Female genital mutilation and urinary incontinence: an analytical comparison with Sudan's prevalent demography.

OBJECTIVE: Female genital mutilation/cutting impacts over 200 million women globally and is linked to obstetric complications as well as long-term urogynecological and psychosexual issues that are frequently overlooked and inadequately addressed. This study aimed to assess the impact of female genital mutilation/cutting on urinary incontinence. METHODS: This cross-sectional study was conducted in the gynecology department of the Research Hospital located in the Nyala rural region of Sudan. The participants were interviewed to gather socio-demographic and background information. In addition, they received a thorough gynecological examination to evaluate the presence and type of female genital mutilation/cutting. The Incontinence Impact Questionnaire and the Urogenital Distress Inventory were applied to the group with female genital mutilation/cutting and the control group without female genital mutilation/cutting to evaluate urinary incontinence and related discomfort. Subsequently, the scores of both participant groups were compared. RESULTS: The study compared age, weight, height, BMI, gravida, parity, and sexual intercourse averages between groups. The mean Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 scores of individuals who underwent mutilation were higher than those of individuals who did not undergo mutilation (p<0.001). Notably, participants subjected to infibulation exhibited significantly higher average scores on both measures in contrast with the other groups (p<0.001). CONCLUSION: A higher proportion of mutilated participants, specifically those with infibulation, are afflicted with symptoms of incontinence.

Female genital mutilation and its associated factors among adolescent girls and young women in Tanzania: analysis of the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2022 TDHS-MIS).

INTRODUCTION: The morbidity and mortality associated with Female Genital Mutilation (FGM) have been clearly documented. Controlling and eventually eradication this practice is very important. Despite a loud call from the WHO and other international organisations, there are extensive nationalities and societies from both developed and developing countries still practising FGM. Understanding the current magnitude and associated factors in Tanzania may bring more light for possible interventions intended to control FGM. This study is timely for this aim. OBJECTIVE: To determine the prevalence of female genital mutilation and its associated factors among adolescent girls and young women in Tanzania. METHODS: Secondary data analysis was conducted on data from the 2022 Tanzanian Demographic and Health Survey. The weighted sample included in this study was 2965 adolescent girls and young women aged 15-24 years. Data analysis was performed using Stata 18.0 software. The strength of the association was assessed using the adjusted odds ratio (aOR) along with its corresponding 95% confidence interval (CI). RESULTS: The overall prevalence of FGM among adolescent girls and young women in Tanzania was 4.9% (95% CI = 3.37, 6.97). The prevalence varied significantly across the zones, ranging from < 1% in both Zanzibar and Southern zones to 19.7% in the Northern zone. Moreover, the results revealed that factors associated with FGM were rural areas (aOR = 2.09, 95% CI = 1.80, 5.44); no education (aOR = 11.59, 95% CI = 4.97, 27.03); poor (aOR = 2.41, 95% CI = 1.20, 4.83); unskilled manuals (aOR = 3.76, 95% CI = 1.97, 7.15); continued FGM (aOR = 3.86, 95% CI = 1.62, 9.18); FGM required by religion (aOR = 8.5, 95% CI = 3.15, 22.96) and watching television at least once a week (aOR = 0.20, 95% CI = 0.70, 1.56) among adolescents and young women in Tanzania. CONCLUSION: Female genital mutilation among adolescent girls and young women aged 15-24 years in Tanzania has decreased slightly between 2015/16 and 2022 from 5.9% to 4.9% respectively. This was mostly associated with education level, place of residence, occupation, wealth index, mass media exposure, attitudes towards FGM. More tailored programs focusing on high prevalence zones targeting adolescent girls and young women are needed to end female genital mutilation by 2030.

What are the health needs of women with female genital mutilation going through menopause?

Female genital mutilation is widely recognised as a practice that causes grave, permanent damage to the genital anatomy and function. The literature has documented its impact on physical, sexual, emotional, and mental wellbeing, and this has informed the development of guidelines and recommendations for managing women with female genital mutilation. There has, though, been little, if any, focus on how women with female genital mutilation experience menopause. A literature search did not return any published research on the topic and there are currently no clinical guidelines for managing the menopause in women who have undergone female genital mutilation. This review calls attention to this gap by exploring the clinical implications that the loss of natural hormones has on the vulvovaginal tissues, as well as on urogenital and sexual function. Psychological aspects of the experience of women with female genital mutilation going through menopause are also explored, as well as common barriers they face in accessing adequate healthcare. Finally, we offer a set of recommendations for clinical practice, including the need to improve current care pathways, and potential directions for future research.

