Showing posts with label discussion. Show all posts
Showing posts with label discussion. Show all posts
Thursday, August 13, 2009
Female Genital Cutting raises childbirth risks
By Amy Norton
August 13, 2009
NEW YORK (Reuters Health) - Pregnant women who underwent female genital cutting as girls are at increased risk of needing an emergency Cesarean section or suffering serious tears during childbirth, a new study finds.
It is estimated that more than 130 million women worldwide have undergone female genital mutilation, also known as female "circumcision." The centuries-old practice, which involves removing part or all of a girl's clitoris and labia, and sometimes narrowing the vaginal opening, remains a common practice in some countries, mainly in sub-Saharan Africa.
With increased immigration, more and more healthcare workers in developed countries are seeing women who have undergone female genital mutilation.
In the new study, doctors at the University of Berne, in Switzerland, followed 122 pregnant women with a history of genital mutilation who received prenatal care at their medical center. They compared their childbirth outcomes with 110 other women the same age who delivered at the hospital.
Overall, women with genital mutilation had a higher risk of emergency C-section; 18 needed the procedure, compared with three women in the comparison group. They were also more likely to suffer severe vaginal tears during delivery -- with nine having the complication, versus one woman in the comparison group.
The findings, which appear in the medical journal BJOG, show that healthcare workers in developed countries need to be prepared to care for women who've undergone genital cutting.
That includes prenatal discussions about how delivery should proceed, Dr. Annette Kuhn, the senior researcher on the study, told Reuters Health in an email.
All of the women with genital cutting in this study had been asked about how they wanted to manage delivery. Six percent wanted to have defibulation -- surgical widening of the vaginal opening -- before giving birth. Another 43 percent wanted it during labor, while one-third requested that it be done only if medically necessary.
A small number of women wanted to have the vaginal opening re-stitched after giving birth -- a request they were denied because it is medically inadvisable, as well as illegal in Switzerland, the researchers note.
It is important, Kuhn said, for health professionals in developed countries to be able to sensitively discuss the issue of female genital cutting, and inform women of their potential treatment options.
Wednesday, June 17, 2009
"There is shock, hemorrhaging, infection, sterility"
June 17, 2009
Female genital cutting, or excision, affects 140 million girls around the world. Although NGOs have tried for years to end this harmful and secretive traditional practice it is difficult to break through cultural barriers. After excising three of her daughters, Tante Mado, a midwife from Guinea, West Africa, decided to take a radical stand against excision that has already led to two villages openly banning the practice. Despite death threats, her approach has also garnered the support of male members of the community.
"When I was 12 I had a full excision and almost lost my life twice. The day of my excision I bled a lot and when I had my first bath I went into shock – my mother screamed and thought that I was dead. Then the wound got badly infected and the healing took more than 15 days. For three days I couldn’t pee or defecate because the position hurt the wound too much. I would ask my Dad: “Dad – why did you do this to me?” He would say it’s tradition and I would reply: “This tradition is too difficult.”
I have now been a midwife for 38 years and I’ve seen all the consequences of excision. For me they are enormous. There is the shock, the hemorrhaging, the infection, sterility. I’ve also seen a lot of mortality at birth and women who had been excised who died. My mum has lost a lot of children – all her children died and I am the only one, the sixth, because all these things are linked to excision.
Still, three of my daughters were excised. I didn’t want it but the social pressure is very strong so I myself became an excisor to do it to my children medically instead of using bark and local methods. After that, people understood that the healing was much faster that way and there were less risks, so I was sent a lot of girls.At one stage, I wasn’t doing a real excision anymore, I would fake it. A lot of people wrote to me saying: “We’re sending you our girl, but don’t excise her – just pretend.” I thought to myself – if all the people who are sending me their daughters got together to fight excision, couldn’t we do something? So I decided not to fake it and said I didn’t do excisions anymore. Better to educate the girl, tell her what excision is, than to pinch her and let her go.
I didn’t have my fourth daughter excised because, by then, I had decided to abandon the practice. She would be the example.
The community held a big conference for the whole forest area, to say that I was forbidding excision, and people told me to flee. I said I wouldn’t. I had a lot of problems but remained very firm. Even in my family, some of them won’t say hello to me because I have refused to do excisions. Sometimes I’m on the street and some people say, “That’s the lady who doesn’t want to do excisions,” and they say, “she’s gonna be killed!’ But I never listen to that.
