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1. Compiled by Dr. Amna
Ahmed
Female Genital Mutilation(FGM)

2. Terminology

Female Genital Mutilation also called
Cutting or Circumcision.

Female Genital Mutilation (FGM) is the
current terminology used by the WHO
and is familiar to most Health Care
Professionals.

3. What is FGM?

The World Health Organization
(WHO) defines female genital mutilation
(FGM) as “all procedures that involve
partial or total removal of the external
female genitalia, or other injury to the
female genital organs for non-medical
reasons.”

4. Cont…

The practice is mostly carried out by
traditional circumcisers using a blade,
who often play other central roles in
communities, such as attending
childbirths. Increasingly

However, FGM is being performed by
health providers.

5. Reasons of FGM

Reasons for practising FGM are varied from one
region to another and include a mix of socio-
cultural factors within families and communities. The
type of procedure performed also varies,
mainly with ethnicity.

In Africa, people considered FGM as a vital
cultural heritage for women to grow properly, as
marriage requirements and control women’s’
sexuality.

6. Prevalence of FGM

It is estimated that more than 200
million girls and women alive today
have undergone female genital mutilation
in the countries where the practice is
concentrated.

7. Normal Female genitalia

8. Types of FGC

The WHO has classified FGC into 4 types, based
on the extent of genital excision.
Type I - Clitoridectomy
Type II - Excision
Type III - Infibulation
Type IV - Other

9. Type I
Clitoridectomy:
partial or total removal of the clitoris (a
small, sensitive and erectile part of the
female genitals) and, in very rare cases, only
the prepuce (the fold of skin surrounding the
clitoris).

10. Type II
Excision:
partial or total removal of the clitoris and the
labia minora, with or without excision of the
labia majora (the labia are "the lips" that
surround the vagina).

11. ss

12. Type III
Infibulation:
narrowing of the vaginal opening through the
creation of a covering seal. The seal is formed by
cutting and repositioning the inner, or outer, labia,
with or without removal of the clitoris.

14. Cont…
Type IV
Unclassified: includes

pricking, piercing or incising of the clitoris and/or labia

stretching of the clitoris and/or labia

cauterization by burning of the clitoris and surrounding
tissue

scraping of tissue surrounding the vaginal orifice or cutting
of the vagina

15. Cont…
•introduction of corrosive substances or herbs
into the vagina to cause bleeding or for the
purposes of tightening or narrowing it
•and any other procedure which falls under
the definition of female genital mutilation
given above.

16. Cont…

Deinfibulation: refers to the practice of
cutting open the sealed vaginal opening
in a woman who has been infibulated,
which is often necessary for improving
health and well-being as well as to allow
intercourse or to facilitate childbirth.

18. Complications

Early complications are usually treated
by a local practitioner, and patients may
only present to a health care professional
for complications that are significant or
occur well after the procedure.

19. Short – term complications

Shock

Pain (lack of anesthesia) injury to adjacent
tissue.

Severe bleeding (hemorrhage, a potentially
life threatening complication)

Acute urine retention

Fractures or dislocations (when a struggling
girl is restrained.

20. Cont…

Infection (depending on the cleanliness of
the instruments, the substances applied to
wounds, and the bindings used on the legs
or cut surfaces).

Fever and septicemia

Potential HIV infection or other blood
born virus

21. Intermediate consequences

Delay in wound healing due to
infection, malnutrition.

Anemia due to profuse bleeding.

Pelvic infection: infection of the uterus
and vagina ascending from the genital
wound, and necrotizing fasciitis.

Irregular bleeding and vaginal
discharge

22. Cont…

Dysmenorrheal due to pelvic infection, or
due to the obstruction of the vaginal
orifice.

Damage to the Bartholin's duct can also
lead to cysts and abscesses.

Formation of a keloid scar because of
slow and incomplete healing of the
wound.

23. Cont…

Vulvar dermoid cyst and abscess

Dyspareunia due to tight of the vaginal
opening, to pelvic infection or vaginismus

24. Keloid scar
Courtesy of CNLPE,
Burkina Faso, © RAINBO

27. Long-term complications

Difficulty in passing urine

Recurring urinary tract infection

PID

Fertility/sexuallity (anorgasmia,apareunia)

Dysmenorrhoae

Psychological (anxiety, somatization,)

Scarring (fibrosis,hematocolpus,keloids)

28. Maternal Obstetrical Complications
•FGM/C substantially increases the risk
of maternal death
•Prolongation of the second stage of labor
•Perinea laceration
•Perinea infections and postpartum sepsis
•Hemorrhage

29. Cont…
•Vesico-vaginal or recto-vaginal fistula
•Difficulties in performing pelvic
examination
•Difficulty with urinary catheterization
•Unnecessary caesarean sections

30. Fetal Complications
Studies (in developing nations) have also documented an
increased risk of:
Lower APGAR scores
Infant resuscitation
Neural damage
IUFD

31. Cont…

According to the WHO, Female Genital
Mutilation/Cutting (FGM/C) increases
the risk of stillbirth three to four times.

Prolonged, obstructed labor and lack of
oxygen during the second phase of
labor can result in stillbirths or children
with cerebral palsy.

32. WHO efforts to eliminate female genital mutilation
focus on:

strengthening the health sector
response: guidelines, tools, training
and policy to ensure that health
professionals can provide medical
care and counseling to girls and
women living with FGM;

33. Cont…

building evidence: generating
knowledge about the causes and
consequences of the practice, including
why health care professionals carry out
procedures, how to eliminate it, and how
to care for those who have experienced
FGM;

34. Cont…

increasing advocacy: developing
publications and advocacy tools for
international, regional and local efforts to
end FGM within a generation.

36. END FGM

This Statement is a call to all States,
international and national organizations, civil
society and communities to uphold the rights of
girls and women.

It also calls on those bodies and communities to
develop, strengthen, and support specific and
concrete actions directed towards ending
female genital mutilation.

37. s