Female genital mutilation (FGM), also known as female genital cutting and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia. The practice is found in Africa, Asia and the Middle East, and within communities from countries in which FGM is common.
This presentation describes all the aspects of the FGM (types effects prevention)etc .
What is Female Genital Mutilation (FGM)?
Procedures for FGM
Prevalence of FGM globally
Types of FGM
Reasons for FGM
The possible consequences of the procedure
The potential impacts of FGM on labor and childbirth
The international organizations response to End FGM practice.
Female Genital Mutilation is cultural practice that seeks to control women and girls. Because of the health risks that plague the practice of FGM, cultures should seek alternate cultural practices to celebrate womanhood.
Female genital mutilation/cutting (FGM/C) has been performed in various forms for millennia and involves the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. In this systematic review we addressed harm occurring during the cutting or alteration modifi cation process and the short-term period
What is Female Genital Mutilation (FGM)?
Procedures for FGM
Prevalence of FGM globally
Types of FGM
Reasons for FGM
The possible consequences of the procedure
The potential impacts of FGM on labor and childbirth
The international organizations response to End FGM practice.
Female Genital Mutilation is cultural practice that seeks to control women and girls. Because of the health risks that plague the practice of FGM, cultures should seek alternate cultural practices to celebrate womanhood.
Female genital mutilation/cutting (FGM/C) has been performed in various forms for millennia and involves the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. In this systematic review we addressed harm occurring during the cutting or alteration modifi cation process and the short-term period
2.1 DEFINITION OF INFERTILITY :
Infertility is defined as a failure to conceive within one or more year of regular unprotected coitus.
2.2 TYPES OF INFETILITY:
1. PRIMARY INFERTILITY:
SECONDARY INFERTILITY
2.3 CAUSES OF INFERTILITY :
• MALE FACTORS :
DEFECTIVE SPERMATOGENESIS
SECONDARY INFERTILITY
2.3 CAUSES OF INFERTILITY :
• MALE FACTORS :
DEFECTIVE SPERMATOGENESIS
Infection
Gonadotropin suppression
Endocrine factors
Immunological factors
Tubal and peritoneal factors
UTERINE FACTORS CERVICAL FACTORS
VAGINAL FACTORS
COMBINED FACTORS
DIAGNOSTIC PROCEDURES
FOR FEMALE
HISTORY
EXAMINATIONS
DIAGNOSTIC EVALUATION:
1. CERVICAL MUCUS STUDY
2. HORMONAL ESTIMATION
3. ENDOMETRIAL BIOPSY
4. SONOGRAPHY
5. LAPROSCOPY
6. INSUFFLATION TEST (Rubin’s test)
2.5 RECENT ADVANCEMENT IN INFERTILITY MANAGEMENT :
ASSISTED REPRODUCTIVE TECHNIQUES (ART)
“ASSISTED REPRODUCTIVE TECHNIQUES INVOLVING DIRECT RETRIEVAL OF OOCYTE FROM OVARY, MANIPULATION OF GAMETS AND EMBROYOS OUTSIDE BODY FOR PURPOSE OF ESTABLISHING PREGNANCY”.
TYPES OF ART :
1. IUI (Intrauterine insemination)
2. IVF-ET(In vitro fertilization & embryo transfer)
3. ZIFT(Zygote intra fallopian transfer)
4. ICSI (Intra cytoplasmic sperm injection) (TESA, PESA, MESA)
5. EMBRYO OR OOCYTE DONATION
6. GESTATIONAL CARRIER
7. SURROGACY
2.6 ROLE OF NURSE IN MANAGEMENT OF
INFERTILITY :
] ASSESSMENT :
- Assessment of the infertile couple is the initial stage of infertility management. The nurse is often the first contact the infertile couple make during their visit for treatment. The nurses role during this stage is to educate the couple about each test or investigation. The nurse plays a vital role in alleviating the fear and anxiety about the various diagnostic procedure.
2] TREATMENT :
- The nurse plays the link between the doctor and the couple and should always be available to the couple for their assistance, guidance and support before, during and after the infertility treatment.
- Numerous ethical issues are associated with infertility treatments and the couple undergoing treatment need appropriate counselling and discussion.
-The goal of the nurse helping the infertile couple is to assist them through the treatment cycle as smoothly as possible.
3] EDUCATION :
- The role of a nurse in educating the patients includes education about the basic male and female anatomy and physiology and how the drugs act on their body, including possible side effects. This may be offered under various setting such as
• Face to face on an individual basis.
