Obstetrics
Female Genital Mutilation (FGM) cause difficulties during childbirth
By The Lancet
Jun 3, 2006 - 8:43:00 AM

The first comprehensive study of the effects of female genital mutilation on women and babies during childbirth has been published by leading medical journal, The Lancet.

The study, which provides the first reliable evidence that female genital mutilation can adversely affect birth outcomes, was undertaken by African and international researchers, including Associate Professor Emily Banks from the National Centre for Epidemiology and Population Health at ANU.

It involved 28,393 women in 28 obstetric centres in six countries: Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan.

The study found that women who have had Female Genital Mutilation (FGM) are significantly more likely to experience difficulties during childbirth and that their babies are more likely to die as a result of the practice.

Complications include the need to have a caesarean section, dangerously heavy bleeding after the birth of the baby and prolonged hospitalisation following the birth.

The degree of complications increased according to the extent and severity of the FGM.

According to the WHO, FGM is a common practice in a number of countries around the world, and over 100 million women and girls are estimated to have had FGM. The study used a three level scale set out by the WHO on FGM severity.

In the case of caesarean section, women who have the most severe form of FGM will have on average 30 per cent more C-sections compared with those who have not had any FGM. Women affected by severe FGM are 70 per cent more likely to suffer haemorrhage after birth.

The researchers also found there was an increased need to resuscitate babies whose mother had experienced FGM, and the death rate among babies during and immediately after birth is also higher.

In all, the study estimated that in the African context an additional one to two babies die per 100 deliveries as a result of the practice.

"This collaborative African study provides the first reliable evidence on the impact of FGM on complications during childbirth, and shows that the practice is likely to be responsible for large numbers of infant deaths and an increased burden of maternal illness, affecting millions of deliveries," Associate Professor Banks said.

Joy Phumaphi, the Assistant Director General, Family and Community Health at the World Health Organization, which organised the study, said: "We should not underestimate the significance of this study. For the first time we have the evidence that deliveries among women who have been subject to FGM are significantly more likely to be complicated and dangerous."

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