Female genital mutilation

• FGM-
Definition
Prevalence
 Classification
Complications( short term & long term)

Presenter- Dr YESIGAT A. @ WKU---Nov-26/2012 E.c

Female genital mutilation

• Also known as female genital cutting and female circumcision

• Is the ritual removal of some or all of the external female genitalia.
• All procedures involving partial or total removal of the external female genitalia
or other injury to the female genital organs whether for cultural or other non-
therapeutic reasons.
• Typically carried out by a traditional circumciser using a blade or razor (with or
without anaesthesia).
• The age at which it is conducted varies from days after birth to puberty; most girls
are cut before the age of five years.
• The procedures differ according to the ethnic group.
• They include removal of the clitoral hood and clitoral glans, removal of the inner
labia and, in the most severe form (known as infibulation), removal of the inner
and outer labia and closure of the vulva.
• In infibulation, a small hole is left for the passage of urine and menstrual fluid,
and the vagina is opened for intercourse and opened further for childbirth.
• There are no known health benefits.
• The practice is rooted in gender inequality, attempts to control women's
sexuality, and ideas about purity, modesty and aesthetics.
• It is usually initiated and carried out by women, who see it as a source of honour,
and who fear that failing to have their daughters and granddaughters cut will
expose the girls to social exclusion.
Prevalence

• FGM is mostly found in what we call "intriguingly contiguous" zone in Africa.

East to west from Somalia to Senegal, and
North to south from Egypt to Tanzania.
• As of 2014, 133 million women and girls were thought to be living with FGM in
the 29 countries in which it is concentrated.
• Egypt, Ethiopia and Nigeria had the highest number of women and girls living
with FGM as of 2013: 27.2 million, 23.8 million and 19.9 million respectively.
• Egypt outlawed FGM in 2007, Ethiopia in 2004 and Nigeria in 2015.
• In 2014 prevalence rates for women in sub-Saharan Africa were 39
percent and for girls aged 0–14, 17 percent.
• For Eastern and Southern Africa the figures were 44 and 14 percent,
and for West and Central Africa 31 and 17 percent.

• FGM is more common in rural areas

Classification

• Based on how much tissue is removed, FGM is classified into four

categories as follows.
• Type I
 Ia- removal of the clitoral hood (rarely performed alone).
 Ib (clitoridectomy)- the complete or partial removal of the clitoral glans
and clitoral hood.
• Type II (excision)- is the complete or partial removal of the inner labia, with or
without removal of the clitoral glans and outer labia.
 IIa -is removal of the inner labia;
 IIb- removal of the clitoral glans and inner labia; and
 IIc- removal of the clitoral glans, inner and outer labia.
• Type III (infibulation or pharaonic circumcision) - the "sewn closed" category, involves
the removal of the external genitalia and fusion of the wound. The inner and/or outer labia are
cut away, with or without removal of the clitoral glans.
 Type IIIa- is the removal and closure of the inner labia and
 Type IIIb - the removal and closure of outer labia.
• Type IV - all other harmful procedures to the female genitalia for non-medical
purposes.
 including pricking, piercing, incising, scraping and cauterization.
 It also includes nicking of the clitoris (symbolic circumcision), burning or
scarring the genitals, and introducing substances into the vagina to
tighten it.
Complications

• FGM harms women's physical and emotional health throughout their

lives.
• It has no known health benefits.
• The short-term and late complications depend on
 the type of FGM, whether the practitioner had medical training, and
whether she used antibiotics and unsterilized or surgical single-use
instruments.
Short-term complications

• Swelling, excessive bleeding/Anemia, pain, urine retention and

healing problems/wound infection.
• Urinary tract infection, septicaemia, tetanus, gangrene, necrotizing
fasciitis (flesh-eating disease) and endometritis.
• Aid the transmission of hepatitis B, hepatitis C and HIV
Late complications

• Formation of scars and keloids that lead to strictures and obstruction.

• Epidermoid cysts that may become infected.
• Neuroma formation (growth of nerve tissue) involving nerves that supplied the
clitoris.
• Vesicovaginal or rectovaginal fistulae can develop (holes that allow urine or
faeces to seep into the vagina).
• Pain during sexual intercourse (dyspareunia) and infertility.
• Painful periods are common because of the obstruction to the menstrual flow,
and blood can stagnate in the vagina and uterus.
• Complete obstruction of the vagina can result in hematocolpos and
hematometra (where the vagina and uterus fill with menstrual blood).
• During pregnancy and child birth:
Difficulty to obtain clear urine sample
Prolonged or obstructed labor
Perineal tears

Psychologically-anxiety, depression, PTSD.

The End !!

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