Female Genital Mutilation/Cutting Related to Reproductive Health Needs During Pregnancy and Birth.

Female genital mutilation and cutting (FGM/C) is a human rights violation and a form of gender-based violence. Yet it is estimated that more than 230 million women and girls globally and over half a million women and girls living in the United States have been subjected to FGM/C or are at risk. Due to rising rates of immigration to the United States, it is more likely that health care providers will encounter patients subjected to FGM/C. In this column, I review clinicians' knowledge of and experience in delivering care to women with FGM/C, patient experiences, the role of clinical guidelines, screening, research gaps, laws, and data. I conclude with recommendations from professional organizations related to the reproductive health needs of women affected by FGM/C during pregnancy and birth.

[Complications of female genital mutilation: epidemiology and management of cases at Ouahigouya regional teaching hospital, Burkina Faso]. / Complications des mutilations génitales féminines : épidémiologie et prise en charge des cas au Centre hospitalier universitaire (CHU) régional de Ouahigouya, Burkina Faso.

Background: Female genital mutilation is still common in Burkina Faso, despite decades of struggle against its practice. The northern region of this country has one of the highest prevalence of this practice at the national level with 76% of women mutilated. The objective of our study was to describe the health complications of female genital mutilation treated in the referral hospital in this region. Patients and methods: This was a descriptive cross-sectional study with retrospective data collection over a 13-year period, from September 15, 2009 to September 14, 2022. Patients admitted for genital or loco-regional complications related to genital mutilation were included. Mutilated parturients without infibulation, victims of vulvar tears or who had undergone episiotomy were not included. Results: We recorded 204 patients, representing 3,1% of consultants, and an annual frequency of 15.7 cases. The ages of the victims ranged from 15 months to 31 years. The 15-20 age group was the most represented (49.3%). Victims were more likely to come from urban than rural areas. The main reasons for consultation were vulvar stricture, dyspareunia, impossibility of sexual intercourse, and dysuria. These were medium- and long-term complications of the mutilation. These complications were related to infibulation in 81.8% of cases and to type II mutilation in 18.2%. Surgery accounted for 89.9% of treatments, with drug treatments alone accounting for 10.1%. Deinfibulation was the most common surgical procedure. No clitoral reconstruction was performed. The outcome was favourable in all cases. Conclusion: There are many local and regional complications of genital mutilation, but fortunately their treatment has a good anatomical prognosis. However, psychological complications remain to be evaluated and managed in our context. The management of these complications should be an opportunity to raise awareness among the patients' family circles to abandon the practice.

"People will talk about her if she is not circumcised": Exploring the patterning, drivers and gender norms around female genital mutilation in Ethiopia's Somali region.

Over the past decade there has been a burgeoning literature on social norms and the need to understand their context-specific patterning and trends to promote change, including to address the harmful practice of female genital mutilation (FGM), which affects around 200 million girls and women globally. This article draws on mixed-methods data collected in 2022 and 2023 with 1,020 adolescents and their caregivers, as well as key informants, from Ethiopia's Somali region to explore the patterning, drivers, and decision-making around FGM. Findings indicate that almost all Somali girls can expect to undergo FGM before age 15, and that infibulation is near universal. Critically, however, we find that respondents' understanding of infibulation is rooted in traditional practice, and many girls are now "partially" infibulated-an invasive procedure that girls nonetheless see as an improvement over the past. These shifts reflect religious leaders' efforts to eliminate traditional infibulation--and the health risks it entails--by promoting "less invasive" types of FGM as a requirement of Islam. We also find evidence of emergent medicalization of the practice, as mothers-who are the primary decision-makers-seek to further reduce risks. Adult and adolescent respondents agree that FGM is a deeply embedded social norm, but distinguish between FGM as a perceived religious requirement, and infibulation as a cultural requirement. For girls and women, the importance of FGM is framed around social acceptance, whereas boys and men focus on FGM as a requirement for marriage as it allows families to control girls' sexuality. The article concludes by reflecting on the implications of our findings for programming in high-prevalence contexts. Key conclusions include that FGM interventions should not rely on empowering individuals as "champions of change" but rather prioritize engagement with whole communities, and should be open in the short term to incremental harm-reduction approaches.

