Female genital mutilation or FGM is all procedures where part or all of
the external female genitalia are removed for non-medical reasons.
It's a deeply rooted traditional practice that occurs in specific populations.
It can be performed at any stage of a woman's life, really from infancy,
right up until adulthood. It's most commonly performed before puberty perhaps between about
the ages of 5 and 8. It's really a major infringement of women's human rights.
FGM is against the law in the UK and has been so since 1985. If someone is found guilty of
carrying out FGM in the UK or arranging for a girl to go abroad for FGM then they face
a maximum prison sentence of 14 years and a substantial fine if found guilty.
There are increasing numbers of women from FGM practicing communities living in the UK
and there are two really separate and important issues here. Firstly, is identifying women that
have undergone FGM so that we can offer them appropriate health care but second to that is
the really important issue of young girls being at risk of FGM and we know that the single most
relevant fact that puts the girl at risk of FGM is to be born into a community that practices FGM.
What that means is that it's really important for NHS staff such as doctors,
midwives and nurses to be aware of this.
But also for the general public, for people who may be working with children, such as teachers.
The most likely time that a young girl is taken abroad for FGM would be during
the long school summer holiday and so it's important that if there is
any suspicion that that might happen that the right people are informed.
Things that might lead you to suspect that would be if the child says she's
going home for something special, some party or event after which she may be
grown up. Then you can ring the police. You can ring your local social services.
The short-term effects of FGM, if you imagine these procedures are done in general not by
medical personnel. They're done under unsterile and unsanitary conditions.
They're done without any anaesthetic or analgesia on a small child. The immediate
consequences are obviously damage to the genital organs, it's removal of the genital organs,
damage to surrounding organs and this can lead to haemorrhage and to infection.
The other effects which are more difficult to to measure are it's clear that there are
great psychological effects if you think about the trauma of such a procedure.
So long lasting psychological damage to women that have undergone this and
also increasingly we realise that it would cause psychosexual problems,
so if you have your clitoris removed, so you have no sensation and the vagina is narrow
and sex is painful, then psychosexual problems are also extremely common.
Because the instruments are not sterile. You also have an increased risk of blood-borne infections
such as hepatitis B and HIV. Girls and women are left with urinary problems such as incontinence,
unable to control their urine or recurrent urinary tract infections.
It increases the risk of infertility. If however you do manage to become pregnant
you have an increased risk of haemorrhage during childbirth.
There's also an increased risk that the baby may die during labour or shortly after birth.
If a woman is pregnant and has had FGM then she will need an assessment of the vagina to
see whether the vagina is too narrow for her to give birth to her baby naturally and if
the vagina is too narrow then she will require a procedure called a deinfibulation procedure.
Sometimes that's called a reversal of FGM. It's not a true reversal you can't put back the tissue
that's been removed but what it does do it opens the vagina to make delivery of the baby easier.
There are specialist clinics throughout the UK that see women who have had FGM.
It's really important that women have information on how to access those services.
For more information about FGM and where to go for advice or help, please visit www.nhs.uk/fgm
If you are worried that someone else may be at risk of
or affected by FGM, contact the Child Protection Helpline
on 0808 800 5000. If you have been affected by FGM or are worried that
you may be at risk from FGM contact the Metropolitan Police Child Abuse
Investigation Command (Project Azure) helpline on 020 7161 2888.