The physical impacts of FGC…
Can be incredibly harmful to a girl’s health, and can often lead to issues throughout her life. The most extreme consequence is death. In such cases when a girl dies as a direct result of FGC it is due to either a haemorrhage or from contracting tetanus during the procedure and dying in the ensuing weeks. Girls who have the procedure performed in situations where more than one girl is cut using the same, unsterilized tool may also be at risk of contracting HIV.
Those who have been infibulated (also known as Type 3, when the entrance to the vagina is sewn almost completely closed) are also likely to have trouble passing urine, which can lead to bladder infections. This happens when the urethra is blocked and urine cannot easily escape. FGC also causes issues when girls who have had the procedure start to menstruate. Menstrual blood passing through the sewn up hole can cause severe pelvic pain and painful periods, with stagnant menstrual blood causing a build-up of bacteria that leads to pelvic inflammation and severe abdominal cramps. This can cause monthly, even daily pain for the girl and can at times even lead to internal infection which can then lead to death. Problems with urination and menstruation can also be associated with other types of FGC, for example Type 2, as after the labia minora have been cut, they may knit together as they heal.
FGC is also known to cause infertility. This occurs when the build-up of stagnant menstrual blood and other vaginal secretions leads to the inflammation of the pelvis, in turn affecting the womb. Shorter term, but no less upsetting implications of FGC include open sores, cysts and keloid scarring, as well as shock.
The emotional and psychological impacts of FGC…
Still remain largely unknown. There is a wealth of anecdotal evidence to suggest that FGC has a long lasting effect on a woman’s mental well-being, however, and can even cause post-traumatic stress. Recent studies that have been carried out have supported this anecdotal evidence. It is not only the trauma and memory of being cut – which evidence suggests is a memory many girls and women carry with them and which can cause feelings of fear, helplessness, horror, and severe pain – but the ongoing effects of FGC throughout a girl’s life that can lead to emotional distress.
Difficulties resulting from painful periods, and further pain during sex and childbirth can cause girls and women to experience further trauma, as well as lower self-esteem, an increased likelihood of depression and anxiety, and in some cases personality disorders. Women and girls who have undergone the procedure have also been known to experience memory loss, and blackouts as a result of post-traumatic stress. Not only that, but if a girl has undergone Type 3 cutting, otherwise known as infibulation, she will literally have to re-live the procedure when she is cut open and re-sewn for sexual intercourse, and later childbirth if she becomes pregnant.
Although studies on the emotional and psychological impacts of FGC are not quite as widely available as the physical effects, a 2010 study from a group of girls in Iraqi Kurdistan found that:
“All circumcised participants remembered the day of their circumcision as extremely frightening and traumatizing. Over 78% of the girls described feelings of intense fear, helplessness, horror, and severe pain, and over 74% were still suffering from intrusive re-experiences of their circumcision.”
Other side effects of FGC include…
A detrimental effect on a girl’s socio-economic opportunities. FGC also increases the likelihood of leaving school at a young age. This is often caused by the multiple absences that come as a result of painful periods as well as bleeding throughout the month, which is a common physical side effect of FGC in girls and women. The knock-on effects of leaving school at a young age are well-documented and include earning less, and having less control and agency over life choices including marriage, pregnancy, and family planning.
FGC is also linked to child marriage and instances of early first pregnancy when the girl’s body is not physically mature enough for pregnancy and birth which in turn can lead to its own set of both physical and psychological problems. The effects of dealing with painful sexual intercourse and/or infertility caused by FGC can also lead to even further psychological and emotional damage, as well as causing difficulties in relationships and marriage, even in some cases leading to divorce or abandonment.
FGC can lead to an increased risk of childbirth complications…
And is a major contributing factor to maternal mortality. According to the WHO, women who have experienced the most extreme form of FGC (infibulation) are 70% more likely to experience post-partum haemorrhage, and 30% more likely to require a caesarean section. As such it is not all that surprising to find that those regions where FGC is practised are also the regions where the highest infant and maternal mortality rates are found. For example, there are one to two more infant deaths per 100 births among women who have undergone FGC of any type (Type 1, 2, or 3) than among uncut women.
Complications both in childbirth and in the collection of data also occur when we take into consideration all the births that occur outside of hospitals. The research undertaken by the WHO was done amongst women giving birth in hospital, but as it stands currently only 46% of women living in Sub-Saharan Africa give birth with a skilled assistant as an attendant, and we must therefore presume that the numbers of both infant and maternal mortality, as well as the incidences of complications during childbirth as a result of FGC are actually much higher than we know.
A 2013 study from the Norwegian Knowledge Centre for the Health Services which collated findings from a large number studies, found that women who had undergone FGC (regardless of type), were twice as likely as women who had not been cut to experience difficult labour.
FGC can impact the experience of sexual intercourse…
By being both painful and traumatic. For those women who have undergone Type 3, otherwise known as infibulation, the pain is even worse, as a hard plug of scar tissue is formed over where there was once the soft opening of the vagina. Some women will have to be physically cut open in order to allow penetration, in which case the procedure is known as de-infibulation. Even if the woman is not cut open medically, the hole will be too small to be opened without force.
For many women, it is not only the first instance of sexual intercourse that causes pain. The scar tissue around the vaginal orifice will continue to cause pain and discomfort during sex throughout a woman’s lifetime, and often this not only affects her, but also her partner who may well experience discomfort and stress at being the one to cause pain during sex.