Maternal origin matters: Country of birth as a risk factor for obstetric anal sphincter injuries.

OBJECTIVE: Obstetric anal sphincter injuries (OASIS) are severe complications to vaginal births with potential long-term consequences. Maternal origin has been proposed to affect the overall risk, but the association and underlying explanation are uncertain. The objective was to assess the association between maternal country of birth and OASIS. METHODS: A Swedish nationwide cohort study including singleton term vaginal births during 2005-2016. Data were extracted from the Swedish Medical Birth Registry and Statistics Sweden. Modified Poisson regression analyses were performed to obtain crude and adjusted risk ratios (RRs). Adjustments were made in four cumulative steps. Sub-analyses were performed to investigate the risk of OASIS associated with female genital circumcision (FGC). RESULTS: In all, 988 804 births were included. The rate of OASIS in Swedish-born women was 3.5%. Women from East/Southeast Asia had an increased risk of OASIS (adjusted RR [aRR] 1.71, 95% confidence interval [CI] 1.60-1.83), as did women born in Sub-Saharan Africa (aRR 1.60, 95% CI 1.49-1.72). The risk remained significantly increased also after adjustment for maternal height. By contrast, women from South/Central America had a decreased risk of OASIS (aRR 0.65, 95% CI 0.56-0.76). FGC was associated with an increased risk of OASIS (aRR 3.05, 95% CI 2.60-3.58). Episiotomy appeared to have an overall protective effect (aRR 0.95, 95% CI 0.92-0.98), but not significantly more protective among women with female genital mutilation. CONCLUSIONS: Country of birth plays an important role in the risk of OASIS. Women from East/Southeast Asia and Sub-Saharan Africa are at significantly increased risk as compared with Swedish-born women, whereas women from South/Central America are at lower risk. FGC is also a significant risk factor for OASIS.

[Obstetrical and neonatal prognosis of patients with a history of female genital mutilation]. / Pronostic obstétrical et néonatal des patientes ayant un antécédent de mutilation génitale féminine.

OBJECTIVE: Female genital mutilation (FGM) covers all procedures involving partial or total removal of the external genitalia for non-therapeutic purposes. The period of pregnancy and childbirth is probably more at risk of complications for these women. The main aim of this study was to compare obstetrical, maternal and neonatal outcomes in patients with a history of female genital mutilation with patients without such a history. METHODS: All deliveries taking place between January 2005 and June 2022 at Besançon University Hospital in patients with a history of FGM were included. This group was compared with a randomly selected group of deliveries of patients with no history of FGM. A total of 87 deliveries with a history of FGM were included and compared with 696 deliveries with no history of FGM. RESULTS: There were significantly more instrumental deliveries (27.6% vs. 17.5%, P=0.01), more caesarean sections (23% vs. 14.1%, P=0.01), more episiotomies (9.2% vs. 0.7%, P<0.01), more first-degree perineal tears (30.8% vs. 20.8%, P=0.02), second-degree (13.9% vs. 5.3%, P<0, 01), third-degree (3.1% vs. 0.2%, P=0.02), more anterior perineal tears (23.1% vs. 2.5%, P<0.01), increased duration of pushing efforts (13 min vs. 10 min, P=0.05) and greater blood loss (297 cc vs. 165 cc, P<0.01) in the group with a history of FGM. There was no statistically significant difference in neonatal outcome. CONCLUSION: The obstetrical prognosis of patients with a history of FGM is significantly poorer. Neonatal prognosis remains unchanged.

The comparison of sexual function in types I and II of female genital mutilation.

BACKGROUND: Female genital mutilation has many sexual, physical, and psychological consequences. The present study aimed to examine the relationship between Female Genital Mutilation/Cutting (FGM/C), and Sexual Function among circumcised women in Sardasht City, Iran." METHODS: In this present cross-sectional study, 197 women who were mutilated entered the study by simple random sampling from two healthcare centers in Sardasht, Iran. A gynecologist first performed a genital examination to identify the type of female genital mutilation of participants. Subsequently, Socio-demographic and FGM/C-related characteristics checklist and the female sexual function index questionnaire were completed by interview method. Data were analyzed using SPSS 23 software. RESULTS: Type I and II of female genital mutilation were performed in 73.1 and 26.9% of the participants, respectively. The age range of performing female genital mutilation in type I and II of female genital mutilation was 4-10 years old in 67.4% and 71.1% respectively. Traditional practitioners/local women carried out the circumcision in all of the participants, and Sunnah/tradition was reported as the most common reason for doing this procedure. The average total score of FSFI index in type I and II of female genital mutilation was 23.5 ± 2.0 and 17.4 ± 2.39, respectively. In all domains of FSFI, women with type II of female genital mutilation obtained lower scores than women with type I. CONCLUSION: Circumcised women have reduced scores in all domains of FSFI, and the severity of sexual dysfunction is related to the type of FGM/C. Considering the prevalence of female genital mutilation and its adverse effects, it is imperative to initiate cultural improvements through education and awareness. By educating and raising awareness among individuals about this issue, we can foster positive changes and address the problem effectively.

A long-term complication of clitoral cyst after female genital mutilation.

Female genital mutilation (FGM) was seen in 30 countries, especially in Africa and also in Asia and the Middle East. According to WHO data, Somalia is where FGM is performed most frequently. Our study aimed to evaluate the recordings of patients with FGM who were diagnosed with a traumatic clitoral cyst. We identified the clitoral cyst cases between February 2015 and August 2020. We collected clinical, surgical, sociodemographic, and histopathological details such as age, marital status, patient resume, age at which FGM was performed, complaints, size of the cyst consultation reasons, FGM procedural long-term complications, sexual function, husband polygamic relationship status, and histological findings. A total of 21 patients diagnosed with clitoral cysts were included in the study. The technique was easily applied in every patient, and the cysts were removed intact, except in 2 patients. There were no intraoperative complications; only minimal bleeding was seen. Except for one patient, all had unilocular cysts, and the final pathological examination revealed an epidermal inclusion cyst. We observed a neuroma developed due to genital trauma due to FGM in one of our patients. Female circumcision and its consequences are not familiar to many healthcare professionals in the developed world. We want to increase awareness of female circumcision and its long-term complication of clitoral cysts among healthcare professionals worldwide.

La mutilación genital femenina como problema de salud pública / No disponible

No disponible

Percepciones de los hombres sobre las complicaciones asociadas a la mutilación genital femenina / Male perceptions of sequelae associated with female genital mutilation

Objetivo: Explorar el conocimiento de los hombres procedentes de países donde se realiza la mutilación genital femenina sobre las consecuencias negativas en la salud de las mujeres afectadas. Métodos: Metodología cualitativa con enfoque etnometodológico, a través de entrevistas semiestructuradas individuales y grupales a 25 hombres, en relación con la mutilación genital femenina, seleccionados mediante triple muestreo. Se entregó una carta de presentación del estudio a los participantes y la declaración del consentimiento informado, y se les solicitó permiso para grabar la entrevista en audio. El análisis de los datos se realizó con el softwareinformático Atlas. Ti7. Resultados: Los participantes contrarios al corte son conscientes de la diversidad de complicaciones físicas, obstétricas, psicológicas, sobre la sexualidad y sociales en las mujeres sometidas a mutilación. Sin embargo, los hombres que tienen un posicionamiento favorable muestran en general un desconocimiento de los problemas secundarios a esta práctica. Conclusiones: Los participantes procedentes de países donde se realiza la mutilación genital femenina, contrarios a mantener esta práctica, muestran un mayor conocimiento de las consecuencias negativas que los que se manifiestan a favor. El diseño de herramientas y programas de sensibilización destinados a la lucha contra la mutilación genital femenina debe visibilizar las complicaciones sobre la salud de las mujeres y las niñas, e incluir intervenciones familiares que impliquen a los hombres en el proceso de erradicación de esta práctica (AU)