• In a group situation,
• Fertility nurses should also educate the couple about the self-administer medications.
• Proper knowledge of administration of these medicines and storage conditions for medications, as well as the possible side affects, should be imparted to the couple undergoing treatment.
4] PSYCHOLOGICAL SUPPORT :
-A couple undergoing infertility treatments are usually under stress due to variety of reasons.
it describes in detail about causes, investigations and management of female infertility.in the end of presentation, it includes a video demonstration to describe the management options of assisted conception.
Female Genital Mutilation/Cutting: A statistical overview and exploration of ...UNICEF Publications
Over the last two decades, reliable data on FGM/C have been generated through two major sources: the Demographic and Health Surveys (DHS), supported by the United States Agency for International Development (USAID), and the Multiple Indicator Cluster Surveys (MICS), supported by UNICEF. The new UNICEF report reviews all available DHS and MICS data and presents the most comprehensive compilation to date of statistics and analyses on FGM/C. It covers all 29 countries in Africa and the Middle East where FGM/C is concentrated and includes, for the first time, statistics from countries where representative survey data were lacking. The report highlights trends across countries, and it examines differentials in prevalence according to social, economic, demographic and other variables. The findings add crucial evidence that sheds further light on how abandonment of harmful social norms can be accelerated.
2.1 DEFINITION OF INFERTILITY :
Infertility is defined as a failure to conceive within one or more year of regular unprotected coitus.
2.2 TYPES OF INFETILITY:
1. PRIMARY INFERTILITY:
SECONDARY INFERTILITY
2.3 CAUSES OF INFERTILITY :
• MALE FACTORS :
DEFECTIVE SPERMATOGENESIS
SECONDARY INFERTILITY
2.3 CAUSES OF INFERTILITY :
• MALE FACTORS :
DEFECTIVE SPERMATOGENESIS
Infection
Gonadotropin suppression
Endocrine factors
Immunological factors
Tubal and peritoneal factors
UTERINE FACTORS CERVICAL FACTORS
VAGINAL FACTORS
COMBINED FACTORS
DIAGNOSTIC PROCEDURES
FOR FEMALE
HISTORY
EXAMINATIONS
DIAGNOSTIC EVALUATION:
1. CERVICAL MUCUS STUDY
2. HORMONAL ESTIMATION
3. ENDOMETRIAL BIOPSY
4. SONOGRAPHY
5. LAPROSCOPY
6. INSUFFLATION TEST (Rubin’s test)
2.5 RECENT ADVANCEMENT IN INFERTILITY MANAGEMENT :
ASSISTED REPRODUCTIVE TECHNIQUES (ART)
“ASSISTED REPRODUCTIVE TECHNIQUES INVOLVING DIRECT RETRIEVAL OF OOCYTE FROM OVARY, MANIPULATION OF GAMETS AND EMBROYOS OUTSIDE BODY FOR PURPOSE OF ESTABLISHING PREGNANCY”.
TYPES OF ART :
1. IUI (Intrauterine insemination)
2. IVF-ET(In vitro fertilization & embryo transfer)
3. ZIFT(Zygote intra fallopian transfer)
4. ICSI (Intra cytoplasmic sperm injection) (TESA, PESA, MESA)
5. EMBRYO OR OOCYTE DONATION
6. GESTATIONAL CARRIER
7. SURROGACY
2.6 ROLE OF NURSE IN MANAGEMENT OF
INFERTILITY :
] ASSESSMENT :
- Assessment of the infertile couple is the initial stage of infertility management. The nurse is often the first contact the infertile couple make during their visit for treatment. The nurses role during this stage is to educate the couple about each test or investigation. The nurse plays a vital role in alleviating the fear and anxiety about the various diagnostic procedure.
2] TREATMENT :
- The nurse plays the link between the doctor and the couple and should always be available to the couple for their assistance, guidance and support before, during and after the infertility treatment.
- Numerous ethical issues are associated with infertility treatments and the couple undergoing treatment need appropriate counselling and discussion.
-The goal of the nurse helping the infertile couple is to assist them through the treatment cycle as smoothly as possible.
3] EDUCATION :
- The role of a nurse in educating the patients includes education about the basic male and female anatomy and physiology and how the drugs act on their body, including possible side effects. This may be offered under various setting such as
• Face to face on an individual basis.
• In a group situation,
• Fertility nurses should also educate the couple about the self-administer medications.
• Proper knowledge of administration of these medicines and storage conditions for medications, as well as the possible side affects, should be imparted to the couple undergoing treatment.
