Making the cut
Female circumcision raises the risks during childbirth.
By Amy Norton
Pic: iStockphoto.com
Article originally in
Reuters
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.