Female Genital Mutilation (FGM) encompasses all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. Internationally recognized as a grave violation of the human rights, health, and integrity of women and girls, FGM carries no health benefits whatsoever. Instead, it alters normal physiological structures and disrupts healthy bodily functions. In many Nigerian communities, the practice is deeply entrenched as a rite of passage into womanhood, preserving cultural identity, and ensuring chastity before marriage. Midwives working across Nigeria encounter girls and women living with the physical and emotional scars of these procedures daily. Recognizing FGM strictly as a harmful traditional practice rather than a therapeutic intervention is vital for driving effective clinical care and community advocacy.
The World Health Organization classifies FGM into four distinct types based on the severity of the tissue removed:
Type III, often referred to as pharaonic circumcision, presents the most severe mechanical and obstetric obstructions during childbirth.
The health consequences of FGM span across a woman's entire lifespan. Immediate complications occur during or shortly after the procedure, often performed using unsterilized blades in unhygienic settings by traditional practitioners.
In the labor ward, women with Type III infibulation frequently require surgical deinfibulation to allow safe passage of the fetus and prevent prolonged obstructed labor, perineal tearing, and obstetric fistula.
Providing care for survivors of FGM requires profound empathy, clinical skill, and a non-judgmental attitude. Midwives must conduct gentle, trauma-informed physical examinations, acknowledging that the patient may experience high levels of anxiety or flashbacks. Antenatal care planning should include discussions regarding anticipated childbirth challenges, pain management, and consent for any necessary surgical procedures like deinfibulation. Psychological rehabilitation is equally important, addressing chronic anxiety, depression, and sexual dysfunction resulting from trauma. Midwives act as a bridge between clinical treatment and community counseling, ensuring women receive holistic support for both their physical injuries and mental well-being.
Eradicating FGM requires robust legislation backed by community engagement and education. In Nigeria, the Violence Against Persons Prohibition (VAPP) Act explicitly bans FGM, prescribing penalties for perpetrators and anyone who promotes the practice. Many Nigerian states have also domesticated this law. However, passing laws alone is insufficient. Midwives play a frontline role in prevention through community sensitization, engaging traditional and religious leaders, and educating young mothers during antenatal and immunization clinics. By championing open dialogues about bodily autonomy and reproductive rights, midwives help shift cultural norms and protect future generations of girls from harm.