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- Berggren, Vanja, 1972-, et al.
(author)
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Infibulated women have an increased risk of anal sphincter tears at delivery : a population-based Swedish register study of 250 000 births
- 2013
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In: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 92:1, s. 101-108
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Journal article (peer-reviewed)abstract
- Objective. To investigate the risk for anal sphincter tears (AST) in infibulated women. Design. Population-based cohort study. Setting. Nationwide study in Sweden. Population. The study population included 250 491 primiparous women with a vaginal singleton birth at 37–41 completed gestational weeks during 1999–2008. We only included women born in Sweden and in Africa. The African women were categorized into three groups; a Somalian-group, n = 929, where over 95% are infibulated; the Eritrea-Ethiopia-Sudan-group, n = 955, where the majority is infibulated, compared to other African countries, n = 1035, where few individuals are infibulated, but had otherwise similar anthropometric characteristics. These women were compared to 247 572 Swedish-born women. Methods. Register study with data from the National Medical Birth Registry. Main outcome measures. AST in non-instrumental and instrumental vaginal delivery. Results. Compared to Swedish-born women, women from Somalia had the highest odds ratio for AST in all vaginal deliveries: 2.72 (95% CI 2.08–3.54), followed by women from Eritrea-Ethiophia-Sudan 1.80 (1.41–2.32) and other African countries 1.23 (0.89–1.53) after adjustment for major risk factors. Mediolateral episiotomy was associated with a reduced risk of AST in instrumental deliveries. Conclusion. Delivering African women from countries where infibulation is common have an increased risk of AST compared with Swedish-born women, despite delivering in a highly technical quality healthcare setting. AST can cause anal incontinence and it is important to investigate risk factors for this and try to improve clinical routines during delivery to reduce the incidence of this complication.
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| 2. |
- Fried, S, et al.
(author)
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Outpatients' perspectives on problems and needs related to female genital mutilation/cutting: a qualitative study from somaliland
- 2013
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In: Obstetrics and gynecology international. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2013, s. 165893-
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Journal article (peer-reviewed)abstract
- Aim. To explore female outpatients’ perspectives on problems related to female genital mutilation/cutting (FGM/C) and their views on information, care, and counseling.Setting. An FGM/C support center at a maternity clinic in Hargeisa, Somaliland.Methods. A qualitative, descriptive study, using content analysis of seven semistructured interviews with female outpatients.Results. All participants had been ignorant of the etiology of their FGM/C-related complications and hesitant to seek care. All had undergone infibulation but did not wish the same for their daughters. In recent years they had learnt through religious leaders and media campaigns that infibulation was unapproved by Islam. A less severe FGM/C type, “Sunna,” was more accepted; however, few could define what “Sunna” meant. Condemning and ridiculing attitudes against uncircumcised women prevailed in their community.Conclusions. New ideas and concepts related to FGM/C enter the common discourse in the Somali society while traditional norms and values still prevail. Religion was shown to have a strong impact on FGM/C practices and beliefs. Interventions aiming to raise awareness of health consequences of all types of FGM/C, as well as where to seek care for complications, are needed in Somaliland. Involvement of religious leaders in anti-FGM/C programs is essential.
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| 3. |
- Isman, E, et al.
(author)
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Midwives' Experiences in Providing Care and Counselling to Women with Female Genital Mutilation (FGM) Related Problems
- 2013
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In: Obstetrics and gynecology international. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2013, s. 785148-
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Journal article (peer-reviewed)abstract
- Aim. The aim of this study was to elucidate midwives experiences in providing care and counselling to women with FGM related problems.Setting. The study was conducted at a maternity clinic in Hargeisa, Somaliland.Method. A qualitative, inductive study were performed with eight midwives living in Somaliland. The interviews had semi-structured questions. Content analysis was used for the analysis.Findings. The main findings of the present study were how midwives are challenged by culture and religion when providing FGM counselling. The most prominent challenge is the perception that FGM is an important part of the culture and from this point of view the midwives work is apprehended as interfering and subverting the Somali culture. Having personal experience of FGM emerged as a benefit when counselling women.Conclusion. There is a contradiction between the professional actions of performing FGM despite a personal belief against FGM. Midwives as a professional group could be important agents of change and further research is needed about the midwives role in this process.
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