Midwives set to intervene over female genital mutilation Midwives could be asked to raise the issue of female genital mutilation with pregnant women. Photograph: David Jones/PA Midwives could be asked routinely to raise the issue of female genital mutilation with pregnant women from communities where the practice is prevalent. The Department of Health is looking at gathering data on the numbers who have been illegally mutilated in an attempt to safeguard children and potentially increase the number of prosecutions. Campaigners applaud the move, pointing out that often women are not examined during pregnancy and so the first time NHS professionals are aware that a woman has been cut is during childbirth, when it may be too late to give her the help she needs. It is also hoped that collecting the data will help to identify the baby girls at birth who may be at risk in the future. "Female genital mutilation has not been taken seriously by the authorities to date, as many professionals consider it to be a cultural practice and are reluctant to address this for fear of being accused of being racist by the affected communities," said Efua Dorkenoo, advocacy director of the genital mutilation programme of Equality Now. It is estimated that in England and Wales there are 66,000 women who have undergone mutilation, while 24,000 girls are at risk of undergoing mutilation. Mutilation is illegal in the UK, but there have been no prosecutions because women and girls do not come forward to give evidence against those in their community, often in their family, who perpetrate or aid the crime. It is also clear, says Dorkenoo, that girls are increasingly being cut at younger ages, before they have any independence or knowledge that the practice is not normal in British society. Some are taken abroad in the school holidays, but it is thought others are mutilated in the UK. The Royal College of Midwives is already looking at improving the documentation on mutilation in antenatal and maternity units. Janet Fyle, a midwife and policy adviser for the college, says that she believes midwives are prepared to ask pregnant women if they have undergone mutilation. "When the Department of Health in the last government set up the taskforce on violence against women and girls, one of the recommendations was that we must ask about mutilation and not be afraid of sensitivities," she said. But, she added, there had been no guidance as to what should happen next if the woman needed surgery or psychological help or other support. Data on the extent of the practice and those at risk was badly needed and midwives would be willing to ask questions, she said. They would need to ask not only whether women had been subjected to mutilation but also whether they had strong links still to communities abroad where it was practised - which would be an indicator of whether the baby, if a girl, would later be at risk. Campaigners say progress is being made by an increasingly joined-up approach. If the health department makes a final decision to incorporate mutilation in the maternal and child datasets after April, that will mark an important moment. The Home Office is already involved. Guidance from the Crown Prosecution Service, designed to secure more convictions of people involved in mutilation, came out in November. Any child born after a strengthening of the law against mutilation in 2003 who is mutilated is a victim of crime, said Fyle. She believes midwives will be willing to inform the police if they discover it has happened once that generation reaches child-bearing age. The Nursing and Midwifery Council says where a crime has been committed they are duty-bound to co-operate with the authorities. It is terrible that little girls are mutilated in this way. We are the soft touch in Europe," Fyle said. France, by contrast, has significant numbers of prosecutions. Collecting data on women who have undergone mutilation will not only make prosecution and the protection of children easier but will also enable educational efforts to take place in the communities of the UK where it is supported. Dorkenoo says mutilation is "to do with the control of female sexuality and is a form of gender-based violence against girls and women. To address it properly requires a holistic approach which brings together educational and legislative measures, including child protection measures. It is also child abuse, she says. The parallels between mutilation and other forms are blatantly evident. In all instances, children experience confusion, guilt, fear and anxiety. In almost all cases the child victim has a close relationship with the perpetrator of the crime - an adult (usually a parent or family member in the case of mutilation), who holds significant physical and emotional power over them. The child who undergoes mutilation is silenced and any sense of entitlement to her natural sexuality is removed forever. A spokesperson for the health department said: "Female genital mutilation is a serious criminal offence. Health professionals should always take action when they believe a child or young person has been assaulted in any way, to protect them and others from further harm.