Deinfibulation

Deinfibulation (reversal of FGM Type 3) may be requested by women: prior to marriage (in order to allow for penile penetration); during pregnancy in preparation for birth (at around 24 weeks’ gestation); or during teenage years (or beyond) if menstruation and urination is difficult. The Female Genital Mutilation Clinical Care Deinfibulation Guidelines includes information on undertaking a deinfibulation assessment, the deinfibulation procedure, post procedure care and referral contacts for gynaecological outpatient services throughout New Zealand (New Zealand FGM Education Programme, 2009c): see www.fgm.co.nz.

Couples or women on their own may present to health services days before marriage requesting deinfibulation. It is important that the request is treated as urgent. Some women have been put on waiting lists while husbands have repetitively tried to penetrate through the scar tissue during sexual intercourse. This has caused unnecessary physical and psychological trauma and distress to both partners.

It is essential that deinfibulation is accompanied by comprehensive health education, including discussion on physiological changes following the procedure (New Zealand FGM Education Programme, 2009c). The woman will experience significant changes in urination, menstruation and sexual intercourse; being prepared for these changes will help prevent confusion and anxiety following the procedure.

My doctor never talked about re-stitching the circumcision (after birth), or what it would be like afterwards. I was left wide open and I thought that I was incontinent for many months.
Female refugee (Denholm & Jama, 1997)