Women who have had Female Genital Mutilation (FGM) are significantly more likely to experience difficulties during childbirth and their babies are more likely to die as a result of the traditional yet gruesome practice, according to a new United Nations study released today, which reiterated calls for total abolition of a practice that currently affects 100 million people worldwide.
The study, the first to give clear evidence of the harmful effects for women and babies, cites serious complications during childbirth include the need to have a caesarean section, dangerously heavy bleeding after the birth and prolonged hospitalization, with the degree of complications increasing depending on the extent and severity of the FGM.
The death rate among babies during and immediately after birth is also much higher, in some case up to about 55 per cent. Because the study was carried out in hospitals, experts said death and harm rates were probably significantly higher overall, as many women in the societies where FGM is practiced give birth at home.
“As a result of this study we have, for the first time, evidence that deliveries among women who have been subject to FGM are significantly more likely to be complicated and dangerous,” UN World Health Organization (WHO) Assistant Director-General for Family and Community Health Joy Phumaphi said of the practice which is particularly common in Africa.
“FGM is a practice steeped in culture and tradition but it should not be allowed to carry on. We must support communities in their efforts to abandon the practice and to improve care for those who have undergone FGM. We must also steadfastly resist the medicalization of FGM. WHO is totally opposed to FGM being carried out by medical personnel,” she added.
Women who have been subjected to the most serious form of FGM – FGM III comprising excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening – will have on average 30 per cent more caesarean sections compared with those who have not had any FGM.
Similarly there is a 70 per cent increase in numbers of women suffering from postpartum haemorrhage in those with FGM III compared to those women without FGM.
As for the newborns, the researchers found an increased need to resuscitate those whose mothers had had FGM, 66 per cent higher in the case women of FGM III.
The death rate during and immediately after birth is also much higher for those born to mothers with FGM: 15 per cent so in those with FGM I (excision of the prepuce, with or without excision of part or all of the clitoris); 32 per cent in those with FGM II (excision of the clitoris with partial or total excision of the labia minora); and 55 per cent in those with FGM III.
It is estimated that in the African context an additional 10 to 20 babies die per 1,000 deliveries as a result of the practice.
WHO’s Director of the Special Programme for Human Reproduction Research (HRP), Paul Van Look, noted that the study was based only on research carried out in hospitals. “The consequences for the countless women and babies who deliver at home without the help of experienced staff are likely to be even worse,” he said.
The study involved 28,393 women at 28 obstetric centres in six countries, where FGM is common – Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan. The centres varied from relatively isolated rural hospitals to teaching hospitals in capital cities.
Although practices vary from country to country, FGM is generally performed on girls under 10 years of age and leads to varying amounts of scar formation. It is not entirely clear why FGM leads to increased complications during childbirth, but one possible explanation is that this scar tissue is relatively inelastic and can lead to obstruction and tearing of the tissues around the vagina during childbirth.
“FGM remains a pressing human rights issue and reliable evidence regarding its harmful effects, both for mothers and their babies, should contribute to the abandonment of the practice,” WHO said. “It is in direct violation of young girls’ rights, has both short-term and long-term adverse health consequences, and is an unnecessary procedure.”