I also get told that I’m being deceived by white people. I say, if you asked your wife what had happened to her during her excision, if you were used to hearing what happens, you would never have said that. The consequences of excision are too serious.
When I talk to a village we start by having reflection days. They are like a community forum where we ask people to think about the practice – what are the positives and negative sides – and the whole community speaks. This gives them the opportunity to talk about sexuality, which is a very taboo subject. On that day we gather a lot of information. Then, based on this information, we go into the village little by little to chat with the families, in the schools, everywhere.
People know that I’m very honest and direct and I don’t deceive them. If I say I do something I do it. If I don’t I don’t. And most of all, the example of my daughter has really impacted people’s memory.
When we see that the community is starting to adhere to the idea, we train the girls from the families that have decided to abandon to open up the dialogue. The success comes from the fact that in the group, the practitioners have been convinced and have themselves abandoned the practice.
The first time I heard a village was banning excision I thought it was a dream.
• Tante was speaking to Plan International, an international organisation that works to promote the rights of children, to end child poverty.
Female genital cutting, or excision, affects 140 million girls around the world. Although NGOs have tried for years to end this harmful and secretive traditional practice it is difficult to break through cultural barriers. After excising three of her daughters, Tante Mado, a midwife from Guinea, West Africa, decided to take a radical stand against excision that has already led to two villages openly banning the practice. Despite death threats, her approach has also garnered the support of male members of the community.
"When I was 12 I had a full excision and almost lost my life twice. The day of my excision I bled a lot and when I had my first bath I went into shock – my mother screamed and thought that I was dead. Then the wound got badly infected and the healing took more than 15 days. For three days I couldn’t pee or defecate because the position hurt the wound too much. I would ask my Dad: “Dad – why did you do this to me?” He would say it’s tradition and I would reply: “This tradition is too difficult.”
I have now been a midwife for 38 years and I’ve seen all the consequences of excision. For me they are enormous. There is the shock, the hemorrhaging, the infection, sterility. I’ve also seen a lot of mortality at birth and women who had been excised who died. My mum has lost a lot of children – all her children died and I am the only one, the sixth, because all these things are linked to excision.
Still, three of my daughters were excised. I didn’t want it but the social pressure is very strong so I myself became an excisor to do it to my children medically instead of using bark and local methods. After that, people understood that the healing was much faster that way and there were less risks, so I was sent a lot of girls.At one stage, I wasn’t doing a real excision anymore, I would fake it. A lot of people wrote to me saying: “We’re sending you our girl, but don’t excise her – just pretend.” I thought to myself – if all the people who are sending me their daughters got together to fight excision, couldn’t we do something? So I decided not to fake it and said I didn’t do excisions anymore. Better to educate the girl, tell her what excision is, than to pinch her and let her go.
I didn’t have my fourth daughter excised because, by then, I had decided to abandon the practice. She would be the example.
The community held a big conference for the whole forest area, to say that I was forbidding excision, and people told me to flee. I said I wouldn’t. I had a lot of problems but remained very firm. Even in my family, some of them won’t say hello to me because I have refused to do excisions. Sometimes I’m on the street and some people say, “That’s the lady who doesn’t want to do excisions,” and they say, “she’s gonna be killed!’ But I never listen to that.
I also get told that I’m being deceived by white people. I say, if you asked your wife what had happened to her during her excision, if you were used to hearing what happens, you would never have said that. The consequences of excision are too serious.
When I talk to a village we start by having reflection days. They are like a community forum where we ask people to think about the practice – what are the positives and negative sides – and the whole community speaks. This gives them the opportunity to talk about sexuality, which is a very taboo subject. On that day we gather a lot of information. Then, based on this information, we go into the village little by little to chat with the families, in the schools, everywhere.
People know that I’m very honest and direct and I don’t deceive them. If I say I do something I do it. If I don’t I don’t. And most of all, the example of my daughter has really impacted people’s memory.
When we see that the community is starting to adhere to the idea, we train the girls from the families that have decided to abandon to open up the dialogue. The success comes from the fact that in the group, the practitioners have been convinced and have themselves abandoned the practice.
The first time I heard a village was banning excision I thought it was a dream.
• Tante was speaking to Plan International, an international organisation that works to promote the rights of children, to end child poverty.
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