Impact of female genital mutilation on maternal and neonatal outcomes during parturition.

OBJECTIVE

To evaluate the impact of female genital mutilation on parturition and to create awareness of its implication on women and neonatal health.

DESIGN

A cross-sectional study.

SETTING

Tikur Anbessa, St. Paul's and Ghandhi Memorial hospitals between January and December 1997.

SUBJECTS: One thousand two hundred and twenty five mothers with and 256 without FGM who have had spontaneous, term, singleton and vertex vaginal delivery. Of these, 762 (51.5%) were primipara and 719 (48.5%) of them multipara. The parameters focussed upon included age, ethnicity, parity, type of circumcision, episiotomy, stages of labour, Apgar scores and related complications.

RESULTS

The study revealed that 82.7% of the subjects had one form of FGM. The mean ages for the circumcised and non-circumcised were 25.9 +/- 5.9 and 21.8 +/- 4.5 years, respectively. The frequently performed genital mutilation was type II (85.5%). The mothers who required an episiotomy incision for foetal and maternal indications among the circumcised accounted for 43.0% whereas it was only 24.6% for the referent group. The mean duration of labour by conventional standards is prolonged in primiparae and multiparae both in the circumcised and non-circumcised groups, though the second stage is delayed more so for the circumcised category (p<0.05). The first and tenth minute mean Apgar scores seem to be more favourable for the non-circumcised (p<0.05) but the perinatal mortality rates are quite similar. More complications in terms of perineal tears, bleeding, incontinence and febrile illnesses are registered for the FGM.

CONCLUSION

The study demonstrates the negative impact of FGM more on maternal than neonatal outcomes during parturition.