Female circumcision posted Tuesday Dec 4 2007
I knew about female circumcision for a few years but I never had the opportunity to evaluate a case. I recently had a woman from Africa who came to my clinic because she was having bleeding every time she had sex. She had been in the country for about two months and stated to me that she was married, but stated she was single to the intake person. A very interested male translator was with this woman and I asked if he was her husband or just a friend. He stated he was her friend so I excused him. People in America do not know that in Africa if a man can afford more wife he may be married to several women depending upon where they are from and what tribe. The man was nervous but left. (Bigamy is a crime in the USA in case you forgot.)
I had to have a telephone translator to ask questions and give this patient information.
I found out this woman did have female circumcision. The bleeding was only after sex.
The pelvic examination revealed both labias including the mons pubis was removed. The genital was only a smooth area where the skin of the mons pubis sewn together. A small speculum fit snuggly into her vaginal hole to evaluate the cervix and the vaginal walls.
Clearly the problem was the small entrance into the vagina.
After the woman was dressed I allowed the male companion back in the room (I suspected he was her husband). I showed them a picture of an uncircumcised vulva and explained to them that the tissue was necessary to stretch to deliver a baby. The patient already knew she would have to be cut open to deliver a baby.
My suggestion was to use K-Y jelly and proceed careful when having sexual encounters. There is a possibility that the vaginal hole could open a little more. If she continued to have bleeding, she would need altering the vaginal orifice with surgery.
The reason for the circumcision is religious and to try and convince women and men not to do this is to bleak.
There are women in Africa that are refusing to have this done. They are getting into groups but are usually osterized by their tribes. Sometimes these circumcisions are done when the female is a child but usually around menarche.
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forensic nursing chronicles
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forensic nursing diagnosisFemale Genital Mutilation
Female Circumcision
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