What Is Female genital mutation
Female genital mutilation (FGM), also known as female genital cutting and female circumcision, is the ritual removal of some or all of the external female genitalia. UNICEF estimated in 2016 that 200 million women had undergone the procedures in 27 countries in Africa, as well as in Indonesia, Iraqi Kurdistan and Yemen, with a rate of 80–98 percent within the 15–49 age group in Djibouti, Egypt, Eritrea, Guinea, Mali, Sierra Leone, Somalia and Sudan. The practice is also found elsewhere in Asia, the Middle East, and among communities from these areas around the world.
Typically carried out by a traditional circumcizer using a blade, FGM is conducted from days after birth to puberty and beyond; in half the countries for which national figures are available, most girls are cut before the age of five. Procedures differ according to the country or ethnic group. They include removal of the clitoral hood and clitoral glans; removal of the inner labia; and removal of the inner and outer labia and closure of the vulva. In this last procedure (known as infibulation), a small hole is left for the passage of urine and menstrual fluid; the vagina is opened for intercourse and opened further for childbirth. The United Nations Population Fund estimated in 2010 that 20 percent of women affected by FGM had been infibulated, a practice found largely in northeast Africa.
The practice is rooted in gender inequality, attempts to control women’s sexuality, and ideas about purity, modesty and aesthetics. It is usually initiated and carried out by women, who see it as a source of honour, and who fear that failing to have their daughters and granddaughters cut will expose the girls to social exclusion.
Psychological effects, sexual function
According to a 2015 systematic review there is little high-quality information available on the psychological effects of FGM. Several small studies have concluded that women with FGM suffer from anxiety, depression and post-traumatic stress disorder. Feelings of shame and betrayal can develop when women leave the culture that practises FGM and learn that their condition is not the norm, but within the practising culture they may view their FGM with pride, because for them it signifies beauty, respect for tradition, chastity and hygiene.
FGM may place women at higher risk of problems during pregnancy and childbirth, which are more common with the more extensive FGM procedures. Infibulated women may try to make childbirth easier by eating less during pregnancy to reduce the baby’s size. 99% In women with vesicovaginal or rectovaginal fistulae, it is difficult to obtain clear urine samples as part of prenatal care, making the diagnosis of conditions such as pre-eclampsia harder.491–492 Cervical evaluation during labour may be impeded and labour prolonged or obstructed. Third-degree laceration (tears), anal-sphincter damage and emergency caesarean section are more common in infibulated women.
Neonatal mortality is increased. The WHO estimated in 2006 that an additional 10–20 babies die per 1,000 deliveries as a result of FGM. The estimate was based on a study conducted on 28,393 women attending delivery wards at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan. In those settings all types of FGM were found to pose an increased risk of death to the baby: 15 percent higher for Type I, 32 percent for Type II and 55 percent for Type III. The reasons for this were unclear, but may be connected to genital and urinary tract infections and the presence of scar tissue. The researchers wrote that FGM was associated with an increased risk to the mother of damage to the perineum and excessive blood loss, as well as a need to resuscitate the baby, and stillbirth, perhaps because of a long second stage of labour.
Social obligation, poor access to information
Surveys have found FGM to be more common in rural areas, less common in most countries among girls from the wealthiest homes, and (except in Sudan and Somalia) less common in girls whose mothers had access to primary or secondary/higher education. In Somalia and Sudan the situation was reversed: in Somalia the mothers’ access to secondary/higher education was accompanied by a rise in prevalence of FGM in their daughters, and in Sudan access to any education was accompanied by a rise.
Against the argument that women willingly choose FGM for their daughters, UNICEF calls the practice a “self-enforcing social convention” to which families feel they must conform to avoid uncut daughters facing social exclusion.