Updated guidelines give health professionals clarity on FGM care 

13/07/2015 00:00 
UCLH’s lead clinician on female genital mutilation (FGM) has helped to revise national guidelines for healthcare professionals on providing care to those who have suffered from the practice.

Professor Sarah Creighton, consultant gynaecologist at UCLH, co-authored the updated guidelines published this week by the Royal College of Obstetricians and Gynaecologists (RCOG). Prof Creighton, along with Dr Deborah Hodes, launched the UK’s first FGM clinic for children and adolescents at UCLH in September 2014.

The revised guidelines emphasise that clinical management of women with FGM requires high quality care that is accessible, sensitive and informed, while safeguarding girls at risk.

FGM refers to ‘all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons’. An estimated 137,000 women and girls in England and Wales have undergone the practice which affects those from certain communities from Africa, Asia and the Middle East who often have complex healthcare needs.

Pregnancy presents a key opportunity for healthcare professionals to identify women with FGM, provide information and advice, address healthcare needs and assess the risk to the unborn child or other female family members. The RCOG Green-top Guideline provides evidence-based advice for obstetricians and gynaecologists on the clinical care of women with FGM before, during and after pregnancy, including legal and regulatory responsibilities.

Clinicians must be aware of the short and long term complications of FGM, including scarring, urinary infections, menstrual difficulties, impaired sexual function, painful sexual intercourse, obstetric complications and psychological trauma.

The guideline also emphasises that all healthcare professionals must be aware of the Female Genital Mutilation Act 2003 in England, Wales and Northern Ireland, and the Prohibition of Female Genital Mutilation Act 2005 in Scotland.

Prof Creighton said: “There is absolutely no justification for FGM. It is an abuse which thousands of women in the UK are living with the consequences of, and these women must get the highest quality care from obstetricians, gynaecologists and all in the health service.

“FGM is a violation of human rights and a form of child abuse for which there can be no justification. Thousands of vulnerable women in the UK are living with the long-term physical and psychological consequences of FGM, and these women must receive high quality care by obstetricians, gynaecologists and other healthcare professionals.

“These guidelines draw on the latest scientific evidence and expert opinion to provide further clarity on how healthcare professionals should manage FGM, as well as the organisation of services for women with FGM.”

In order to ensure a consistent approach to data monitoring, the Department of Health has implemented the FGM Enhanced Dataset in England, which requires all acute trusts, general practices and mental health trusts to record data about women with FGM on a monthly basis.

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