Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.
It is often very surprising the degree to which certain practices take place in the world today but thanks to global communication, we are able to bring these issues to light and attend to them accordingly. I would like to discuss a topic which I have personally had some experience with in my home country of Nigeria as a medical practitioner. I will talk about female circumcision, extent of this practice, where, how and why it is practiced, which will help create more understanding about the social dynamics that perpetuate it. Increasing awareness is also important tool on the road to abandonment of this practice, which is a violation of the fundamental rights of girls and women.
Female circumcision, also known as ‘female genital cutting’ or ‘female genital mutilation,’ refers to all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons.
Female circumcision is practiced in about 29 countries mostly concentrated in Africa and the Middle East. According to UNICEF, over 125 million girls and women alive today have been circumcised. Countries with the highest prevalence of this practice are Egypt, Ethiopia, Nigeria, Sudan, Kenya and Burkina Faso.
The majority of the girls are usually ‘cut’ before the age of 5 years with most of the remaining girls being cut by the age of 14. This practice is conducted by traditional practitioners (which include traditional birth attendants, traditional circumcisers, or generally older women) or health personnel (which include doctors, nurses, trained midwives or other health workers).
There are four main types of female genital mutilation:
- Type 1: This involves removal of the hood of the clitoris and all or part of the clitoris (also known as a clitoridectomy)
- Type 2: A more severe form in which there is removal of the clitoris including all or part of the labia minora
- Type 3: This is the most severe form; it involves the removal of the clitoris, the labia minora and adjacent medial part of the labia majora and the stitching of the vaginal orifice, leaving an opening of the size of a pin head to allow for menstrual flow or urine
- Type 4 (Unclassified): This involves mild cuts, pricking, incision of clitoris or labia, stretching the clitoris or labia, cauterization, introduction of corrosive substances and herbs into the vagina and many other forms
Unlike complications from male circumcision such as bleeding and infection, which are minor and tend to be easily treated, girls and women who are circumcised suffer both short and long term consequences. These include damage to the urethra or anus, chronic pelvic infections, sexual dysfunction, difficulty with childbearing, and many other complications. The mental and psychological agony attached with female circumcision is deemed the most serious complication because the problem does not manifest outwardly for help to be offered. The young girl is in constant fear of the procedure and after the ritual she dreads sex because of anticipated pain and dreads childbirth because of complications caused by circumcision.
Multiple reasons have been given to justify female circumcision and it varies between different cultures. Some of the reasons include: traditional practice for preservation of chastity and purification, cleanliness and hygiene, aesthetic reasons, social acceptance, protection of virginity and prevention of promiscuity, increasing sexual pleasure of husband, enhancing fertility and many more. Most of these reasons are founded in beliefs and traditions centuries-old making its origin and significance uncertain and very confusing.
Although traditions, cultures, and beliefs are an important aspect of any society, certain harmful practices should be abolished. The uphill task of changing attitudes towards female circumcision needs a multidisciplinary approach involving legislation, health care professional organizations, empowerment of women in the society, and education and activism of the general public with emphasis on the dangers and undesirability of female genital mutilation.
To learn more about female genital mutilation, please visit Unicef.