Female Genital Mutilation/Female Circumcision

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I am in Dr. Johnson’s class, Forensic Nursing. We are reading “Forensic Nursing” by Lynch. After having read the chapter on Female Genital Mutilation/Female Circumcision (FGM/FC), I was somewhat confused about what I had read. I began to think and wondered why anyone would do this to his or her body. I had heard a little about FGM but had never experienced it in my nursing career. I got on the Internet, Wikipedia encyclopedia online, and did some research. I found out some interesting facts.

The article refers it the practice as female cutting. This is defined as “the amputation of any part of the female genitalia for cultural rather than medical reasons. The text book describes the different type of FGM. The different type are 1) Clitoridotomy, is the removal or splitting of the clitoral hood, 2) Clitoridectomy, the partial or total removal of the external parts of the clitoris, 3) Infibulation or pharaonic circumcision, includes the removal of the clitoris, labia major and the labia minora. The most severe of all of the four different types, 4) is an unclassified type which can include pricking, piercing, cutting, and scraping of the vaginal wall or incisions to the clitoris and vagina, and burning, scarring or cauterizing the tissue.
Historically the practice of FGM dates back to the 5th century B.C. and is believed to have originated in Pharaonic Egypt (hence the name “Pharaonic circumcision”). It has been found to have crossed different religions. It is found among Muslims and Animists. Today FGM/FC is practiced mainly in African countries. It is commonly in a band that stretches from Senegal in West Africa to Somalia on the east coast, as well as from Egypt in the north to Tanzania in the south. It is estimated that in these regions about 95% of all women have under gone this procedure. The practice is also preformed in the Middle East, though it is veiled in secrecy. In the parts of Africa it is practiced openly. Estimates by Amnesty International predict that over 130 million women world wide have been affected by these procedures. Amnesty International estimates that over two million are performed yearly. This practice usually occurs to young women between the ages of 7days to 14 years old.

Female genitalia mutilation is performed for many reasons, which include sexual, sociological, hygiene, and health. Sexually: men of the community feel that it controls or reduces female sexuality. Sociologically: it is used a form of initiation for girls into womanhood. Hygiene; is believed by certain cultures that the female genitalia are dirty and unsightly. Health reasons are the belief that it enhances fertility and child survival.

Female genitalia mutilation has short term and long-term consequences. The short term and most common consequence is that the person can go into shock and bleed to death or die from infection secondary to unsterile procedure. The procedure is very painful as it is usually done without anesthesia. The long-term affects are recurrent urinary tract infections, painful urination, and painful menstrual cycles. Another complication is urinary hesitancy or incontinence. The women can over a period of time develop cyst or abscesses in the vaginal region secondary to the blockage of the Bartholin gland. The skin in the vaginal area becomes very tight and can cause extensive tissue damage during childbirth. The women can develop vaginal/anal fistulas or vaginal/urethral fistulas. The consequences that go with procedure are life long or require extensive surgeries to correct.

Nurses have to have the ability to educate the women that have had this procedure. Most importantly nurses have to be sensitive to the cultural background of the patient and her parents and be respectful to the tradition. The information that should be given to the patient when teaching is a detailed explanation of the female genital anatomy and function. If the parents bring their daughter to have the procedure the nurse should be prepared to explain the adverse side affects and the long-term consequences.
The nurses should also be prepared to know the laws in the United States for performing this procedure to any female under the age of 18. The law states that any one who performs any form of female genitalia mutilations will be charge with a crime and can be fined or be sentenced to a minimum of 5 years in prison, or both.

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