Objective: To explore men's knowledge of the negative consequences of female genital mutilation (FGM) to women's health in countries where this practice is performed. Methods: A qualitative methodology was used with an ethnomethodological approach. Both individual and group semi-structured interviews concerning FGM were conducted with 25 men, selected by triple sampling. A study presentation letter was provided to participants, together with an informed consent declaration. Permission was also procured to record the interviews in audio format. Data analysis was performed using the Atlas Ti7 software. Results: Those participants against FGM are aware of the range of complications this practice can cause, being able to identify physical, obstetric, psychological, sexuality and social consequences in women subjected to FGM. However, those men who are in favour display a general ignorance of the problems resulting from this practice. Conclusions: Participants from countries where FGM is performed who are against this practice are more aware of the negative consequences than those who claim to be in favour. The design of awareness-raising programmes and other tools to combat female genital mutilation must highlight the implications for women's and girls’ health, and include family-targeted campaigns which involve men in the process of eradicating this practice (AU)

Mutilación genital femenina: elementos necesarios para su enfrentamiento / Female Genital Mutilation: necessary elements for its confrontation

Introducción: La mutilación genital femenina (MGF) es una costumbre violatoria de los derechos humanos de las niñas y las mujeres. Objetivo: Describir elementos necesarios relacionados con la mutilación genital femenina. Material y Métodos: Se realizó una revisión bibliográfica en bases de datos disponibles en la plataforma Infomed (Pubmed, EBSCO, Hinari, Scielo) de 18 materiales científicos impresos y electrónicos relacionados con el tema, todos en el último quinquenio y utilizando los descriptores de búsqueda: mutilación genital femenina, tipos, complicaciones, factores de riesgos y prevención. Desarrollo: El número de niñas y jóvenes en riesgo de padecer mutilación genital aumenta en Europa y África, no se puede establecer una religión única, la práctica de la mutilación genital femenina es anterior al Islam y no es habitual entre la mayoría de los musulmanes. Existen diferentes tipos de mutilación: I, II, III, IV, depende de la región anatómica comprometida. Las complicaciones más sobresalientes son: dolor intenso, hemorragias, tétanos, septicemia y psicológicas. Se citan elementos preventivos por el sistema de salud que disminuye la práctica. Conclusiones: La MGF constituye una de las técnicas nefastas más significativas, sumado a ello los principios de internacionalismo del médico cubano prueba que la descripción de los componentes epidemiológicos, tipos, complicaciones de la práctica y el enfoque social de las acciones preventivas; ayudan a los trabajadores de la salud a revertir tal proceder(AU)

Introduction: Female genital mutilation is a violation of human rights of girls and women. Objective: to describe necessary elements related to female genital mutilation. Material and Methods: A literature review of 18 printed and electronic supported scientific materials related to the topic available in Infomed platforms databases (Pubmed, EBSCO, Hinari, Scielo) was performed, all included in the last five years and using searching describers: female genital mutilation, types, complications, risk factors and prevention. Development: The number of girls and young women at risk of genital mutilation increases in Europe and Africa, it is not possible to establish a single religion; practice regarding female genital mutilation predates Islam and is not common among most Muslims. There are different types of mutilation: I, II, III, IV, depends on the anatomical region. The most significant complications include severe pain, hemorrhage, tetanus, septicemia and psychological. Preventive elements are referred by the health system that reduces its practice. Conclusions: female genital mutilation is one of the most significant fateful techniques, added to it, the internationalism principles of the Cuban doctor, proof that the description of epidemiological components, types, complications of it practice and a social approach of preventive actions, help health workers to revert this conduct(AU)

Determinants of female genital mutilation practices in East Gojjam zone, western Amhara, Ethiopia

