Fеmаlе genital mutіlаtіоn/cutting (FGM/C) involves thе removal of thе сlіtоrіѕ, іnnеr-аnd-оutеr lірѕ оf thе vаgіnа, and the sewing оr ѕtарlіng tоgеthеr оf thе two ѕіdеѕ of thе vulvа lеаvіng оnlу a ѕmаll hоlе to раѕѕ urіnе and mеnѕtruаtе – dереndіng оn the tуре. 

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Female gеnіtаl mutіlаtіоn (FGM) comprises аll рrосеdurеѕ іnvоlvіng partial оr tоtаl rеmоvаl of the female еxtеrnаl genitalia оr оthеr іnjurу tо the fеmаlе genital оrgаnѕ for nоn-mеdісаl rеаѕоnѕ.

 Typically FGM is performed with a razor blade on girls between the ages of four and 12, traditionally without anaesthetic.  
FGM can lead to severe bleeding, pain, complete loss of sensitivity,  complications during childbirth, infertility, severe pain during sex,  recurring infections and urine retention. And in some cases it is  lethal. Unlike male circumcision, female genital mutilation also  inhibits sexual pleasure.  

Firstly let looking into the various types of FGM/C that we have. There are 4 types of FGM/C which is been practiced on our females/girl child.

 

Types of FGM

 Female genital mutilation is classified into four types:  

• Type I: Also known as clitoridectomy, this type consists of partial or total removal of the clitoris and/or its prepuce.

• Type II: Also  known as excision, the clitoris and labia minora are partially or  totally removed, with or without excision of the labia majora.

• Type III:  The most severe form, it is also known as infibulation or pharaonic  type. The procedure consists of narrowing the vaginal orifice with  creation of a covering seal by cutting and appositioning the labia  minora and/or labia majora, with or without removal of the clitoris. The  appositioning of the wound edges consists of stitching or holding the  cut areas together for a certain period of time (for example, girls’  legs are bound together), to create the covering seal. A small opening  is left for urine and menstrual blood to escape. An infibulation must be  opened either through penetrative sexual intercourse or surgery.

• Type IV:  This type consists of all other procedures to the genitalia of women  for non-medical purposes, such as pricking, piercing, incising, scraping  and cauterization.

Recent estimates indicate that around  90% of cases include clitoridectomy, excision or cases where girls’  genitals are “nicked” but no flesh removed (Type IV), and about 10% are  infibulations (WHO).  

Complications of FGM

There are numerous forms of complications in female genital mutilation which are not good to our girl child. The following are complications of FGM/C

 

Short term complications

Haemorrhage

Haemorrhage is one of the most common complications of FGM, as  excision of the clitoris involves cutting across the high pressure  clitoral artery and attempts to stop bleeding may not be effective.  Acute extensive bleeding can lead to haemorrhagic shock or even sudden  death in the case of cataclysmic haemorrhage. 

Shock

Shock may occur because of blood loss and the severe pain and trauma  of the procedure. Both haemorrhagic and neurogenic shock can be fatal. 

Pain

The majority of mutilation procedures are performed without  anaesthetics and cause the girl severe pain. Even if a local anaesthetic  is used, multiple insertions of the needle are often required. 

Urinary retention

Urinary Retention is very common and may last for hours or days. It  is commonly due to pain, tissue swelling, inflammation, injury to the  urethra, and fear of passing urine on the raw wound. 

Injury to adjacent tissue

Injury to the urethra, vagina, perineum and rectum can result from  the use of crude instruments, poor light, careless techniques, or from  the struggles of the girl. 

Infection

Infection commonly occurs for a number of reasons; unhygenic  conditions, the use of unsterilized instruments, applications of  traditional herbs or ashes to the wound, contamination of the wound with  urine and/or faeces, or binding of the legs following infibulation  which prevents wound drainage. Septicaemia and tetanus may also develop. 

Fracture or dislocation

Fracture of the clavicle, femur, humerus or hip joint can occur if  heavy pressure is applied to a struggling girl during the procedure - as  often occurs when several adults hold her down. 

Failure to heal

Wounds may fail to heal quickly because of infection, irritation from urine, underlying anaemia or malnutrition. 

  

Long term complications

Difficulties with micturition

Difficulties can occur due to damage to the urethral opening,  obstruction of the urinary opening, or scarring of the meatus - and can  lead to chronic incontinence or difficulty passing urine. For many  infibulated girls, passing urine can take up to 20 minutes when they are  still virgins. 

Recurrent urinary tract infections (UTIS)

Partial occlusion of the vagina and urethra means the normal flow of  urine is deflected and the perineum remains constantly wet and  susceptible to bacterial growth. Retrograde UTI's therefore commonly  occur, affecting the bladder, uterus and kidneys. Damage to the lower  urinary tract during the procedure can also result in urinary tract  infections. 

