FGM consists of all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for cultural or other non-therapeutic reasons. It is common in several countries, predominantly in Africa, and more than 100 million women and girls are estimated to have had FGM worldwide. Whether the outcomes for pregnant women with FGM differ from those without had been unclear until now; previous studies had been small and therefore unreliable.
In the latest study the World Health Organization (WHO) study group on female genital mutilation and obstetric outcome analysed data from 28, 373 women giving birth to a single baby between November 2001 to March 2003 at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal, and Sudan. The investigators examined the women for the presence of, and severity of, FGM prior to giving birth. After birth the women were followed-up until they were discharged from hospital. The team found that women with FGM were more likely to lose their baby during the perinatal period (just before and just after birth) than women who had not had FGM. The researchers found that FGM caused one to two extra perinatal deaths per 100 deliveries, in relation to a background risk of 4-6 perinatal deaths per 100 deliveries. Women with FGM were also more likely to have deliveries complicated by caesarean section, haemorrhage, surgical intervention to enlarge the vagina and assist birth, and extended hospital stays. The excess risk remained even after the researchers took into account other confounding factors, such as maternal age, maternal education, socioeconomic status, and antenatal care visits. The risks were also greater with more extensive FGM, report the authors.
The authors state: "This is a collaborative study conducted in Africa, with African researchers, and provides evidence of great importance to those communities where FGM is practiced. It shows clearly its harmful effects on reproductive outcome, both for women and their infants." (Quote by e-mail; does not appear in published paper)
See also accompanying Comment.
Contact: Christopher Powell, Communications Advisor WHO/Family and Community Health, Telephone: T) +41 22 791 2888 / +41 79 217 3425 powellc@who.int
Journal
The Lancet