4] PSYCHOLOGICAL SUPPORT :
-A couple undergoing infertility treatments are usually under stress due to variety of reasons.
it describes in detail about causes, investigations and management of female infertility.in the end of presentation, it includes a video demonstration to describe the management options of assisted conception.
Female Genital Mutilation/Cutting: A statistical overview and exploration of ...UNICEF Publications
Over the last two decades, reliable data on FGM/C have been generated through two major sources: the Demographic and Health Surveys (DHS), supported by the United States Agency for International Development (USAID), and the Multiple Indicator Cluster Surveys (MICS), supported by UNICEF. The new UNICEF report reviews all available DHS and MICS data and presents the most comprehensive compilation to date of statistics and analyses on FGM/C. It covers all 29 countries in Africa and the Middle East where FGM/C is concentrated and includes, for the first time, statistics from countries where representative survey data were lacking. The report highlights trends across countries, and it examines differentials in prevalence according to social, economic, demographic and other variables. The findings add crucial evidence that sheds further light on how abandonment of harmful social norms can be accelerated.
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Female genital mutilation (FGM)
1. FEMALE GENITAL
MUTILATION
B.Tech (Computer science)
Vth
sem section- B
Group members SUBMITTED TO:-
Tanya Saxena Ms. Priyambada Shah
(BTBTC18093) (1812901) (Dept. of Sociology)
Tanya Makkar
(BTBTC18268) (1812900)
Vandana
(BTBTC18091) (1812910)
Vartika Rana
(BTBTC18089) (1812913)
WOMEN IN INDIAN SOCIETY (ASSIGNMENT-1)
2. Female Genital Mutilation (FGM)
Is a non-medical practice that comprises of all procedures involving partial of total removal of the external female
genitalia or other injury to the female genital organs for non-medical reasons. It is an act performed forcefully on the
victim with the consent or order given by her family. FGM arises from and perpetuates gender inequality. It is usually
performed by traditional practitioners (or elderly people in the community or even midwives) using a sharp object
such as a knife, a razor blade or broken glass. Anaesthetic and antiseptics are generally not used unless the procedure
is carried out by medical practitioners. However, medicalization of FGM is denounced by the World Health
Organization. In many countries, FGM is banned by law but is still being practiced. FGM is practiced all over the
world but is predominant in some countries particularly. Also, there is no such thing as “safe” FGM. FGM is
violence against women and girls, sexual assault, and often it is considered to be about controlling female sexuality
or a tradition to prepare a woman for marriage allegedly to purify them for their husbands. Sometimes it is done to
girls because it was done to their mothers as a rite of passage or a coming-of-age ritual or even without much of an
explanation at all. It’s a cycle of social pressure, that’s hard to shake, but not impossible to end. It has zero health
benefits. Infact on the contrary, the practice can cause life-lasting physical as well as psychological trauma. Also, it
is not prescribed by any religion.
Often girls are cut when they are still very young, in some cases under the age of five. It is estimated that more than
200 million girls and women alive today have undergone female genital mutilation around the world. Furthermore,
there are an estimated 3 million girls at risk of undergoing female genital mutilation every year. The majority of
girls are cut before they turn 15 years old. Although it is often shrouded in secrecy, many survivors are coming into
light and talking about the reality of FGM so that they can help end it all together.
Female genital mutilation is classified into four types:
Type I: Also known as Clitoridectomy, this type consists of partial or total removal of the
external part of the Clitoris and/or its prepuce.
Type II: Also known as Excision, the external part of clitoris and Labia Minora are partially or
totally removed, with or without excision of the Labia Majora.
Type III: The most severe form, it is also known as Infibulation or Pharaonic type. The procedure
consists of narrowing the vaginal orifice with creation of a covering sealby cutting and
appositioning the Labia Minora and/or Labia Majora, with or without removal of the
external part of Clitoris. The appositioning of the wound edges consists of stitching or
holding the cut areas together for a certain period of time (for example, girls’ legs are
bound together), to create the covering seal. A small opening
is left for urine and menstrual blood to escape.
Type IV: This type consists of all other procedures to the genitalia of women for non-medical
purposes, such as pricking, piercing, incising, scraping and cauterization.
3. Cultural and social factors for performing
Female genital mutilation(FGM)
● Where FGM is a social convention (social norm), the social pressure to conform
to what others do and have been doing, as well as the need to be accepted
socially and the fear of being rejected by the community, are strong motivations to
perpetuate the practice. In some communities, FGM is almost universally
performed and unquestioned.
