Swedish healthcare for women subjected to Female Genital Mutilation/Cutting (FGM/C)

Treatment Options ◽

Surgical Care ◽

Healthcare Consumption ◽

Genital Mutilation ◽

System A ◽

Clitoral Reconstruction ◽

Health Complications ◽

Abstract Background: FGM/C can lead to a number of health complications, such as pain during intercourse or childbirth, psychological problems, and postpartum complications. This study seeks to describe and assess Swedish healthcare for women subjected to FGM/C.Methods: This aim encompasses three research foci: (1) to inventory Swedish regional healthcare guidelines and policies for care for women who have undergone FGM/C, (2) to map healthcare consumption among women who have undergone FGM/C, and (3) to map the type of care measures and treatment they have been offered in the Swedish healthcare system. A questionnaire was sent to healthcare regional managers and a database study was conducted.Results: The inventory of the healthcare regions' guidelines shows that five of 21 had no guidelines. The number of women who have been subjected to FGM/C and sought care has increased steadily between 2012 and 2018. Women who have been subjected to FGM/C seek care mostly in connection with pregnancy and childbirth.Conclusions: The type of care that should be offered to women who have been subjected to FGM/C vary depending on individual needs. Care may include surgical procedures in the form of defibulation, clitoral reconstruction, or removal of cysts, as well as psychosexual care. Existing treatment options in surgical care, together with psychosexual treatment, are the care measures that seem to be helpful for some women who have undergone FGM/C, but not for all. Communication and treatment are of great importance in order to be able to offer care to women who have undergone FGM/C.

Female genital mutilation in the UK: considerations for best nursing practice

British Journal of Nursing ◽

10.12968/bjon.2019.28.12.788 ◽

2019 ◽

Vol 28 (12) ◽

pp. 788-791

Author(s):

Bethany Rose

Keyword(s):

Public Health ◽

Nursing Practice ◽

Health Concern ◽

Public Health Concern ◽

Genital Mutilation ◽

Health Complications ◽

The Uk ◽

Female genital mutilation (FGM) is any process that injures or removes part or all of the external female genital organs for non-medical reasons. FGM is a growing public health concern in the UK because of an increase in migration from countries where it is widely practised. Education on FGM for nurses is key to supporting women who have undergone the practice, as well as safeguarding girls and women who are at risk. Nurses must understand the history and culture of FGM as well as the long-term health complications to be able to support affected women both professionally and sensitively.

Response to: Rethinking Reconstruction: Ethical Standards and Practice Guidelines as a Prerequisite to Clitoral Reconstruction Following Female Genital Mutilation/Cutting (FGM/C)

Aesthetic Surgery Journal ◽

10.1093/asj/sjab370 ◽

2021 ◽

Author(s):

Adel M Wilson ◽

Amr A Zaki

Keyword(s):

Practice Guidelines ◽

Ethical Standards ◽

Genital Mutilation ◽

Clitoral Reconstruction ◽

Changes in Sexual Distress, Depression and Sexual Function after Clitoral Reconstruction in Women with Female Genital Mutilation/Cutting

International Journal of Sexual Health ◽

10.1080/19317611.2018.1554613 ◽

2018 ◽

Vol 30 (4) ◽

pp. 412-421 ◽

Cited By ~ 1

Author(s):

Gemma Mestre-Bach ◽

Iris Tolosa-Sola ◽

Ignacio Rodríguez ◽

Pere Barri-Soldevila ◽

Gracia Lasheras ◽

...

Keyword(s):

Sexual Function ◽

Genital Mutilation ◽

Sexual Distress ◽

Clitoral Reconstruction ◽

Posttraumatic Stress Disorder Relapse and Clitoral Reconstruction After Female Genital Mutilation

Obstetrics and Gynecology ◽

10.1097/aog.0000000000001835 ◽

2017 ◽

Vol 129 (2) ◽

pp. 371-376 ◽

Cited By ~ 16

Author(s):

Jasmine Abdulcadir ◽

Francesco Bianchi Demicheli ◽

Alexia Willame ◽

Nathalie Recordon ◽

Patrick Petignat

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Genital Mutilation ◽

Clitoral Reconstruction ◽

Female Genital Mutilation/Cutting in the Swiss HIV Cohort Study: A Cross-Sectional Study

10.21203/rs.3.rs-1065495/v1 ◽

2021 ◽

Author(s):

Fabio Mauri ◽

Sara Cottler-Casanova ◽

Matthias Cavassini ◽

Marcel Stoeckle ◽

Gilles Wandeler ◽

...

Keyword(s):

Cohort Study ◽

Cross Sectional Study ◽

Hiv Positive ◽

Cross Sectional ◽

Female Population ◽

Genital Mutilation ◽

Previous Discussion ◽

Health Complications ◽

Abstract BackgroundFemale genital mutilation or cutting (FGM/C) is the practice of partial or total removal or injury of the external female genitalia for non-medical reasons. It has been documented in at least 30 countries and, as a result of migration, in high-income countries too. FGM/C causes various negative health complications, and may increase the risk of acquiring human immunodeficiency virus (HIV).Our study aims to generate descriptive statistics about FGM/C among HIV positive migrant women included in the Swiss HIV cohort study (SHCS).MethodsThe Swiss HIV Cohort study (www.SHCS.ch) is a national, prospective cohort study with ongoing community and hospital enrolment of HIV-positive individuals in Switzerland. Two questions on history of FGM/C and previous discussion about it with a healthcare professional were administered by treating infectious disease specialists during the 6-monthly routine visits occurring between June and December 2019. We included all women aged above 18 years, born in one of the 30 countries where FGM/C is prevalent, in care for an HIV-infection and recorded in the Swiss HIV Cohort Study.ResultsOur findings show that FMG/C is common (21%) in the SHCS female population originating from Africa. Such data may be largely underestimated given the 33.6% of non-respondents. The vast majority (70%) of the women reporting to have been cut had never discussed FGM/C with a health professional before the study.Conclusions FMG/C is common in the SHCS female population originating from Africa, but often overlooked by health professionals working with this population. FGM/C screening, diagnosis, care and prevention could be improved significantly through training and information.Trial registration: Not Applicable

