Female genital mutilation: an injury, physical and mental harm

Abstract

This article gives an overview over the huge topic of 'female genital mutilation' (FGM). FGM means non-therapeutic, partial or complete removal or injury of each of the external female genitals. It concerns about 130 million women around the world. FGM is performed in about 30 countries, most of which are located in Africa. Four types of FGM are distinguished: type I stands for the removal of the clitoral foreskin, type II means the removal of the clitoris with partial or total excision of the labia minora. Type III is the extreme type of FGM. Not only the clitoris but also the labia minora and majora were removed. The orificium vaginae is sewn up, leaving only a small opening for urine or menstruation blood. Other types like pricking, piercing of clitoris or vulva, scraping of the vagina, etc. were defined as type IV of FGM. The mentioned reasons for FGM are: encouragement of the patriarchal family system, method for birth control, guarantee of moral behaviour and faithfulness to the husband, protection of women from suspicions and disgrace, initiation ritual, symbol of feminity and beauty, hygienic, health and economic advantages. Acute physical consequences of FGM include bleeding, wound infections, sepsis, shock, micturition problems and fractures. Chronic physical problems like anemia, infections of the urinary tract, incontinence, infertility, pain, menstruation problems and dyspareunia are frequent. Women also have a higher risk for HIV infections. During pregnancy and delivery, examinations and vaginal application of medicine are more difficult. Women have a higher risk for a prolonged delivery, wound infections, a postpartum blood loss of more than 500 mL, perineal tears, a resuscitation of the infant and an inpatient perinatal death. Mental consequences after FGM include the feelings of incompleteness, fear, inferiority and suppression. Women report chronic irritability and nightmares. They have a higher risk for psychiatric and psychosomatic diseases. FGM carried out by doctors, nurses or midwives is also called medicalisation of FGM and is definitely unacceptable. Regarding human rights, FGM refuses women the right of freedom from bodily harm. Specific laws that ban FGM exist in many countries in Europe, Africa, USA, Canada, New Zealand and Australia.

Female Genital Cutting and the Health Care Provider’s Dilemma: A Case Study

“…Most females undergo FGC between the ages of 4 and 10 years old or during infancy (Utz-Billing & Kentenich, 2008). It is estimated that 3 million girls are at risk for FGC every year (OHCHR et al, 2008).…”

“…They are at greater risk for maternal and neonatal death (WHO & Department of Reproductive Health and Research, 2001). Women with FGC are more likely to develop anxiety, chronic irritability, psychosis, neurosis, depression, and posttraumatic stress disorder when compared with women without FGC (Utz-Billing & Kentenich, 2008).…”

“…It may be performed by birth attendants, family members, or an esteemed older adult woman in the community. The tissue may be excised in several different ways and with various instruments, including broken glasses, knives, scissors, razors, or sharp stones (Braddy & Files, 2007;OHCHR et al, 2008;Utz-Billing & Kentenich, 2008). In some areas of Gambia, West Africa, it is not uncommon for a woman to use her fingernail to excise the clitoris from female infants (WHO, Department of Gender and Women's Health, & Department of Reproductive Health and Research, 2001).…”

“…U.S. law permits the provider the option of whether or not to reinfibulate. Currently, Canada, New Zealand, Australia, and several countries in Europe and Africa have statutes in place prohibiting female genital mutilation (Utz-Billing & Kentenich, 2008).…”

Juristische Aspekte der rituellen Zirkumzision

“…Eine Geburt kann aufgrund einer Narbenbildung zum Stillstand kommen und f ü r Mutter und Kind t ö dlich enden. Das Infektionsrisiko und die Verblutungsgefahr nach weiblicher Genitalverst ü mmelung sind um ein Vielfaches h ö her als beim m ä nnlichen Geschlecht [32] . Die weibliche Genitalverst ü mmelung ist durch internationale Gesetzgebung ge ä chtet.…”