Every year, the World Health Organization reports that some 3 million girls, most under the age of 15, are subject to female genital mutilation. This number adds to the hefty toll of more than 200 million girls and women already living with the harmful consequences of this brutal, inhumane practice.
For the first time, WHO is issuing guidelines to help health workers provide better physical and psychological care for these girls and women.
Female genital mutilation, or FGM, involves the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons. The practice is prevalent in 30 African countries, as well as a few countries in Asia and the Middle East. In addition, with increased global migration, more cases of FGM are occurring in Europe and North America.
Lale Say, coordinator in WHO's Department of Reproductive Health and Research, says FGM can cause as pain, severe bleeding and even death.
"It has high risks during pregnancy and childbirth, both for the woman who is delivering, but also for her baby,” Say said. “It can cause obstetric tears, difficult labor and even loss of the baby at the time of the delivery. Other health problems, longer-term health problems, include … psychological risks, depression, anxiety and post-traumatic stress disorder."
WHO notes that health workers often are unaware of the negative consequences of FGM and do not know how to treat them. The health agency's new recommendations focus on preventing and treating obstetric complications, and on helping women with depression and anxiety disorders. The guidelines also warn against the so-called medicalization of FGM.
To that end, doctors must refuse requests from family members to perform FGM, says WHO medical officer Doris Chou.
"Medicalization is never acceptable because it violates medical ethics, as it is a harmful practice,” Chou said. “Medicalization itself perpetuates FGM, and the risks outweigh any perceived benefits. … As health care providers, we actually need to recall that we need to uphold the Hippocratic oath — and that is to do no harm."
WHO says the guidelines can help ongoing global efforts to end female genital mutilation by better informing the health community about the many health risks associated with the practice.