Supportive psychotherapy or client education alongside surgical procedures to correct complications of female genital mutilation: A systematic review

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.12042 ◽

2017 ◽

Vol 136 ◽

pp. 51-55 ◽

Cited By ~ 2

Author(s):

Olukayode Abayomi ◽

Moriam T. Chibuzor ◽

Babasola O. Okusanya ◽

Ekpereonne Esu ◽

Edward Odey ◽

...

Keyword(s):

Systematic Review ◽

Surgical Procedures ◽

Supportive Psychotherapy ◽

Genital Mutilation ◽

Client Education ◽

Novel Clitoral Reconstruction and Coverage With Sensate Labial Flaps: Potential Remedy for Female Genital Mutilation

Aesthetic Surgery Journal ◽

10.1093/asj/sjab218 ◽

2021 ◽

Author(s):

Adel M Wilson ◽

Amr A Zaki

Keyword(s):

Sexual Function ◽

Genital Mutilation ◽

Labia Minora ◽

Clitoral Reconstruction ◽

The Mean ◽

Clitoral Pain ◽

Arterial Anatomy ◽

Potential Remedy ◽

Abstract Background Clitoral reconstruction after female genital mutilation (FGM) could help alleviate complications caused by FGM, such as clitoral pain, reduced sensation, diminished sexual function, as well as improving aesthetics of the genitalia and restoring anatomy. Objectives Create sensate labial flaps to cover the neo-clitoris and assess its outcome. Methods Between December 2018 and July 2020, forty patients with FGM underwent clitoral reconstruction and coverage with sensate labial flaps donated by the remnant of the labia minora and were followed prospectively. Flaps were mapped on the less mutilated labia minora, based on recent description of arterial anatomy and innervation. Before the surgery, the patients’ clitoral sensation was assessed on a 6 point scale and they were also given the Female Sexual Functional Index (FSFI) to complete. Eight and twenty four weeks postoperatively, the same assessment was repeated and the data compared. Results The mean preoperative FSFI was 11.64 (range 2.8-25.6) and post-operatively was 29.14 (range 12.8-35.4), demonstrating a significant increase. Similarly, the Clitoral sensation increased from 2.35 (range 1-4) before the surgery to 4.9 (range 2-6) after the surgery, demonstrating a significant increase. In total, 95% of patients benefited from the surgery. Conclusions Clitoral reconstruction after FGM using sensate labial flaps resulted in significant improvement of sexual function, clitoral sensation, genital aesthetics and self-esteem.

Female genital mutilation (FGM) in Somaliland – why is change so slow?

10.36368/shaj.v1i1.254 ◽

2021 ◽

Author(s):

Annika Johansson ◽

Abdirahman Osman Gaas ◽

Amina Mahmoud Warsame

Keyword(s):

Health Workers ◽

Behavioural Change ◽

Small Scale ◽

Community Members ◽

Community Group ◽

Medical Reason ◽

Genital Mutilation ◽

Health Complications ◽

Female genital mutilation (FGM) is defined as any procedure involving the alteration or excision of external female genitalia for no medical reason. Somaliland has among the highest prevalence rates of FGM globally. In this article we describe how the Civil Society Organisation (CSO) ‘Network against female genital mutilation in Somaliland’ (NAFIS) has approached the challenge to reduce the high FGM prevalence. From its start in 2006, NAFIS has developed a multifaceted program to reach the overall goal: the elimination of all forms of FGM in Somaliland. Alone among the group of CSOs in the network, NAFIS introduced in its activities medical care and counselling for women who suffer from the consequences of FGM. From 2011 and onwards, thousands of women have been relieved of their FGM-related health complications and participated in counselling sessions at project centres. Shortly after this visit they have been invited to participate in community group meetings to share their experiences with other women who also have received FGM care and counselling, and other community members. The aim of the article is to describe this model of work - combining FGM care and counselling with community dialogues. The article is basically descriptive, using the authors’ own observations and encounters with project clients and staff over eight years. We have also used findings from three Master's theses on aspects of the process, and from other small scale studies to highlight people’s understanding, experiences and opinions in a context of an on-going health intervention. A lesson learnt from NAFIS project is that it has helped to open up communicative spaces in community dialogues where experiences are shared and understanding created of the harm caused by FGM, without the habitual stigma and shame. We discuss this process in a context of behavioural change theories. A major challenge during the process has been to involve men in the project’s FGM information and counselling activities. The role of nurses/midwives, being the first to meet women with FGM complications, is also discussed and the need emphasised to strengthen capacity of this category of health workers. One type of FGM gaining in usage is the poorly defined sunna, the health risks of which are unclear.