Female genital mutilation and the Swiss health care system (2003)
This study is a Descriptive research regarding All FGM/C with the following characteristics:
Author(s): Clara Thierfelder
FGM/C Type(s): All
Health area of focus: None.
Objective: Objectives of this study were to analyse how immigrant women with FGM experience gynaecological/obstetrical care in the Swiss health care system,and to investigate if gynaecologists/obstetricians and midwives,those health care professionals most directly concerned,are apt to treat and counsel FGM related complications adequately
Study Population: women,physicians and midwives
Findings: The main FGM-related health complications that women from Somalia and Eritrea suffered from were a painful and prolonged menstruation,pain and reduced feelings during sexual intercourse. In Switzerland obstetric complications play a smaller role than in their countries of origin. Therefore,psychosexual complications become more prominent consequences of FGM. The concern of being different from women of the host society as FGM interferes with sexual pleasure,is a consequence that the migrant women face particularly. However,participants who had undergone FGM expressed a strong inter-individual variability with respect to sexual response. Generalisations that having undergone FGM leads to sexual indifference,are not based on evidence and might contribute to stigmatise women concerned. Consequently,the aspect of gynaecological/obstetrical care was found to be more challenging in terms of a culturally sensitive interpersonal interaction between women concerned and health care providers,than in relation to technical management of FGM. The following aspects of the consultation concluded to be critical: the reactions of several health care providers when first facing a mutilated vulva (FGM type III) ranged from disclosing shock in front of the patient to totally ignoring the condition of FGM. A complete medical history related to FGM,including probing for FGM related complications,was not performed in most cases. Particularly,the sexual and social complications were rarely discussed. Regarding prevention,only 8% of the participating health care providers systematically addressed the future of concerned women’s daughters. The issue of reinfibulation (re-establishment of infibulation or re-suturing the vulva after delivery to the antepartum state),a question specifically linked to obstetrical care of women with FGM type III,presents an ethical conflict for the gynaecologists/obstetricians and midwives. Ultimately all interviewed health care providers give priority to the wish of an adult patient and support partially re-suturing the vulva after delivery if requested
Geographical coverage
Region(s):Western Europe
Country(ies):Switzerland