● FGM is often considered a necessary part of raising a girl, and a way to prepare
her for adulthood and marriage.
● FGM is often motivated by beliefs about what is considered acceptable sexual
behavior. It aims to ensure premarital virginity and marital fidelity. FGM is in
many communities believed to reduce a woman's libido and therefore believed to
help her resist extramarital sexual acts.
● Where it is believed that being cut increases marriageability, FGM is more likely
to be carried out.
● FGM is associated with cultural ideals of femininity and modesty, which include
the notion that girls are clean and beautiful after removal of body parts that are
considered unclean, unfeminine or male.
● Though no religious scripts prescribe the practice, practitioners often believe the
practice has religious support.
● Religious leaders take varying positions with regard to FGM: some promote it,
some consider it irrelevant to religion, and others contribute to its elimination.
● Local structures of power and authority, such as community leaders, religious
leaders, circumcisers, and even some medical personnel can contribute to
upholding the practice. Likewise, when informed, they can be effective advocates
for abandonment of FGM.
● In most societies, where FGM is practised, it is considered a cultural tradition
● In some societies, recent adoption of the practice is linked to copying the
traditions of neighbouring groups. Sometimes it has started as part of a wider
religious or traditional revival movement.
4. HEALTH RISKS:
Women and girls living with FGM face serious risks to their health and well-being. Women who have undergone the
procedure are more likely to experience life-threatening complications during childbirth.
It is unacceptable from a human rights as well as a public health perspective, regardless of who performs it.
Short-term health risks of FGM:
Severe pain Cutting the nerve ends and sensitive genital tissue causes extreme
pain.
The healing period is also painful.
Excessive bleeding (haemorrhage). Clitoral artery or other blood vessel is cut.
Shock: Can be caused by pain, infection and/or haemorrhage.
Genital tissue swelling: Due to inflammatory response or local infection.
Human immunodeficiency virus (HIV): Cutting of genital tissues with the same surgical instrument without
sterilization could increase the risk for transmission of HIV between
girls who undergo female genital mutilation together.
Urination problems: Include urinary retention and pain passing urine.
Causes tissue swelling, pain or injury to the urethra.
Impaired wound healing: Can lead to pain, infections and abnormal scarring.
Mental health problems: The pain, shock and the use of physical force during the event, as
well as a sense of betrayal when family members condone Organize
the practice, are reasons why many women describe
FGM as a traumatic event.
Long-term health risks of FGM
Pain: Due to tissue damage and scarring that may result in
trapped or unprotected nerve endings.
Chronic genital infections: With consequent chronic pain, and vaginal discharge
and itching. Cysts, abscesses and genital ulcers may
also appear
Chronic reproductive tract infections: May cause chronic back and pelvic pain
Urinary tract infections: Ascend to the kidneys, potentially resulting in renal
failure, septicaemia and death. An increased risk of
repeated urinary tract infections is well documented in
both girls and adult women who have undergone FGM
Painful urination: Due to obstruction of the urethra and recurrent urinary
tract infections.
Vaginal problems i.e., discharge, itching, bacterial
vaginosis and other infections.
Causes menstrual problems.
Excessive scar tissue (keloids): Excessive scar tissue can form at the site of the cutting.
Sexual health problems: Causes due to removal of, or damage to, highly
sensitive genital tissue.
Leads to scar formation, pain and traumatic memories.
Childbirth complications: FGM is associated with an increased risk of caesarean
section, postpartum haemorrhage.
5. WHAT IS OUR RESPONSIBILITY?
All professionals have a responsibility toward safeguarding children
If concerned a girl is at risk you have a duty to seek urgent guidance and inform the Child Protection Team, or
Safeguarding Board.
If a child is admitted after mutilation advice should be sought urgently from the local social services, local police child
protection unit or National Society for Prevention of Cruelty to Children. This should include addressing concern for
other children in the family who may not have undergone the procedure.
For all cases, a psychological assessment should be included for any women who has undergone FGM and they should
be offered referral to a psychologist.
Practitioners should seek medico-legal advise from their defense union if unsure of their position.
Remember most women do not choose mutilation and the procedure is carried out in childhood. The practice is seen
by some cultures as normal, is traditional, and in some communities is viewed as a 'coming of age' ritual. The woman
will not only have suffered through experiencing female genital mutilation, but also through migration and separation,
and in some cases war. It is important to remain non-judgmental, and offer support.
In Mali, 76% of girls up to the age of 14 have undergone female genital cutting, compared to 83% of 15 to 49-year-
olds - suggesting a declining trend. However, the practice has not yet officially been outlawed by the government.
