The reproductive health needs of Somali women affected by female genital mutilation living in Manchester, United Kingdom

The reproductive health needs of Somali women affected by female genital

mutilation living in Manchester, United Kingdom

N.H. Mullin (1), H. Lovel (2), Z. Mohammed (3)

Highfield Clinic, Widnes, Cheshire, UK (1); University of Manchester

School of Primary Care, Manchester, UK (2); Central Manchester Primary Care

Trust, Manchester, UK (3)

Background: Female genital mutilation (FGM), usually type 3 (the most

severe form), affects over 90% of Somali women. FGM is illegal in the UK. There

is a rapidly increasing Somali population in Manchester. In other parts of the

UK, special African Well Woman Clinics have been set up to provide culturally

sensitive reproductive health care to women affected by FGM.

Objectives: A health needs assessment was carried out to discover the

reproductive health needs of Somali women affected by FGM; and to ascertain if a

community family planning service could provide an acceptable service to these


Design and methods: A systematic literature search on FGM was

performed. Somali women, men and Somali health professionals were interviewed

individually for a video commissioned by the World Health Organisation. Focus

groups comprising of representatives from the local Somali population were

brought together to discuss topics of concern. A health questionnaire was

developed from the discussions of the focus groups and was completed by other

members of the Somali community.

Results: Qualitative and quantitative analysis was used. FGM was

reported to have influences across the life course. The main themes were

consistent with the world literature. FGM in childhood is normal in Somali and

is often associated with acute health problems including pain, bleeding,

infection and urinary retention. Menstrual problems may occur in puberty,

sometime necessitating de-infibulation (re-opening). In later life there may be

sexual problems, effects on fertility and childbirth. We discovered

socioeconomic and sociocultural reasons facilitating continuation and factors

against FGM. Women complained of a lack of knowledge and understanding by UK

doctors and midwives. This Somali population expressed a desire to have easy and

timely access to the FGM reversal operation (before marriage and pregnancy)

rather than having to wait to see the local female hospital gynaecologist.

Conclusions: The adult Somali female population in Manchester suffers

many complications of FGM. There is a need for an improved FGM reversal service

in Manchester. This could be provided by the local family planning service when

an acceptable location for the clinic is established and medical staff with

gynaecological experience have been trained in the simple reversal procedure.

Further work on FGM issues is being carried out within the Somali community.

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