title: Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006-2012: a descriptive study.
abstract: Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compared to women without FGM. Exploratory studies suggest radical change to abandonment of FGM by communities after migration to countries where FGM is not prevalent. Women who had been subjected to FGM as a child in their countries of origin, require specialised healthcare to reduce complications and further suffering. Our study compared obstetric outcomes in women with FGM to women without FGM who gave birth in a metropolitan Australian hospital with expertise in holistic FGM management.
  
  
  
  The obstetric outcomes of one hundred and ninety-six women with FGM who gave birth between 2006 and 2012 at a metropolitan Australian hospital were analysed. Comparison was made with 8852 women without FGM who gave birth during the same time period. Data were extracted from a database specifically designed for women with FGM and managed by midwives specialised in care of these women, and a routine obstetric database, ObstetriX. The accuracy of data collection on FGM was determined by comparing these two databases. All women with FGM type 3 were deinfibulated antenatally or during labour. The outcome measures were (1) maternal: accuracy and grade of FGM classification, caesarean section, instrumental birth, episiotomy, genital tract trauma, postpartum blood loss of more than 500 ml; and (2) neonatal: low birth weight, admission to a special care nursery, stillbirth.
  
  
  
  The prevalence of FGM in women who gave birth at the metropolitan hospital was 2 to 3 %. Women with FGM had similar obstetric outcomes to women without FGM, except for statistically significant higher risk of first and second degree perineal tears, and caesarean section. However, none of the caesarean sections were performed for FGM indications. The ObstetriX database was only 35 % accurate in recording the correct FGM type.
  
  
  
  Women with FGM had similar obstetric outcomes to women without FGM in an Australian metropolitan hospital with expertise in FGM management. Specialised FGM services with clinical practice guideline and education of healthcare professionals may increase the detection rate of FGM and improve obstetric management of women with FGM.
authors: Discipline of Obstetrics and Gynaecology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia. nesrin.varol@sydney.edu.au.
authors: Nesrin
authors: N
authors: Varol
authors: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
authors: Angela
authors: A
authors: Dawson
authors: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
authors: Sabera
authors: S
authors: Turkmani
authors: Centre for Clinical Epidemiology & Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Sydney, NSW, Australia.
authors: John J
authors: JJ
authors: Hall
authors: Department of Obstetrics and Gynaecology, Auburn Hospital, Sydney, NSW, Australia.
authors: Susie
authors: S
authors: Nanayakkara
authors: Department of Obstetrics and Gynaecology, Auburn Hospital, Sydney, NSW, Australia.|Discipline of Obstetrics and Gynaecology, School of Medicine, Notre Dame University, Sydney, NSW, Australia.
authors: Greg
authors: G
authors: Jenkins
authors: Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
authors: Caroline S E
authors: CS
authors: Homer
authors: School of Public Health, University of Sydney, Sydney, NSW, Australia.
authors: Kevin
authors: K
authors: McGeechan
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D019093:Circumcision, Female / Q000009:adverse effects* / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology; D010502:Perineum / Q000293:injuries; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome; D055815:Young Adult
keywords: Australia; Data collection; Female genital mutilation; Obstetric complications