Antenatal care for women with FGM
Maternal Health for CALD Women Resource
eCALD Supplementary Resources
Women with FGM may require special care before, during and after birth: see the Female Genital Mutilation Clinical Care Antenatal, Labour & Birth and Postnatal Guidelines for information (New Zealand FGM Education Programme, 2009b). The New Zealand FGM Education Programme publishes information relating to the possible health complications of FGM, and includes legal information for practitioners (available at www.fgm.co.nz New Zealand FGM Education Programme, 2009b; 2009c).
Effective communication
Many studies relating to the maternity experiences of women affected by FGM in western countries indicate that their needs are poorly understood and frequently not met (Denholm, 2004a; 2004b; Denholm & Powell, 2009). Most women report very negative experiences, particularly in regard to the attitudes of health professionals, care in labour and birth, and postnatal care. Many women affected by FGM have reported experiencing offensive and condescending reactions from health professionals regarding their circumcisions. Effective communication requires sensitive and non-judgemental attitudes from health professionals who are caring, supportive and knowledgeable about FGM.
| ORIGINS OF WOMEN AFFECTED BY FGM LIVING IN NEW ZEALAND (Ministry of Health, 2012) |
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| Country | Percentage of women affected in country of origin | Type of FGM | Terminology |
| Somalia | 97.9 | Type 2 and 3 | Gudniinka |
| Ethiopia | 74.3 | Type 1 and 2 | Gerezat |
| Eritrea | 88.7 | Type 1 and 2 | Mkinshab |
| Djibouti | 93.1 | Type 2 and 3 | Excision |
| Sudan, northern | 90.0 | Type 2 and 3 | Tahoor |
| Egypt | 95.8 | Type 1 | Khitan |
| Kurdistan | 77.9 | Type 1 and 2 | Khatana |
| Indonesia | No documented prevalence | Type 1 or 2 | Sunat |
| Malaysia | No documented prevalence | Type 1 or 2 | |
| India | No documented prevalence | Type 1 or 2 | |
Note: Of the small number of women from Sudan residing in New Zealand, most come from South Sudan, where the prevalence of FGM is extremely low.
What are the complications of FGM?
There are numerous short and long term physical, sexual and psychological complications associated with FGM, which vary depending on the extent of the tissue removed (WHO, 2016). The most severe complications occur with FGM Type 3 (Denholm, 1998b; Denholm, 2004).
Short term complications can include (WHO, 2016):
- Severe pain.
- Excessive bleeding (haemorrhage).
- Genital tissue swelling.
- Fever.
- Infections eg tetanus.
- Urinary problems.
- Wound healing problems.
- Injury to surrounding genital tissue.
- Shock.
- Death.
Long term complications can include:
- Difficulties with micturition.
- Recurrent urinary tract infections.
- Difficulties with menstruation.
- Inability to achieve penetration during sexual intercourse.
- Anxiety and fear of sexual intercourse.
- Complications in pregnancy.
- Complications in labour and birth.
- Sexual dysfunction.
- Physiological distress related to the initial procedure which could possibly continue throughout the woman’s life.
Where FGM has been practiced for many generations, women may not associate these health complications with FGM, but rather see them as a normal part of being a woman.