Background Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compared to women without FGM. Exploratory studies suggest radical change to abandonment of FGM by communities after migration to countries where FGM is not prevalent. Women who had been subjected to FGM as a child in their countries of origin, require specialised healthcare to reduce complications and further suffering. Our study compared obstetric outcomes in women with FGM to women without FGM who gave birth in a metropolitan Australian hospital with expertise in holistic FGM management. Methods The obstetric outcomes of one hundred and ninety-six women with FGM who gave birth between 2006 and 2012 at a metropolitan Australian hospital were analysed. Comparison was made with 8852 women without FGM who gave birth during the same time period. Data were extracted from a database specifically designed for women with FGM and managed by midwives specialised in care of these women, and a routine obstetric database, ObstetriX. The accuracy of data collection on FGM was determined by comparing these two databases. All women with FGM type 3 were deinfibulated antenatally or during labour. The outcome measures were (1) maternal: accuracy and grade of FGM classification, caesarean section, instrumental birth, episiotomy, genital tract trauma, postpartum blood loss of more than 500 ml; and (2) neonatal: low birth weight, admission to a special care nursery, stillbirth. Results The prevalence of FGM in women who gave birth at the metropolitan hospital was 2 to 3 %. Women with FGM had similar obstetric outcomes to women without FGM, except for statistically significant higher risk of first and second degree perineal tears, and caesarean section. However, none of the caesarean sections were performed for FGM indications. The ObstetriX database was only 35 % accurate in recording the correct FGM type. Conclusion Women with FGM had similar obstetric outcomes to women without FGM in an Australian metropolitan hospital with expertise in FGM management. Specialised FGM services with clinical practice guideline and education of healthcare professionals may increase the detection rate of FGM and improve obstetric management of women with FGM.

en_US

dc.publisher

BioMed Central

en_US

dc.relation.ispartof

BMC Pregnancy and Childbirth

en_US

dc.relation.isbasedon

10.1186/s12884-016-1123-5

en_US

dc.subject.classification

Obstetrics & Reproductive Medicine

en_US

dc.subject.mesh

Perineum

en_US

dc.subject.mesh

Humans

en_US

dc.subject.mesh

Pregnancy Complications

en_US

dc.subject.mesh

Pregnancy Outcome

en_US

dc.subject.mesh

Circumcision, Female

en_US

dc.subject.mesh

Delivery, Obstetric

en_US

dc.subject.mesh

Cesarean Section

en_US

dc.subject.mesh

Case-Control Studies

en_US

dc.subject.mesh

Pregnancy

en_US

dc.subject.mesh

Adolescent

en_US

dc.subject.mesh

Adult

en_US

dc.subject.mesh

Australia

en_US

dc.subject.mesh

Female

en_US

dc.subject.mesh

Obstetric Labor Complications

en_US

dc.subject.mesh

Young Adult

en_US

dc.subject.mesh

Adolescent

en_US

dc.subject.mesh

Adult

en_US

dc.subject.mesh

Australia

en_US

dc.subject.mesh

Case-Control Studies

en_US

dc.subject.mesh

Cesarean Section

en_US

dc.subject.mesh

Circumcision, Female

en_US

dc.subject.mesh

Delivery, Obstetric

en_US

dc.subject.mesh

Female

en_US

dc.subject.mesh

Humans

en_US

dc.subject.mesh

Obstetric Labor Complications

en_US

dc.subject.mesh

Perineum

en_US

dc.subject.mesh

Pregnancy

en_US

dc.subject.mesh

Pregnancy Complications

en_US

dc.subject.mesh

Pregnancy Outcome

en_US

dc.subject.mesh

Young Adult

en_US

dc.title

Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006–2012: a descriptive study

Background Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compared to women without FGM. Exploratory studies suggest radical change to abandonment of FGM by communities after migration to countries where FGM is not prevalent. Women who had been subjected to FGM as a child in their countries of origin, require specialised healthcare to reduce complications and further suffering. Our study compared obstetric outcomes in women with FGM to women without FGM who gave birth in a metropolitan Australian hospital with expertise in holistic FGM management. Methods The obstetric outcomes of one hundred and ninety-six women with FGM who gave birth between 2006 and 2012 at a metropolitan Australian hospital were analysed. Comparison was made with 8852 women without FGM who gave birth during the same time period. Data were extracted from a database specifically designed for women with FGM and managed by midwives specialised in care of these women, and a routine obstetric database, ObstetriX. The accuracy of data collection on FGM was determined by comparing these two databases. All women with FGM type 3 were deinfibulated antenatally or during labour. The outcome measures were (1) maternal: accuracy and grade of FGM classification, caesarean section, instrumental birth, episiotomy, genital tract trauma, postpartum blood loss of more than 500 ml; and (2) neonatal: low birth weight, admission to a special care nursery, stillbirth. Results The prevalence of FGM in women who gave birth at the metropolitan hospital was 2 to 3 %. Women with FGM had similar obstetric outcomes to women without FGM, except for statistically significant higher risk of first and second degree perineal tears, and caesarean section. However, none of the caesarean sections were performed for FGM indications. The ObstetriX database was only 35 % accurate in recording the correct FGM type. Conclusion Women with FGM had similar obstetric outcomes to women without FGM in an Australian metropolitan hospital with expertise in FGM management. Specialised FGM services with clinical practice guideline and education of healthcare professionals may increase the detection rate of FGM and improve obstetric management of women with FGM.

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