Obstetric management of women with female genital mutilation

Key content Female genital mutilation is the partial or total removal of the female genitalia for non‐medical reasons. The practice is illegal in the United Kingdom. It is estimated that one woman dies every 10 minutes from the sequelae of the procedure. Healthcare professionals require adequate training in the clinical management of women with this condition and they also need to demonstrate great cultural sensitivity. In types III and IV the narrowed vaginal opening is likely to cause obstetric problems. Defibulation prepregnancy is the most desirable option, failing which it may be carried out antenatally or during early labour (less desirable options). Learning objectives To know about the practice of female genital mutilation, different types of mutilation procedures and associated medical complications. To learn about the obstetric complications and childbirth experience of women with the condition in the developed world. To understand how delivery of obstetric services in the UK for women with genital mutilation could be improved. To understand the ethical and child protection issues associated with the practice. Ethical issues Female genital mutilation is a violation of universal human rights. The procedure is regarded as a form of child abuse but not given the same recognition on the grounds that it is carried out with the best intentions for the future welfare of the child. Is it right to impose a Western concept of justice, which outlaws female genital mutilation, on a society where the practice is widely accepted? Please cite this article as: Rashid M, Rashid MH. Obstetric management of women with female genital mutilation. The Obstetrician & Gynaecologist 2007;9:95–101.