Female genital mutilation: analysis of the first twelve months of a southeast London specialist clinic

Objectives To analyse the sources and reasons for referral of women who have undergone genital mutilation to a recently established specialist clinic, and to determine the consequences of the genital mutilation procedure. Design Retrospective descriptive case series. Setting The maternity units of Guy's and St. Thomas's Hospital, London. Population One hundred and sixteen women attending the clinic over a one-year period. Main outcome measures (1) sources and reasons for referral to the specialist clinic; (2) characteristics of the women attending the clinic; (3) acute and chronic complications of the genital mutilation procedure; (3) attitudes towards female genital mutilation. Results Complete case records were available for 10S women. Of the 86 women who could remember the procedure, 78% were performed by a medically unqualified person, usually at home (71%), at a median age of seven years. Acute and chronic complications were each present in 86%; of women with Type III genital mutilation. Most women (82%) were referred by their midwife because they were pregnant? of whom 18% were primiravid. Eighteen non-pregnant women also attended the clinic to request either defibulation or for advice. None of the 89 pregnant women requested rs-infibulation after delivery, but almost 6% were seriously considering having their daughter undergo genital mutilation outside the United Kingdom. In addition, fewer than 10% of the women refused to continue the tradition of female genital mutilation. Conclusions During its first year, the recently established African Well Woman Clinic has provided specialist care for 116 women with genital mutilation. Such women may attend with a variety of common medical or psychiatric conditions and often do not volunteer that they have undergone the procedure. Doctors and midwives in particular, should enquire specifically about genital mutilation when caring for women from high risk countries, and offer the services of specialist clinics for female genital mutilation.