FEMALE GENITAL MUTILATION Amber Blumling BSN RN CEN

FEMALE GENITAL MUTILATION Amber Blumling BSN, RN, CEN PA ENA Horizon’s Conference 2016

LEARNING OBJECTIVES What is Female Genital Mutilation (FGM) Different types of FGM Health consequences of FGM Identify at risk populations Global initiatives to end FGM Resources in the U. S. for victims of FGM http: //godandwheatgrass. com/2015/02/no-tolerance-female-genital-mutilation-story/

WHAT IS FGM?

WHAT IS FGM All procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons (WHO, UNICEF, UNFPA, 1997) Classified into Type I-III based on anatomical extent of the cutting Type IV - All other harmful procedures to the female genitalia for non-medical purposes

TYPES OF FGM Normal Type III All Images from: http: //pediatrics. aappublications. org/content/102/1/153

PREVALENCE OF FGM

Percentage of girls and women aged 15 to 49 years who have undergone FGM/C Unicef, 2013

TOP 10 AT RISK IMMIGRANT GROUP IN THE U. S. ACCORDING TO U. S. CITIZENSHIP AND IMMIGRATION SERVICES 1. Egypt 6. Sierra Leone 2. Ethiopia 7. Sudan 3. Somalia 8. Kenya 4. Nigeria 9. Eritrea 5. Liberia 10. Guinea

STATISTICS ON FGM IN THE U. S. 507, 000 U. S. women and girls who had undergone FGM/C or were at risk of the procedure (PRB’s data analysis U. S. Department of Citizenship &Immigration Services) Egypt, Ethiopia, and Somalia accounted for 55 percent of all U. S. women and girls at risk in 2013 Combination of high FGM/C prevalence rates and a relatively large number of immigrants Girl with immigrant parents from high risk areas are at high risk and often cut while on vacation to family country of origin

WHY FGM CONTINUES

CULTURAL BELIEFS BEHIND FGM Rite of passage Preserving chastity Ensuring marriageability Religion Hygiene Improving fertility Enhancing sexual pleasure for men Tradition http: //28 toomany. org/about-28 toomany/what-we-do/

HEALTH CONSEQUENCES OF FGM

SHORT-TERM HEALTH CONSEQUENCES Severe pain Hemorrhage Shock Genital tissue swelling Infections HIV Urinary problems Psychological consequences Death http: //period 4 isujackb. weebly. com/victims. html

LONG-TERM HEALTH CONSEQUENCES Pain from tissue damage and scarring Infections Chronic Genital Infections Chronic Reproductive Tract Infections UTI HIV Dysuria Menstrual Problems Keloids Sexual Health, Obstetric, & Perinatal Complications Psychological Consequences https: //blacknotwhitedippedinchocolate. wordpress. com/2013/08/

GLOBAL INITIATIVES TO END FGM

UNITED NATIONS INTERNATIONAL HUMAN RIGHTS LAW Human Rights Instruments Universal Declaration of Human Rights Civil and Political Rights Covenant Economic, Social and Cultural Right Covenant Treaties Children’s Rights Convention on the Elimination of all Forms of Discrimination against Women Banjul Charter European Convention Declarations Declaration on the Elimination of Violence Against Women Programme of Action of the ICPD Beijing Declaration and Platform for Action Note: Under international human rights law, governments are bound to refrain from violating people’s rights and ensuring that rights are universally enjoyed in their jurisdictions. Governments are held responsible for failing to take steps to prevent the practice of FGM

CHANGING CULTURAL NORMS Local Campaigns Advocacy National Laws against FGM Enforcement of punishment for parents and practitioners Campaigns International World Health Organization United Nations Children’s Fund (UNICEF) United Nations Population Fund (UNFPA)

U. S. INITIATIVES TO END FGM

U. S. LAW ON FGM Congress passed in 1996 making it illegal to perform FGM/C 23 states have laws against the practice Against the law to perform FGM/C in the United States on a girl under the age of 18 or to send or attempt to send her outside the United States so FGM/C can be performed.

RESOURCES IN THE U. S. Citizenship & Immigration Services www. uscis. gov 1 -800 -994 -9662 Equality Now Americas Office www. equalitynow. org U. S. Administration for Children and Families - Office of Refugee Resettlement www. acf. hhs. gov 202 -401 -9246 U. S. Department of Health and Human Services - Office on Women’s Health 212 -586 -0906 www. womenshealth. gov info@equalitynow. org 800 -994 -9662 U. S. Aid Federal Bureau of Investigation www. usaid. gov www. fbi. gov compliance@usaid. gov 202 -324 -3000

LIFE AFTER FGM

UNICEF SPEAKING OUT AGAINST FGM https: //youtu. be/Pjy 8 j. RRGHc. U

Questions?

REFERENCES Center for Reproductive Rights. (2006). Female genital mutilation: A matter of human rights. Retrieved from http: //www. reproductiverights. org. Council on Child and Adolescent Health. (1998). Female genital mutilation. Pediatrics, 102 (1). Retrieved from http: //pediatrics. aappublications. org/content/102/1/153 Daughters of Eve. (2015). About FGM. Retrieved from http: //www. dofeve. org/about-fgm. html. Equality Now. (2015). Female genital mutilation (FGM). Retrieved from http: //www. equalitynow. org. Nuor, N. (2008). Female genital cutting: A persisting practice. Reviews of Obstetrics & Gynecology, 1(3), 135 -139. NHS Choices. (2015). Female genital mutilation. Retrieved from http: www. nhs. uk. Orchid Project. (2016). Orchid project. Retrieved from http: //orchidproject. org. U. S. Citizenship & Immigration Services. (2016). Female genital mutilation or cutting (FGM/C). Retrieved from https: //www. uscis. gov/humanitarian/female-genital-mutilation-or-cutting-fgmc World Health Organization. (2014). Female genital mutilation. Retrieved from http: www. who. int/mediacentre/factsheets/fs 241/en/. World Health Organization. (2016). Classification of female genital mutilation. Retrieved from http: //www. who. int/reproductivehealth/topics/fgm/overview/en/ World Health Organization. (2016). Female genital mutilation. Retrieved from http: //www. who. int/mediacentre/factsheets/fs 241/en/