Background: Female genital mutilation is one of the harmful traditional practices among women and girls. More than 130 million girls and women live today who have undergone female genital mutilation. In Ethiopia, a high prevalence (74.3% national and 68.5% in Amhara region) has been reported. This study was aimed to identify determinant factors of female genital mutilation practices in East Gojjam Zone, Western Amhara, Ethiopia. Methods: A community based cross sectional study was conducted among 730 women aged 15-49 years and having children < 5 years old in September, 2014. Data were collected using a pretested interviewer administered questionnaire. Descriptive statistics were used to describe study objectives, and bivariate and multivariate analysis to identify determinant factors to female genital mutilation.Results: 718 women and 805 daughters participated in the study. FGM prevalence was 689 (96%) and 403 (49%) among women and daughters< 5 years of age, respectively. Type1 and type 2 FGMs were common and daughters <1 years of age exhibited 91% female genital mutilation. Daughters' age, parent education level, residence, women circumcision history, culture, health education, frequent health extension workers follow up and participation in anti FGM interventions were risk factors to female genital mutilation practice.Conclusions: Female genital mutilation practices continues to be a major problem to women and daughter <5 years of age in the study area. A number of factors were associated with FGM practices including daughters' age, parent education level, residence, health education, culture, mothers circumcision history, frequent health extensions workers follow up and participation in anti FGM interventions were determinants to higher FGM practices

WHO guidelines on the management of health complications from female genital mutilation / Lignes directrices de l'OMS sur la prise en charge des complications des mutilations sexuelles féminines

These guidelines are intended primarily for health-care professionals involved in the care of girls and women who have been subjected to any form of female genital mutilation (FGM). This document also provides guidance for policy-makers, health-care managers and others in charge of planning, developing and implementing national and local health-care protocols and policies. The information contained in this document will also be useful for designing job aids and pre- and in-service professional training curricula in the areas of medicine, nursing, midwifery and public health for health-care providers caring for girls and women living with FGM.

Estrategias para el abordaje y prevención de la mutilación genital femenina desde la Enfermería: Una revisión videográfica / Strategies aimed at approaching and preventing the female genital mutilation from nursing: Video-graphic review

Objetivo principal: Identificar las estrategias que pueden utilizarse en la prevención de la mutilación genital femenina en inmigrantes originarias de países donde se realiza esta práctica. Metodología: revisión de la videografía. La búsqueda se realizó de octubre de 2013 a febrero de 2014, utilizando las palabras clave "mutilación genital femenina", "ablación del clítoris" y "female genital mutilation". Se seleccionaron 9 vídeos. Resultados: la estrategia para prevenir la práctica es la información. Los testimonios en contra también son eficaces. En España se utilizan mediadores interculturales y la carta de no mutilación. Conclusión principal: las enfermeras pueden trabajar la prevención de la mutilación genital proporcionando información sobre sus consecuencias, reforzando la información con mediadores interculturales o testimonios disponibles en vídeos. También disponen de recursos ante riesgo inminente de mutilación

Objective: To identify strategies that can be used in the prevention of female genital mutilation on immigrant groups that come from countries where female genital mutilation is a traditional practice. Methods: Systematic videography review. Research was made between October 2013 and February 2014. Keywords used were "mutilación genital femenina", "ablación del clítoris" and "female genital mutilation". From all the videos obtained, 9 were selected. Thematic Sections: Information is the strategy to prevent the practice of female genital mutilation. Experience and testimonials are also effectives. In Spain, there are intercultural parameters and the no mutilation letter. Conclusions: Nurses can work in the prevention of the genital mutilation by providing information on the consequences of this practice, strengthening information by intercultural mediators or video testimonials. Nurses also have resources to prevent any imminent mutilation risk

Mutilación genital femenina y sus complicaciones a largo plazo / Female genital mutilation and its long-term complications

Introducción: La ablación o mutilación genital femenina incluye una amplia variedad de prácticas que suponen la extirpación total o parcial de los genitales externos o su alteración por razones que no son de índole médica. Causa daños irreversibles y pone en peligro la salud, e incluso la vida de la mujer o niña afectada.Objetivo: Caracterizar la mutilación genital femenina y sus complicaciones a largo plazo en la comunidad de Fajikunda, Gambia, entre marzo y septiembre de 2012.Método: Se realizó un estudio descriptivo prospectivo a 117 mujeres que asistieron al centro de salud por cualquier motivo que requiriera examen ginecológico y se estudiaron las variables grupo de edades, tipo de mutilación, grupo étnico y complicaciones.Resultados: Del total, 98 mujeres eran de 45 años de edad o menos; la clitoridectomía (tipo I) fue la práctica más frecuente; la inflamación pélvica crónica y el dolor en los genitales fueron las complicaciones a largo plazo que mayor asociación estadística demostraron con relación a la mutilación. La anorgasmia presentó una alta incidencia en la población estudiada.Conclusiones: La prevalencia de la mutilación genital femenina en Fajikunda es aproximadamente la misma que en Gambia, la tipo I es la más practicada y generalmente en jóvenes de la etnia Mandinga(AU)

