Skip to main content


Log in

Are obstetric outcomes affected by female genital mutilation?

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript


Introduction and hypothesis

Female genital mutilation (FGM) has been associated with adverse obstetric and neonatal outcomes, such as postpartum haemorrhage (PPH), perineal trauma, genital fistulae, obstructed labour and stillbirth. The prevalence of FGM has increased in the UK over the last decade. There are currently no studies available that have explored the obstetric impact of FGM in the UK. The aim of our study was to investigate the obstetric and neonatal outcomes of women with FGM when compared with the general population.


We conducted a retrospective case–control study of consecutive pregnant women with FGM over a 5-year period between 1 January 2009 and 31 December 2013. Each woman with FGM was matched for age, ethnicity, parity and gestation with subsequent patients without FGM (control cohort) over the same 5-year period. Outcomes assessed were mode of delivery, duration of labour, estimated blood loss, analgaesia, perineal trauma and foetal outcomes.


A total of 242 eligible women (121 FGM, 121 control) were identified for the study. There was a significant increase in the use of episiotomy in the FGM group (p = 0.009) and a significant increase in minor PPH in the control group during caesarean sections (p = 0.0001). There were no differences in all other obstetric and neonatal parameters.


In our unit, FGM was not associated with an increased incidence of adverse obstetric and foetal morbidity or mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. WHO. Female genital mutilation: an overview. Geneva: World Health Organisation; 1998.

    Google Scholar 

  2. United Nations Children’s Fund. Female mutilation/cutting: a statiscal overview and exploration of the dynamics of change. 2013.

  3. Macfarlane A, Dorkenoo E. Female genital mutilation in England & Wales. Updated statistical estimates of the numbers of affected women in living in England and Wales and girls at risk. London: Equality Now and City University London; 2014.

    Google Scholar 

  4. Amasanti M, Imcha M and Momoh C. (2016) Compassionate and proactive interventions by health Workers in the UK: a better approach to prevent and respond to female genital mutilation. PLoS Med. 13(3) e1001982 dio:

  5. Mathers N, Rymer J. Mandatory reporting of female genital mutilation by healthcare professionals. Br J Gen Pract Jun. 2015;65(635):282–3.

    Article  Google Scholar 

  6. Dorkenoo E, Morison L, Macfarlane A. A statistical study to estimate the prevalence of female gential mutilation in England and Wales. Summary report. UK: Foundation for Women’s Health, Research and Development (FORWARD); 2007.

    Google Scholar 

  7. Adelufosi A, Edet B, Arikpo D, Aquaisua E, Meremikwu MM. Cognitive behavioral therapy for post-traumatic stress disorder, depression or anxiety disorders in women and girls living with female geneital mutilation: a systematic review. Int J Gynaecol Obstet. 2017;136(Suppl 1):56–9.

    Article  PubMed  Google Scholar 

  8. Moxey J, Jones L. A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. BMJ Open. 2016;6:e009846.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rushwan H. Female genital mutilation (FGM) management during pregnancy, childbirth and the postpartum period. Int J Gynaecol Obstet. 2000;70:99–104.

    Article  CAS  PubMed  Google Scholar 

  10. Banks E, Meirik O, Faley T, et al. Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. Lancet. 2006;367:1835–41.

    Article  PubMed  Google Scholar 

  11. WHO. A systematic review of the health complications of female genital mutilation including sequelae in childbirth. Geneva, Switzerland: World Health Organization; 2000.

    Google Scholar 

  12. NICE Intrapartum care for healthy women and babies CG 190 December 2014.

  13. Royal College of Obstetricians and Gynaecologists. Female Genital Mutilation and its Management. 2015. Green-top Guideline No 53.

  14. Berg RC, Underland V. The obstetric consequences of female genital mutilation/cutting: a systematic review and meta-analysis. Obstet Gynaecol Int. 2013;

  15. Wuest S, Raio L, Wyssmueller D, Mueller MD, Stadlmayr W, Surbek DV, et al. Effects of female gential mutilation on birth outcomes in Switzerland. BJOG. 2009;116(9):1204–9.

    Article  CAS  PubMed  Google Scholar 

  16. Naidu M, Sutltan AH, Thakar R. Reducing obstetric anal sphincter injuries using perineal support: our preliminary experience. Inj Urogynecol J. 2016;

  17. Sheldon WR, Blum J, Vogel JP, Souza JP, Gülmezgolu AM, WHO Multicountry Survey on Maternal and Newborn Health Research Network. Postpartum haemorrhage management, risks and maternal outcomes: findings from the World Health Organization multicountry survey on maternal and newborn health. BJOG. 2014;121(Suppl 1):5–13.

    Article  PubMed  Google Scholar 

  18. Gilber L, Porter W, Brown VA. Postpartum haemorrhage – continuing problem. BJOG. 1987;94:67–71.

    Article  Google Scholar 

  19. Ndlaye P, Diongue M, Gaye A, Ouedraogo D, Dia AT. Female genital mutilation and complications in childbirth in the province of Gourma (Burkina Faso). Sante Publique. 2010;22(5):563–700.

    Article  Google Scholar 

  20. Elnashar A, Abdelhady R. The impact of female genital cutting on health of newly married women. Int J Gynecol Obstet. 2007;97(3):238–44.

    Article  CAS  Google Scholar 

  21. Prual A, Bouvier-Colle MH, de Bernis L, Bréart G. Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Bull World Health Organ. 2000;78(5):593–602.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Jager F, Schulze S, Hohlfeld P. Female genital mutilation in Switzerland: a survey among gynaecologists. Swiss Med Wkly. 2002;132(19–20):259–64.

    PubMed  Google Scholar 

  23. Leye E, Ysebaert I, Deblonde J, Claeys P, Vermeulen G, Jacquemyn Y, et al. Female genital mutilation: knowledge, attitudes and practices of Flemish gynaecologist. Eur J Contracept Reprod Health Care. 2008;13(2):1820190.

    Article  Google Scholar 

  24. Tamaddon L, Johnsdotter S, Liljestrand J, Essen B. Swedish health care providers’ experience and knowledge of female genital cutting. Health Care Women Int. 2006;27(8):709–22.

    Article  PubMed  Google Scholar 

  25. Purchase TC, Lamoudi M, Colman S, Allen S, Latthe P, Jolly K. A survey on knowledge of female genital mutilation guidelines. Acta Obstet Gynaecol Scand. 2013;92(7):858–61.

    Article  Google Scholar 

  26. Zaidi N, Khalil A, Roberts C, Browne M. Knowledge of female genital mutilation among healthcare professionals. J Obstet Gynaecol. 2008;27:161–4.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ranee Thakar.

Ethics declarations

Conflicts of interests


Financial disclaimer


Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balachandran, A.A., Duvalla, S., Sultan, A.H. et al. Are obstetric outcomes affected by female genital mutilation?. Int Urogynecol J 29, 339–344 (2018).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: