title: Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation: a review of global experience.
abstract: OBJECTIVE
  to identify how midwives in low and middle income countries (LMIC) and high income countries (HIC) care for women with female genital mutilation (FGM), their perceived challenges and what professional development and workplace strategies might better support midwives to provide appropriate quality care.
  
  
  METHODS
  an integrative review involving a narrative synthesis of the literature was undertaken to include peer reviewed research literature published between 2004 and 2014.
  
  
  RESULTS
  10 papers were included in the review, two from LMIC and eight from HIC. A lack of technical knowledge and limited cultural competency was identified, as well as socio-cultural challenges in the abandonment process of the practice, particularly in LMIC settings. Training in the area of FGM was limited. One study reported the outcomes of an education initiative that was found to be beneficial.
  
  
  CONCLUSIONS
  professional education and training, a working environment supported by guidelines and responsive policy and community education, are necessary to enable midwives to improve the care of women with FGM and advocate against the practice.
  
  
  CONCLUSIONS
  improved opportunities for midwives to learn about FGM and receive advice and support, alongside opportunities for collaborative practice in contexts that enable the effective reporting of FGM to authorities, may be beneficial and require further investigation.
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology, Sydney, Australia. Electronic address: angela.dawson@uts.edu.au.
authors.forename: Angela
authors.initials: A
authors.lastname: Dawson
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology, Sydney, Australia.
authors.forename: Sabera
authors.initials: S
authors.lastname: Turkmani
authors.affiliation: NSW Education Program on FGM, NSW Health, Australia.
authors.forename: Shairon
authors.initials: S
authors.lastname: Fray
authors.affiliation: Auburn Hospital, NSW Health, Australia.
authors.forename: Susie
authors.initials: S
authors.lastname: Nanayakkara
authors.affiliation: Queen Elizabeth II Research Institute for Mothers and Babies, University of Sydney, Australia.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Varol
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology, Sydney, Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: Homer
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D019093:Circumcision, Female / Q000193:education* / Q000523:psychology*; D054521:Cultural Competency; D003906:Developing Countries; D005260:Female; D006801:Humans; D008880:Midwifery / Q000592:standards*; D011247:Pregnancy
keywords: Female genital mutilation; Midwifery education; Midwifery practice; Supportive work environments