Introduction: The ablation or female genital mutilation includes a wide variety of practices dealing with total or partial extirpation of the external genitalia or its alterations for reasons other than of medical nature. It causes irreversible damages and puts in danger the health or even the life of the woman or child involved.Objective: The aim of the present study is to characterize female genital mutilation and its long-term complications in Fajikunda community, Gambia, between March and September 2012.Method: A descriptive prospective study was performed to 117 women that attended the health unit for reasons requiring gynecological examination and the variables age group, mutilation type, ethnic group and complications were studied.Results: Of the total, 98 women were 45 years old or less; the clitoridectomy (type I) was the most frequent practice; cronical pelvic and genital pains were the long-term complications that showed a major statistical association with relation to mutilation.Conclusions: The prevalence of female genital mutilation in Fajikunda is approximately the same as in Gambia, the type I is the most performed and generally within young women belonging to Mandinga ethnic group(AU)

Reflections on female circumcision discourse in Hargeysa, Somaliland: purified or mutilated?

In communities where female circumcision is carried out, increasingly large segments of the population have been exposed to strong arguments against the practice. This study aimed to explore diverse discourses on female circumcision and the relationship between discourses and practice among informants who have been exposed both to local and global discourses on female circumcision. A qualitative study was carried out in 2009/10 in Hargeysa, Somaliland, employing interviews and informal discussion. The main categories of informants were nurses, nursing students, returned exile Somalis and development workers. The study findings suggest that substantial change has taken place about perceptions and practice related to female circumcision; the topic is today openly discussed, albeit more in the public than in the private arena. An important transformation moreover seems to be taking place primarily from the severe forms (pharaoni) to the less extensive forms (Sunna). (Afr J Reprod Health 2014; 18[2]: 22-35)

Una visión globalde la mutilación genital femenina / A global vision about female genital mutilation

La Organización Mundial de la Salud, el Fondo de Naciones Unidas para la Infancia (UNICEF) y otras organizaciones utilizan tanto el término «mutilación genital femenina» (MGF) como los de «circuncisión femenina» o «exéresis genital femenina». Este tipo de prácticas atentan contra la integridad física y psíquica de las mujeres y las niñas. Los análisis más recientes indican que, anualmente, unos 4 millones de niñas y mujeres son sometidas a algún tipo de ablación en el continente africano. Casi la mitad de las afectadas se ubican en dos países: Egipto y Etiopía. Es preciso un asesoramiento jurídico a los profesionales de la salud que garantice las acciones para luchar contra estas prácticas tradicionales de mutilación de los genitales de la mujer, que constituyen una violación de los derechos humanos, en particular por su carácter discriminatorio y violento y por las consecuencias perjudiciales que conllevan para la salud. En la legislación española cualquier mutilación constituye un delito de lesiones, tipificado y sancionado. El objetivo de este trabajo es realizar una actualización sobre la MGF y sobre las recomendaciones en los cuidados durante el embarazo, el parto y el puerperio (AU)

The World Health Organization, UNICEF and other organizations use the term female genital mutilation (FGM) but others use female circumcision. This type of practices attempt over women’s physical and mental integrity, knowing that is an amputation of a functional part of the feminine genitalia. Though is difficult to calculate the total of women affected, recent data analysis says that annually about 4 million of girls and women are in risk of suffer it. About half of them are in Egypt and Ethiopia. The age can vary between 5 and 14 years of age. Legal advice is necessary to health professionals, to ensure action to combat these practices, the genital mutilation of women, mostly from the customs of African countries, which constitute a violation human rights. Spanish law does not specifically ban female genital mutilation, but whatever kind of mutilation practiced is an offense, defined and punished in our legal system. The aim of this paper is an update on FGM and on the recommendations of care during pregnancy, childbirth and postpartum (AU)