Posted by By Azoma Chikwe on
Two gynaecologists who did a study on female genital mutilation have reported that a circumcised woman is most likely to have at least one caesarean section....
Two gynaecologists who did a study on female genital mutilation have reported that a circumcised woman is most likely to have at least one caesarean section.
Explaining this to Daily Sun, Dr Mairo Mandara, senior country advisor, Population Programme said that the vagina is an elastic organ and any form of mutilation on it, including cutting off the clitoris, reduces the elasticity of the area and affects the women involved during childbirth.
With reduced elasticity, Mandara continued, most circumcised women deliver their babies through caesarean section.
The gynaecologist said she was shocked at the increase in the rate of caesarian section in the country. She lamented that for a country to have an increase in caesarean rate involves large amount of money because it increases the cost of childbirth by a big margin.
Contributing, Prof. Friday Okonofua, Executive Director of International Federation of Gynaecology and Obstetrics, who led the study, added that circumcised women are more likely to bleed during childbirth and have post-partem haemorrhage which is the most common cause of death in women during delivery
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Prof Friday Okonofua
We found that female genital mutilation increases the chances that a woman will have one caesarean section. That means that women that have female genital mutilation are more likely to deliver by caesarean section then women were not circumcised. Also, a woman who has female genital mutilation is more likely to bleed during delivery and have post-partem haemorrhage. And post-partem haemorrhage is the most common cause of death in women during delivery.
It simply means that circumcised women, who are more likely to have post-partem haemorrhage may not want to experience these complications in pregnancy and are, therefore, afraid of getting pregnant. Circumcised women are more likely to stay longer in hospital as a result of complications of childbirth. They are also more likely to have episotomy, which is cut as well as peel during the time of delivery, all complications which can make a woman have additional problems during the process of childbirth.
Some people claim that without female genital mutilation, women are likely to be promiscuous, but we've done a similar study which shows this is not true.
Women, who have been circumcised have the same sexual feelings like women who are not circumcised. They are also likely to have the same number of sexual partners. So, female genital cutting does not reduce sexuality of women.
There are pieces of legislation in about 13 states. And, in fact, the House of Representatives has actually passed the law against female genital mutilation. It is only the Senate that did not pass it. About 13 states today have legislated against the practice and these include Delta, Edo, Ogun, Cross River, etc.
But apart from legislation, we need to be proactive. We need to disseminate this information so that people know that a woman who has been circumcised is more likely to experience difficulty during childbirth. And if you know that you are going to have difficulty during childbirth why give yourself the risk?
Advocacy should be carried out. We should let women know. The issue is that many women don't know, including men, that female genital cutting has these adverse effects.
The World Health Organisation has said that female genital mutilation should not be medicalized. The Nigerian Medical and Dental Council frowns at any doctor who practises female genital mutilation. I am sure that the Nursing and Midwifery Council also frowns at the practice. I am a senior officer of Nigerian Medical Association, I am a senior officer of Society of Gynaecologists of Nigeria. We have told all doctors and midwives that female genital mutilation should not be practised as a medical procedure.
Dr Mairo Mandara
Women go through much trauma because they are held down and their private parts are cut, they have severe pain and it mentally affects them for the rest of their lives. Women also have pain during sex if they have female genital mutilation. It causes marital disharmony. Women do not want to have conjugal relationships with their spouses because of the pain and the trauma and that will cause much stress in the marriage and may lead to divorce.
It could also lead to infections. Sometimes, these things are done by traditional birth attendants in unhygienic situations. Infections could set in and these infections could ascend. At the end, a young girl may be at the age of seven, or at the age of seven days, have an infection that will ascend to her uterus and tubes and make her infertile in future. You wonder what that woman goes through in that kind of culture because she is infertile. And she becomes infertile not because of the sins she committed but because her parents have decided to circumcise her as a baby.
In terms of laws and sanctions, it hasn't worked in other countries. In Egypt, for example, when there were sanctions, female genital mutilation went underground. People did it secretly. The other key partners apart from the media, is to get religious leaders and community leaders committed to these things; they are the custodians of our cultures, they are the custodians of religion and if they speak in the public and in the religious organisations, people will listen to them. So, in effecting behavioural change, the key partners in doing this are the media and faith-based groups.
As an obstetrician, what really shocked me is that there was an increase in caesarean section rate. For a country to have an increase in the rate of caesarean rate is a huge amount of money. We are talking about turning delivery from maybe the rate of N500 or N1000 to maybe N20,000 due to caesarean section, that's significant.
Female genital mutilation is a product of culture of the people. Different cultures do it for different reasons. In some cultures, it does not exist. If you go to southern Kaduna and you ask them of female genital mutilation, they are shocked. They ask you what it is, because it does not exist there. For example, in some areas of Ekiti, I understand they do it to save the life of the unborn child, because if the head of the unborn child touches the clitoris it dies. As advocates, we need to tell them and prove to them that what really kills these babies is not touching the clitoris but something else and also give them alternatives. They will stop it.
In some areas you don't get a husband if you have not done it. I personally was involved in a research where I looked at education of people who have had female genital mutilation and want to circumcise their children. What was significant was tertiary education. Tertiary education has significant impact on women.
In essence, cultural influences affect women, but it is less likely to affect women who have had tertiary education. Such women are less bound by culture and pressure for circumcise.