Female Genital Mutilation: Unveiling the Complications and the Role of WHO

Introduction:

Female genital mutilation (FGM) is a method of removing the external female genitalia or any other injury caused to external genital organs. This practice of FGM is usually carried out by females between infancy and adolescence. FGM is considered a the violation of human rights of females and is considered a discriminatory practice against women and it is mostly practiced in African and Middle East Asian countries. FGM is an unethical practice and causes psychological, sexual, social, physical, and obstetric complications in women, and in some instances, it may lead to death also. In some places healthcare workers are involved in FGM, World Health Organization (WHO) strongly pleases providers not to perform FGM and has developed a strong strategy to support health workers against medicalization.

What Is the Need to Practice FGM?

Various reasons contribute to the existence of FGM, it is a gender inequality practice that is deeply seated in some regions of the world. Usually, FGM is done to suppress sexual desire in girls before marriage, some consider FGM as a ritual that is done before marriage and is passed by the generations. Families think that their female child is ineligible for marriage if she has not undergone FGM, this strong belief makes FGM very difficult to get abandoned.

What Are the Types of FGM?

There are four main categories of female genital mutilation:

• Type 1: The prepuce and/or the clitoral glans may be removed completely or partially.

• Type 2: The clitoral glans and the labia minora, or inner vulva folds, may be removed entirely or partially, together or separate from the elimination of the labia majora, or outer vulva skin folds.

• Type 3: The contraction of the vaginal aperture by the formation of a covering seal is sometimes referred to as infibulation.

• Type 4: This covers any additional hazardous non-medical treatments performed on the female genitalia, such as poking, piercing, incising, and cauterizing the area.

Who Is at Risk?

FGM is most commonly performed on young girls between the ages of infancy and puberty, however, it can also be done on adult women. Over 200 million women and girls living today have gone through FGM, with more than three million girls thought to be susceptible to experiencing it each year. FGM is a global concern.

What Are the Disadvantages of FGM?

No health benefits are associated with FGM, instead, there is so much harm for the women and the children who are genetically mutilated. Any form of FGM leads to complications, and these complications are classified as long-term and short-term complications.

1. Long-Term Complications of FGM Include:

• Continuous Pain: The tissue damage would result in scarring and intense pain because of the exposed nerve endings around the female genitals.

• UTI (Urinary Tract Infections): This infection occurs in any part of the urinary system such as the kidneys, urethra, bladder, and ureters. Repeated risk of UTI is seen in FGM, this recurrence could lead to septicemia (blood infection caused by bacteria and is a life-threatening condition), kidney failure, and ultimately death. UTI also causes a burning sensation during urination.

• Vaginal Infections: FGM could cause itching, dryness, redness around the vagina, foul-smelling discharge, and bacterial vaginosis can also be noticed.

• Menstrual Problems: Girls and women who have undergone FGM suffer from painful menstruation and irregular menstrual cycles.

• Sex-Related Issues: Due to damage to genital tissues sex could be painful for women who have faced FGM. Reduced sexual desire, not getting enough pleasure during sex, and pain during intercourse are the problems faced by women.

• Complications During Childbirth: FGM is linked to an increased risk of postpartum bleeding, episiotomy, extended labor, and difficulty in birthing, followed by the tearing of tissues during childbirth.

• Mental Status of the Women: Women and girls who have faced FGM experience anxiety disorders, depression, and post-traumatic stress disorder (it is a type of disorder that develops due to a traumatic and shocking event).

• Human Immunodeficiency Virus (HIV): Trauma to the vaginal epithelium caused by FGM causes direct penetration of the virus.

Short-Term Complications of FGM Include:

• Immense Pain: Cutting of the most sensitive female genitals (clitoris) causes extreme pain as the nerve endings are exposed to the external environment. This can also cause ulcers around the genital region.

• Hemorrhage and Shock: As the clitoral artery is cut during FGM, this leads to excessive bleeding and septic shock (a fatal condition where the blood pressure drops because of the presence of infection in the blood).

• Inflammation and Abscess: The cutting of the genitals could cause swelling, reddening, and pain in the area. Infections can also occur due to the usage of unsterilized and contaminated instruments.

• Delayed Wound Healing: Usage of contaminated instruments could cause delayed wound healing. Delayed wound healing can lead to infections, scarring of the tissues, and prolonged pain.

• Micturition (Urination) Problems: FGM can cause infections of the urethra where women experience urinary retention, pain, and discomfort while passing the urine.

Is Medicalization of FGM Safe?

In some countries FGM is carried out by healthcare workers such as nurses and midwives, this is called the medicalization of FGM. Practicing FGM by medically certified workers is against medical ethics. However, FGM if carried out by health care professionals or by elderly people is not a safe and secure procedure. Any form of FGM could alter the biological cycle of the female functions which could even lead to life-threatening conditions.

Does FGM Have Any Benefits?

FGM is not justified medically and it does not have any health benefits. Rather FGM can cause complications both in the short-term and long-term affecting the overall health of the women. FGM is a highly harmful and unnatural practice of hindering with natural activity of women’s and girls’ bodies.

What Is the Role of the World Health Organization In FGM?

In 2008, the World Health Organization in its assembly passed the WHA61.16 resolution on the eradication of FGM. WHO has taken the following steps regarding the FGM:

• Medical care and reassurance have been given to the women and the children who are affected by FGM.

• WHO has highlighted and coordinated activities against FAG in all the sectors of society such as education, health, justice, finance, and women’s affairs.

• Nurses and midwives are trained to develop personal skills to discuss the complications of FGM and their prevention strategies.

• Educating young women and children and developing defense mechanisms among the women to stop FGM both regionally and locally.

• WHO has developed a strategy against the medicalization of FGM and continues to work along with its partner organizations to prevent FGM in particular countries.

Conclusion:

Female genital mutilation is the unethical practice of cutting down sensitive external female genital organs, which carries lifelong complications in women. Over 200 million children and women have undergone FGM in various countries so far. FGM is a dangerous practice even when performed by healthcare professionals and it should be banned completely. No matter who is performing FGM, it is purely a violation of universal human rights. WHO (World Health Organization) and UNICEF (United Nations International Children’s Emergency Fund) along with local governments are collectively working against FGM.