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female genital deinfibulation

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  • Female genital cutting or mutilation (FGM) sometimes called female circumcision is a practice which is thought to have existed for thousands of years (1)
    • is most commonly practised in countries in northern sub-Saharan Africa; in the Sahel region, in the horn of Africa and Egypt, but it is also found outside Africa e.g. amongst women and families migrating to European countries and the US from these locations

  • it is estimated that world-wide between 100-140 million women are thought to have undergone FGM and 3 million girls annually are thought to be at risk
    • FGM varies from a more or less ritual and symbolic genital cutting, through to levels of severity which include removal of the clitoris; and/or removal of the labia minora; and/or infibulation (abrasion and stitching together) of the labia majora after which a small hole is left through which urination and sexual activity can occur
      • this last form requires reopening (and re-closure) for childbirth

    • what is infibulation?
      • refers to the removal of the clitoris, partial or total removal of the labia minora and stitching together of the labia majora

    • what is de-infibulation (defibulation)?
      • infibulation creates a physical barrier to sexual intercourse and childbirth
        • an infibulated woman therefore has to undergo gradual dilation of the vaginal opening before sexual intercourse can take place. Often, infibulated women are cut open (the process of defibulation) on the first night of marriage (by the husband, or a circumciser), in order to enable the husband to be intimate with his wife
        • at childbirth, many women also have to be cut again, because the vaginal opening is too small to allow for the passage of a baby. Attempts at forcible penetration may cause rupture of scars and sometimes perineal tears, dyspareunia, and vaginismus. Excessive penile force during first intercourse can cause severe bleeding, shock and infection

    • what is re-infibulation?
      • in some communities, the raw edges of the wound are sutured again after childbirth, recreating a small vaginal opening. This is referred to as re-infibulation

  • FGM is carried out on girls at different ages ranging from babies and toddlers to teenagers. It is frequently carried out in unsterile conditions by traditional practitioners. This is both the result of its traditional form and its illegality in many places means that it is conducted in such conditions

  • Complications can include immediate urinary and genital tract infection, pain and haemorrhage, complications in childbirth and social, psychological and sexual complications
    • the public health burdens of FGM include both consequences for women or daughter mortality and ongoing morbidity concerns through their life span.

FGM, a dangerous and potentially life-threatening procedure to which women and girls in many countries are subjected has been viewed as a Human Rights violation in many countries.