Objective: To evaluate the impact of female genital mutilation on parturition and to create awareness of its implication on women and neonatal health.
Design: A cross-sectional study.
Setting: Tikur Anbessa, St. Paul's and Ghandhi Memorial hospitals between January and December 1997.
Subjects: One thousand two hundred and twenty five mothers with and 256 without FGM who have had spontaneous, term, singleton and vertex vaginal delivery. Of these, 762 (51.5%) were primipara and 719 (48.5%) of them multipara. The parameters focussed upon included age, ethnicity, parity, type of circumcision, episiotomy, stages of labour, Apgar scores and related complications.
Results: The study revealed that 82.7% of the subjects had one form of FGM. The mean ages for the circumcised and non-circumcised were 25.9 +/- 5.9 and 21.8 +/- 4.5 years, respectively. The frequently performed genital mutilation was type II (85.5%). The mothers who required an episiotomy incision for foetal and maternal indications among the circumcised accounted for 43.0% whereas it was only 24.6% for the referent group. The mean duration of labour by conventional standards is prolonged in primiparae and multiparae both in the circumcised and non-circumcised groups, though the second stage is delayed more so for the circumcised category (p<0.05). The first and tenth minute mean Apgar scores seem to be more favourable for the non-circumcised (p<0.05) but the perinatal mortality rates are quite similar. More complications in terms of perineal tears, bleeding, incontinence and febrile illnesses are registered for the FGM.
Conclusion: The study demonstrates the negative impact of FGM more on maternal than neonatal outcomes during parturition.