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Hindawi Publishing CorporationObstetrics and Gynecology InternationalVolume 2013, Article ID 240421, 2 pageshttp://dx.doi.org/10.1155/2013/240421

EditorialFemale Genital Mutilation, Cutting, or Circumcision

Johanne Sundby,1 Birgitta Essén,2 and R. Elise B. Johansen3

1 Institute of Health and Society, University of Oslo, Norway2Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, Sweden3Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Norway

Correspondence should be addressed to Johanne Sundby; [email protected]

Received 10 November 2013; Accepted 10 November 2013

Copyright © 2013 Johanne Sundby et al.This is an open access article distributed under theCreativeCommonsAttribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Female genital mutilation (FGM), female genital cutting, orfemale circumcision of women, the theme addressed in thisspecial issue has many terms. The short form acronym FGMis understood by most, and it does contain the notion thatwe are talking about a traditional practice that is harmful.The practice affects women in diaspora as well as Africancountries, and men are involved as decision makers andattitude changers. Cutting is a neutral term, and circumcisionis a more traditional terminology. Each term carries a certainvalue. But the practice is the same regardless of name.

In order to understand the tradition, assist womenwho have undergone it, and promote action against it, itis important to have solid knowledge. This knowledge ispartly medical and partly social. Thus, research based ona multitude of methods is warranted. This special issue isindeed a combination of social science and medical researchon different aspects of the practice, that is also a genital healthhazard for women.

The special issue addresses FGM from different anglesand geographical places. Somalis are heavily affected as wellwith the most extensive form of FGM, and several studiespresented are from Somalia or about Somalis elsewhere.There is a paper on health provider issues from Somalia thatreveals howhealthworkersmay view the practice in a countrywhere cutting is the norm (Lazar et al.). The other side of theissue in Somaliland, the care needed by clients, is described inanother paper (Fried et al.). But also in West Africans, wheremost practice less extensive forms of FGM, its gender aspectsis addressed, as the studies from the Gambia and SierraLeone demonstrate (Kaplan et al. and Bjalkander et al.). InSierra Leone, as in other countries, there are some difficulties

encountered in how to assess the types and magnitude ofFGM.

The phenomenon of FGM is important to gynaecologistsfor several reasons. Firstly, as it is a harmful practice thataffects women, OB/GYN professionals may want to partic-ipate in initiatives that lead to its abandonment. As this isa topic that many people feel strongly about, some work onbut fewer actually know how to handle, several articles in thisissue may assist those who want to do their share in definingappropriate community interventions that they may want toengage in. The review of strategies presented here and thepaper on attitude change are important contributions to theknow-how literature. Somemay think that harm reduction isa way forward, and others claim that full abandonment is theonly way (Gele et al.).

Secondly, as this harmful practice is associated withhealth risks that OB/GYN professionals have to manage,many OB/GYN face problems when delivering babies ofwomenwho have undergone FGM, yet others have to providedifferent types of care to alleviate the problem, especially theobstetric consequences and their management. This specialissue provides evidence for the harmful effects (Berg, Under-land). As there may be an increased attempt to medicalizethe cutting, and requests for doctors to involve themselvesin “harm reduction” strategies, it is important that OB/GYNand nursing professionals are also fully aware of the reasonsfor wanting to be cut, male and female resistance to change,and knowledge about how harmful this practice is (Isman etal.).

The issue of harm reduction is indeed controversial, asthe bottom line message is to end the practice altogether.

2 Obstetrics and Gynecology International

If one thinks that taking one step at a time and involvingprofessionals in the procedure will eventually eliminate thepractice, it may violate the very reason for medical peopleto practice “do no harm.” This is an issue that should betransparent and heavily debated everywhere. To performFGM for “harm reduction” may as well turn into yet anotherprofit operation for some health workers, because consumersask for it. To have solid evidence on the damage done towomen is therefore important. The systematic meta-analysispaper in this issue is the best of that knowledge (Johansen etal.).

This special issue tries to link some evidence and expe-rience from the social sciences into clinical obstetrics andgynaecology. We, as OB/GYN doctors, know that culture,social position, and gender also formourwork environments,cause disease and complications are determinants for choiceswe and our patients make. Therefore, we hope you will enjoythis issue and join the growing group of colleagues who takethis practice seriously as a step to a better health for girls andwomen everywhere.

Johanne SundbyR. Elise B. Johansen

Birgitta Essen

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