An explorative study of Sudanese midwives' motives, perceptions and experiences of re-infibulation after birth.
OBJECTIVE
to explore Sudanese midwives' motives for and perceptions and experiences of re-infibulation after birth and to elucidate its context and determinants.


METHODS
triangulation of methods, using observational techniques and open-ended interviews.


METHODS
two government hospitals in Khartoum/Omdurman, Sudan, for the observations and in-depth interviews with 17 midwives.


RESULTS
midwives are among the major stakeholders in the performance of primary female genital cutting (FGC) as well as re-infibulation. Focusing on re-infibulation after birth, midwives were trying to satisfy differing, and sometimes contradictory, perspectives. The practice of re-infibulation (El Adel) represented a considerable source of income for the midwives. The midwives integrated the practice of re-infibulation into a greater whole of doing well for the woman, through an endeavour to increase her value by helping her to maintain her marriage as well as striving for beautification and completion. They were also trying to meet socio-cultural requests, dealing with pressure from the family while balancing on the edge of the law.


CONCLUSIONS
the findings confirm that midwives are important stakeholders in perpetuating re-infibulation, and indicate that the motives are more complex than being only economic. The constant balancing between demands from others puts the midwives in a difficult position. Midwives' potential role to influence views in the preventative work against FGC and re-infibulation should be acknowledged in further abolition efforts.
Berggren
Vanja
V
Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
Abdel Salam
Gerais
G
Bergström
Staffan
S
Johansson
Eva
E
Edberg
Anna-Karin
AK
D000328:Adult; D000368:Aged; D019093:Circumcision, Female / Q000208:ethnology / Q000451:nursing*; D003466:Cultural Characteristics; D004954:Esthetics; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000592:standards*; D009042:Motivation; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D011247:Pregnancy; D012307:Risk Factors; D013397:Sudan; D016387:Women's Health / Q000208:ethnology*