FGM
July 31st, 2007 | Penlight
Last month the Egyptian government banned all female “circumcision” following the death of a 12 year old girl. Technically it had been banned in 1997, but continued on through a loop hole that allowed it in cases of medical necessity. Research done by Unicef in 2005 found that 96% of Egyptian married women aged 15-49 reported being circumcised. All this was first brought to my attention by TofuLou at her blog, Manifest Destiny. It’s a good post and she has drawings and descriptions of the different extents to which it’s done.
I prefer the term Female Genital Mutilation. Circumcising a woman, if that is what’s done, would be the equivalent of removing a man’s foreskin, meaning the clitoral hood would be removed. In FGM, the entire clitoris is removed and in many cases, the labia minora are also removed. In a practice called infibulation, the the clitoris and the surrounding area, including the labia minora, are excised and the labia majora are sewn together. I once took care of an older woman who had this done. She was in heart failure and needed a foley catheter inserted. She was very upset about having to disrobe, but with her female relatives helping her and her privacy protected, she did. As I went to insert the foley I was astonished to find-nothing. There was nothing there except for the tiniest orifice. I knew what FGM was, but I never expected to see it.
Although sometimes associated with Islam, FGM is more of a cultural phenomenon and is practiced by followers of animism, Christianity and Islam. In other Muslim countries it is unheard of. FGM is usually done on prepubescent girls, but has even been done on infants, according to the WHO. Very often, it is done without anesthetic and in unhygienic conditions. (The State Department) Although families with money will find doctors who will do it under anesthetic and in better conditions, the World Health Organization considers the “medicalization” of FGM to be unethical and condemns the practice. Defenders say that being “cut” ensures a woman being faithful to her husband and that without it, she is unmarriageable. Suffice it to say, this practice is known to cause numerous complications, not the least of which is the risk of bleeding and infection at the time it’s done. According to Our Bodies, Ourselves For The New Century, long term complications include abscess formation, scar neuromas, dermoid cysts, painful sexual intercourse, and vulvar adhesions. Scar tissue can lead to urinary retention and infections, kidney stones, dysmenorrhea and chronic pelvic inflammation, which can lead to infertility.
Communities in the US with high percentages of immigrants may see an influx of FGM. According to the CDC, in some communites, doctors report that as many as 2/3’s of their population has had it done. It is becoming common enough that they have introduced ICD codes for the condition. It goes on to say that women that have undergone infibulation must have surgery before they can have intercourse or deliver a baby. Multiparous women who have undergone infibulation and then reinfibulation following birth are more likely to have complications and a high incidence of maternal and fetal death with subsequent births.
Women who have undergone FGM live in our country and it’s possible you will encounter them in your nursing practice. If a woman presents in labor she may have to have surgery to enlarge the vaginal opening or have a C-section. Knowledge of this practice will help you understand the many complications that can result. Of utmost importance is to be nonjudgemental in your dealings with them. Some may worry that being against FGM could be considered racist or not being culturally sensitive, but this practice is condemned by the WHO, the UN and many other international organizations, as well as leaders in some of the countries where it is practiced. For more information go to CARE.
I graduated Brookdale Community College in December, 1996. Most of my nursing experience has been in the emergency room, but I've also done stints in the OR and PICU. For the last 3 years I've worked as a transplant coordinator for an organ procurement organization. These experiences I share in my blog at Donor Cycle. I also live with my amazing husband, my teenage daughter and my new baby girl. Along with a smelly dog, various cats and too many fish they make up the rest of my life.
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Whoa. Thanks for posting this. I have yet to come across it in practice, but I know there have to be women in my community who have had FGM. Made me dizzy just reading about it. : (
I’m SO happy that atleast one person’s attention was drawn to the subject from my post; It’s tragic that women are suffering such acts. It’s a hard line to draw between culture and tradition, but, I think that once someone’s body becomes involved it should be a personal choice. But, then these women become shunned…
I had this discussion with some fellow classmates and presented a thought that many misconstrued as my support of this practice. I don’t, however, I think many people in cultures that do not perform FGM are forgetting we perform male circumcision for cultural reasons (in most cases) as well. Even though male circumcision has less risks and isn’t likely to lead to any long term problems like FGM, we often forget that it is a welcomed cultural decision made by families (just like American male circumcision is). So I guess outside of the medical complications that can result from FGM, who are we from one culture to say what another culture should do and find acceptable?
Well, I have to say I have issues with male circumcision too, but that’s for another day. I will say that if we go by the “because that’s the way we’ve always done” we will never see progress as a species. It used to be ok for a man to hit his wife as long as the rod was less than the diameter of his thumb. It used to be ok for 4 year olds to clean chimneys and help support their family.
And again, what they do to girls, not old enough to understand, is akin to chopping off the whole penis, not just the foreskin. I think I like to think I am very culturally sensitive, but when the First Lady of Egypt condemns a practice that 96% of her female constituents have had done, I think it’s ok to say enoughs enough.
I agree with Susan with everything that she said. I chose not to circumcise my youngest so that he will have the choice at a more mature age. I can’t imagine how mutilating a woman so that she will be more chaste for her future husband is considered humane. I also understand that while we need to be culturally sensitive, there a limits.
Genital mutilation in both women and men are mentally disturbing. Why does the world of have to be this way? If the removal of the foreskin is okay, then the removal of the female foreskin should also be okay. There cannot be sexist bias. But the removal of the entire thing especially without their own personal consent is wrong. I was circumcised when I was born, I’m glad I was, I would have gone through with it later in life anyway. There’s not much pain to it and it’s not life threatening. But It’s your body and you should have the choice, male or female. Another thing that disturbs me is disrespecting the genitals in the media and thus by society. Why is it in a movie if someone is hit in the testicles, breasts or the clitoris it’s funny? It makes me want to go postal. If enough nerve damage is sustained to the testicles or the clitoris it can cause neurogenic shock and thus kill someone. Neurogenic shock is shock caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls. This can also result from severe central nervous system (brain and spinal cord) damage. With the sudden loss of background sympathetic stimulation, the vessels suddenly relax resulting in a sudden decrease in peripheral vascular resistance and decreased blood pressure. People need to wake up and not be so ignorant. Start respecting one another. Imagining the humiliation these women go through makes me sick.