Antenatal Care Utilization and Female Genital Mutilation in Kenya

Despite female genital mutilation being a risk factor for obstetric complications, we know very little about antenatal care (ANC) utilization among circumcised women. Applying Goffman's stigma theory and drawing data from the 2014 Kenya Demographic and Health Survey, we compared the frequency of ANC visits and timing of first ANC visit between circumcised and uncircumcised women in Kenya. In the total sample of Kenyan women who made at least one ANC visit, only 55% made ANC visits at least four times, and only 19% made an ANC visit within the first trimester of their pregnancy. Moreover, 34% of women were circumcised. We also found that circumcised women were less likely to visit ANC at least four times (OR = 0.82, p < 0.01) and to make the first ANC visit within the first trimester (OR = 0.84, p < 0.05) than their uncircumcised counterparts, after controlling for theoretically relevant variables. Based on our findings, we provide two major recommendations for policymakers. For one, there may be the urgent need for health interventions to provide circumcised women with obstetric services such as defibulation. For another, to reduce internalized stigma and alienation from medical spaces, health practitioners should be trained to exhibit cultural sensitivity and empathy towards circumcised women who access health facilities.