Call The Midwife tackles the subject of Female Genital Mutilation in its sixth series as a Somalian mother comes to the attention of the nuns and nurses at Nonnatus House.
When Valerie and Barbara bring the young mother to the clinic for her first appointment they notice something very different about her genitalia, but as they’ve never encountered it before they’re not sure what’s going on. They are both appalled and baffled: "Do you mind me asking, have you had any surgery... down there?"
It’s the first time they’ve encountered a patient who has been, in her own words, “cut” – and their introduction to FGM.
What is FGM?
Female Genital Mutilation or FGM physically alters the female genital organs. There’s no medical reason for the procedure, which is usually carried out on young girls between the ages of 5 and 10 years old.
FGM is also known as female circumcision or cutting, and is referred to by terms such as sunna, gudniin, halalays, tahur, megrez and khitan among other names.
The NHS divides FGM into four different types, depending on what the procedure involves.
Why does FGM happen?
A girl’s parents or family usually decide that FGM is the best option for her based on their beliefs. Those beliefs are not necessarily religious – though they can be. Other reasons for carrying out FGM include custom, preserving tradition, preserving virginity, a belief that it is associated with cleanliness, to protect family honour and for social acceptance, particularly when it comes to purity before marriage.
How does FGM affect pregnancy and childbirth?
It can be more difficult for women who’ve had FGM to conceive a child and the procedure can also make it difficult and painful to have sexual intercourse.
Those who do fall pregnant despite the procedure need to notify their midwife as soon as possible so plans can be put in place to ensure proper care is available for the mother and child.
Can FGM be reversed?
Unfortunately there’s very little that can be done to reverse the effects once the procedure has been carried out.
Surgery can be performed to open up the vagina, however this procedure (also known as deinfibulation) can’t replace the removed tissue or undo the damage caused.
It’s recommended that this procedure is carried out before someone falls pregnant if possible, though it can also be carried out during pregnancy or while the mother is in labour.
Does FGM still happen?
Yes, FGM is still carried out in communities in many parts of Africa, the Middle East and Asia. It is now illegal in the UK, but that doesn’t stop families sending their daughters abroad for the procedure.
UK law states that it is an offence to perform FGM or take a child abroad for the purpose of undergoing the procedure. It is also illegal to help anyone perform FGM on themselves in or outside the UK, help anyone perform it in the UK, or help anyone outside the UK perform FGM on a UK national or resident.
Anyone who performs FGM can face up to 14 years in prison and anyone found guilty of failing to protect a girl from FGM can face up to seven years in prison.
For more information on FGM visit www.NHS.uk/fgm