Female Genital Mutilation (FGM) comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. The World Health Organization (WHO) classifies these procedures into four distinct types based on the anatomical extent of tissue removal. This standard classification helps healthcare providers document clinical findings accurately, plan appropriate nursing interventions, and communicate standardized data across public health sectors in Nigeria and globally.
Type I FGM involves the partial or total removal of the clitoris and/or the prepuce, which is the clitoral hood. When only the prepuce is removed, it is designated as Type Ia, whereas removal of both the clitoris and prepuce is designated as Type Ib. Clinically, nurses inspecting this area will note the absence of normal clitoral structures or scarring over the site. This procedure causes immediate severe pain, bleeding, and long-term sensory impairment.
Type II FGM, known as excision, involves the partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. Subdivisions include Type IIa (removal of the labia minora only), Type IIb (removal of the clitoris and labia minora), and Type IIc (removal of the clitoris, labia minora, and labia majora). Women who have undergone excision often present with extensive scar tissue, fused labial remnants, and chronic pelvic discomfort.
Type III FGM, or infibulation, is the most extensive form. It involves narrowing the vaginal orifice through the creation of a covering seal. This seal is formed by cutting and repositioning the labia minora or labia majora, sometimes through stitching, with or without removal of the clitoris. A small opening is left for urine and menstrual flow to escape. This creates profound obstetric and urological complications that require specialized midwifery and nursing management.
Type IV encompasses all other harmful procedures to the female genitalia for non-medical purposes. Examples include pricking, piercing, incising, scraping, and cauterization of the genital area. Nurses must recognize that these practices, though sometimes perceived as less severe by local communities, still carry significant risks of infection, hemorrhage, and psychological trauma.
Community health nurses occupy a front-line position in eradicating FGM and supporting affected women. Responsibilities include conducting culturally sensitive community education, identifying victims during routine antenatal care, providing empathetic psychological support, and managing chronic physical complications. Advocacy against the practice requires collaborating with local leaders while maintaining a non-judgmental stance to encourage women to seek clinical help.