Chronic pelvic infections

Partial occlusion of the vagina and urethra increases the likelihood  of infection and ascending pelvic infections are common. The infections  are often painful and may be accompanied by a noxious discharge  spreading to the uterus, fallopian tubes and ovaries - and frequently  become chronic. 

Infertility

Infertility can occur due to chronic pelvic infections causing irreparable damage to the reproductive organs. 

Vulvul abscesses

Vulval abscesses develop due to deep infection resulting from faulty  healing or an embedded stitch causing the formation of an abscess. 

Neurinoma

Neurinoma can develop when the dorsal nerve of the clitoris is cut or  trapped in a stitch or in scar tissue. The surrounding area becomes  hypersensitive and unbearably painful. 

Keloid scars

Keloid scars result from slow and incomplete healing of the wound and  the production of excess scar tissue. The scars may obstruct the  vaginal opening and be so extensive that they prevent penile  penetration. 

Dermoid cysts

Dermoid cysts result from inclusion of the epithelium during healing,  leading to swelling or pockets producing secretion. The cysts vary in  size, are extremely painful and can prevent sexual intercourse. 

Calculus formation

Calculus formation develop due to menstrual debris or urinary  deposits in the vagina or in the space behind the bridge of the scar  tissue. 

Fistulae

Vesico-vaginal or recto-vaginal fistulae can form as a result of  injury during circumcision, de-infibulation, re-infibulation, sexual  intercourse, or obstructed labour. Urinary and faecal incontinence may  be lifelong with severe social consequences. 

Difficulties with menstruation

Partial or total occlusion of the vaginal opening commonly results in  dysmenorrhoea or amenorrhea. Haematocolpos occasionally occurs from the  retention of menstrual blood due to the almost complete coalescence of  the labia. 

Increased risk of HIV transmission

There is an increased risk of HIV transmission due to the use of the  same unsterile instruments in-group circumcisions, repeated cutting and  stitching during labour, and the higher incidence of lacerations and  abrasions during intercourse. 

Sexual complications

Many women who have undergone FGM experience various forms and  degrees of sexual aberrations. These may include fear associated with  initial sexual intercourse, pain associated with sexual intercourse,  difficulty or inability to have sexual intercourse, vaginismus, and  decreased sexual pleasure and fulfilment. 

It is difficult to assess the  impact of FGM on women's sexual fulfilment however, as each individual  woman with FGM will be affected differently. Factors such as the type of  FGM and the amount of tissue removed, the extent of scarring, the  experience of the initial procedure, cultural and social expectations,  and affection and bonding in sexual relationships will all impact  directly on sexuality and sexual functioning. [back to top]   

Childbirth complications

There are a range of childbirth complications that can be associated  with FGM, particularly with Type 3 FGM (infibulation). The extent of the  complications varies depending on factors such as the type of FGM,  parity, and the nature of the scar tissue. Complications that can occur  following infibulation, particularly amongst primigravidas, are as  follows: 

• in the event of a miscarriage the foetus may be retained in the  uterus or the birth canal, and performing a dilation and curettage maybe  difficult
• incorrect assessment of the stage of labour, cervical dilation, and  foetal presentation due to the inability to perform vaginal examinations
• inability to perform an induction with prostaglandins due to the very narrow introitus
• difficulty applying a foetal scalp electrode, performing a foetal  blood sample, or inserting a urinary catheter due to the very narrow  introitus
• difficulty identifying some obstetric emergencies such as cord prolapse due to an inability to perform a vaginal examination
• increased risk of bleeding, wound infection, and damage to  surrounding tissues due to repeated deinfibulation, particularly if it  is not performed correctly
• prolonged and obstructed labour due to partial or total occlusion of  the vaginal opening. This can lead to increased risk of uterine  inertia, rupture or prolapse, tearing to the perineum, haemorrhage, and  fistula formation. The baby may have an increased risk of suffering  neonatal brain damage or death as a result of birth asphyxia
• repetition of deinfibulation and reinfibulation weakens the scar  tissue and at the beginning of menopause a woman may have a mass of  fibrous tissue resulting in incontinence and prolapses of the vaginal  wall.

 

Psychosocial complications

There is very limited research on the impact of FGM on psychological  health. The research that has been conducted is sparse and as FGM is  condoned in many of the countries where it is practiced, research is  likely to have been limited by social and cultural restrictions on the  exploration of any negative impacts of the practice. Some of the negative psychological effects that have been reported  include feelings of anxiety, fear, bitterness and betrayal, loss of  trust, suppression of feelings, feelings of incompleteness, loss of self  esteem, panic disorders and difficulty with body image. 

When  considering the psychosocial consequences of FGM, it is important to  balance the traumatic impact of the initial FGM procedure and its  long-term sequelae, against the social and cultural benefits that FGM  brings to young girls in the communities where it is practiced 

SAY O TO FEMALE GENITAL MUTILATION. LET US SAVE OUR GIRL CHILD TODAY.