , low self-esteem)

Who is at risk ?

FGM is mostly carried out on young girls sometimes between infancy and adolescence and
occisonally adult women. More the 3 million girls are estimated to be at risk for FGM annually.
Problem Statement:
FGM has physical, psychological and social impact on peoples live's.

The direct physical impact it has is on the health and safety og the girls who experience FGM.

The health risk of the practice include bleeding, infection, higher risk of maternal and infant
mortality , infertility, high risk of contracting , HIV , difficulty menstruating, painful, urination &
UTIs.

FGM can also cause short-term and long-term psychological trauma.In short=term it can trigger
behavioral distrubances in children, which are closely linked to a loss of trust in their families or
caregivers .In the longer term, women can experience anxiety and depression.

Finally, the tradition can have social impacts on individuals and families. In the areas where it is
deemed an essential rite of passage , not undergoing cutting can result in social exclusion of
families and girls are often stigmatized and discriminated against.

Justification
Many practitioners of female genital mutilation believe that the procedure is dictated by tradition
and is necessary to ensure marriage because men refuse to marry intact women. It is
sometimes stated that the purpose of female genital multiation is to control women's , sexuality,
and in some settings intact women are considered dishonorable prostitues. FGM is perpetrated
because it gives men power over women as group . While no religion specifically requires
female genital, patriarchal religions create the cultural meiliu that allows this practice to
continue.

Objectives:
General Objectives:

The main objective of this research is to explore (understand) the reasons why FGM is
continued to be practiced among Sudan and other Afican Countries.

Specific objectives:

Assesement and management of women with complications due to FGM during pregnancy.

Assesment and management of women with FGM during labour and delivery.

Management of women with FGM during postpartum period.

Methodolgy:

Study Design:
Cross sectional study on health care providing facilities
Study Area:
The study area will be conducted with differenet health care providing facilities across the
borders of Khartoum State.

Bashair Teaching Hospital

Military Hospital Helipad Hospital

Omdurman Maternity Hospital

Study population:

The number of females that suffer from complications after female

circumcision.

The inclusion criteria:

Participants of 100 females, aged from 15 to 30 years old , Arabic

speakers & sudan in nationality.

The Exclusion criteria:

History of FGM patients

Study Duration:
This study will be conducted in period extended from May to November 2021.

Sampling:
Sample size determination The desired sample was obtained using the Cochrans formula for
calculating sample size n=z2pq/d2{14} Where n=desired minimal sample population
z=standard normal deviation & nbsp; d=degree of accuracy 4% q=1-p Hence substituting the
value into the formula: n=z2pq/d2

Total of Data Collection:

Paper questionnaire, closed questions.

The data will be collected by Face-to-Face interview to elicit information from the physician.

Data will be collected with simple language questionnaire is self administer for literate
people and interview for illiterate peoples and the statistic and the statistical package for
social science program (SPSS).

Ethical Consideration:
Approval will be obtained from faculty of medicine in Sudan International University , then
from the research ethical committee. Later permission from Ministry of Health , Verbal
Consent from the participations.

Duration of Research:

1/5/2021 – 1/11/2021

Budget:

Items /cost total

Transportation

Data Analysis

Thesis Analysis

Others

References and Citing:

www.mayoclinics.org

www.sciencedirect.com/science

www.researchgate.net