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Female Genital Mutilation

Figure 13

The World Health Organization defines FGM as 'all procedures involving the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons'.

The practice entails the removal and/or damaging of normal female genital tissue and can interfere with the normal function of the female body.

There are four types of FGM, all of which are illegal in the UK.

Type 1. Clitoridectomy. Partial or total excision of the clitoris, and in a few cases of the prepuce only.

Type 2. Excision. Partial or complete excision of the clitoris and labia minora, with or without the removal of the labia majora.

Type 3. Infibulation. Narrowing of the vaginal opening by forming a covering seal by cutting and repositioning the inner or outer labia. It may also involve removal of the clitoris. This is the most extreme physical type and tends to lead to the most physical complications for the woman or girl and at childbirth.

Type 4. Other. This type of FGM entails all other harmful practices to the female external genitalia for non-medical reasons, including pricking, piercing, incising, scraping and cauterising. Type 4 includes labial stretching, as well as genital tattooing and piercing.

FGM is not associated with any health advantages and may lead to physical and psychological complications, and in the worst cases death of a woman or girl who has had FGM and/or death of her child due to complications in pregnancy and/or labour. FGM may be performed at any age, though the peak prevalence is five to eight years of age. In addition, women may undergo the procedure repeatedly after each time they give birth in order to restore the narrow vaginal opening created by type 3 FGM and widened in childbirth. This is called reinfibulation.

The practice of FGM is deeply rooted in certain cultures and communities. It is often viewed as a rite of passage performed in order to ensure that girls and young women remain pure and chaste in preparation for marriage. Other motives include hygiene, aesthetics, and religious and cultural reasons. It is, however, important to highlight that there is no basis for the practice of FGM in Muslim, Christian or Jewish religious texts.

FGM has been illegal in the UK since the Female Circumcision Act of 1985. The 1985 Act was superseded by the Female Genital Mutilation Act of 2003, which extended the offence to FGM performed abroad, and which makes FGM punishable by up to 14 years in prison. The Serious Crime Act 2015 introduced new provisions to tackle FGM, including the Mandatory Reporting Duty. Failure to comply may result in Fitness to Practise proceedings

The Practising Midwife featured articles

Female circumcision: double standards

2012; 15(11): 27 - 28

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FGM: dispelling the myths, exploring the facts

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FGM and midwifery practise

2016; 19(4):13 - 16

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Further reading

World Health Organization (2016). Female Genital Mutilation. Available at:

Home Office. Female genital mutilation: guidelines to protect children and women. Available at:

Royal College of Obstetricians and Gynaecologists. FGM management. Available at:

Royal College of Midwives. Tackling FGM in the UK: Intercollegiate recommendations for identifying, recording and reporting. Available at:

FGM factsheet for NHS staff (2015). FGM Prevention Programme: requirements for NHS staff. Available at:

The Home Office, e-learning module on FGM. Available at:

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