6. PREVENTION TO FGM
1. CHALLENGE THE DISCRIMINATORY REASONS FGM IS PRACTISED
Among the discriminatory reasons FGM is practiced is a perceived need to control female sexuality. “The purpose
of female genital cutting is to ensure that a girl behaves properly
2. CHANGE TRADITIONS - WITH THE SUPPORT OF OLDER
GENERATIONS
“In the past, grandmothers used to tell fairy tales and fables containing concealed life lessons. But nowadays
children just don’t want to know. Similarly, grandmothers were the ones who provided sexual education. We’ve lost
that role too, but I think it should be reinstated.” says Ma, 65 (pictured below). Among the discriminatory reasons FGM
is practiced is a perceived need to control female sexuality. “The purpose of female genital cutting is to ensure that a
girl behaves properly
3. EDUCATE GIRLS ON THEIR RIGHT TO DECIDE WHAT HAPPENS TO
THEIR BODY
Girls should be educated as for the FGM like-wise what is the FGM stands for, (Female genital mutilation (FGM) is
a procedure performed on a woman or girl to alter or injure her genitalia for non-medical reasons.
4. SPEAK OUT ABOUT THE RISKS AND REALITIES OF FGM
FGM has lasting physical and mental consequences that need to be discussed so that girls and women no longer have
to suffer in silence.
5. SPREAD UNDERSTANDING THAT RELIGION DOES NOT DEMAND FGM
There is a widespread view among practitioners of female genital mutilation (FGM) that it is a religious
requirement, although prevalence rates often vary according to geography and ethnic group
6. TACKLE THE SECRECY THAT ALLOWS CUTTING TO CONTINUE
In the old days genital cutting was an initiation rite to prepare them for their future the whole community would
participate but now a days it become more controversial and it usually take place discretely at home and the girls who
are cut are getting younger and younger this is because the younger a girl is the less lightly she will be to discuss it
with her friends.
7. KEEP PUSHING FOR FGM TO BE BANNED
Cutting is a violation of children’s right the right to physical integrity the right to good health and freedom to make
your own choices it even violates a child’s right to be educated if the wounds become infected because the cutter uses
an unsterilized knife for example the girl will fall ill and be unable to attend the school
7. World Health Organization (WHO)
Response
In 2008, the World Health Assembly passed resolution WHA61.16 on
the elimination of FGM, emphasizing the need for concerted action in
all sectors - health, education, finance, justice and women's affairs.
WHO efforts to eliminate female genital mutilation focus on :
Strengthening the health sector response: developing and implementing
guidelines, tools, training and policy to ensure that health care providers can
provide medical care and counselling to girls and women living with FGM and
communicate for prevention of the practice
Building evidence: generating knowledge about the causes, consequencesand
costs of the practice, including why health care providers carry out the practice,
how to abandon the practice, and how to care for those who have experienced
FGM.
Increasing advocacy: developing publications and advocacy tools for
international, regional and local efforts to end FGM, including tools for policy
makers and advocates to estimate the health burden of FGM and the potential
public health benefits and cost savings of preventing FGM
WHO together with 9 other United Nations partners, issued a statement on the
elimination of FGM to support increased advocacy for its abandonment, called:
“Eliminating female genital mutilation: an interagency statement”. This statement
provided evidence collected over the previous decade about the practice of FGM.
In 2010, WHO published a "Global strategy to stop health care providers from
performing female genital mutilation" in collaboration with other key UN agencies
and international organizations. WHO supports countries to implement this
strategy.
In May 2016, WHO in collaboration with the UNFPA-UNICEF joint programme on
FGM launched the first evidence-based guidelines on the management of health complications
from FGM. The guidelines were developed based on a systematic
review of the best available evidence on health interventions for women living with
FGM.
In 2018, WHO launched a clinical handbook on FGM to improve knowledge,
attitudes, and skills of health care providers in preventing and managing the
complications of FGM.
8. CONCLUSION
A greater understanding of FGM will help health professionals to improve the health care
provided and cease further alienation of the women involved. Increasing awareness by educating
the communities involved could help to challenge themselves harmful practices.
Even though FGM may be normative and considered to be of cultural significance in some
settings, the practice is always a violation of human rights, with the risk of causing trauma and
leading to problems related to girls’ and women’s mental health and well-being.
FGM has been associated with medical, sociocultural, and economic consequences.
Elimination of FGM is possible through directing resources in an efficient manner.
Targeted interventions can include cultural and ethnical proponents.