Global Perspective on Deinfibulation
Kytöaho, Heidi; Rinne, Johanna (2018)
Kytöaho, Heidi
Rinne, Johanna
Laurea-ammattikorkeakoulu
2018
All rights reserved
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:amk-201804164776
https://urn.fi/URN:NBN:fi:amk-201804164776
Tiivistelmä
Female genital mutilation (FGM) causes many adverse physical, mental, sexual, and obstetric outcomes. Surgical deinfibulation is a procedure in which the sealed vagina opening is cut open, and thereby can ease the problems caused by FGM. One goal in National Institute for Health and Welfare’s Action Plan for Sexual and Reproductive Health 2014 - 2020 is to increase research related to FGM. Finland does not have national guidelines concerning deinfibulation currently. Surgical deinfibulation after FGM is available but it has been too rarely used in Finland although it could reduce the negative impact of FGM.
The objective of this study is to seek evidence on deinfibulation related practices facilitating the guideline creation process of National Institute of Health and Welfare professionals working with women living with FGM. The research questions of this study are: 1. What are the factors facilitating or barring the use of deinfibulation? 2. What are the advantages and disadvantages of deinfibulation? 3. When is the ideal timing to undergo deinfibulation?
Integrative literature review was used as a method for this study. Data search was conducted in December 2017 by using five databases. After the evaluation process, 22 qualitative and quantitative studies with varying designs were included. Quality of observational studies was assessed with the help of STROBE, qualitative studies were assessed with the help of CASP and systematic literature reviews were assessed with the help of PRISMA. Evidence from the primary studies were extracted, analysed and synthesized by themes.
Women seek deinfibulation for various reasons, pregnancy and health problems caused by FGM being most prevalent. From a health care point of view, themes such as knowledge, management, experience, communication, and clarity and continuity of care were identified as barriers and facilitators. From the viewpoint of women living with FGM, several cultural factors, such as fear of not getting married, value of women’s virginity and virtue, and the value of men’s virility and sexual pleasure emerged from the evidence.
Deinfibulation appears to be a simple procedure with minor complication. Deinfibulation can reverse some adverse health outcomes caused by FGM such as painful periods, urinary tract infections, sexual problems, and obstetric problems such as caesarean section and perineal tears. Overall satisfaction for the procedure was good but part of the women have difficulties accepting the new body image after deinfibulation.
Deinfibulation performed before or during labour is comparable in the terms of obstetric outcomes although the trend was favourable on deinfibulation performed before labour. Women’s preferences of the timing of deinfibulation differs, although most women seem to prefer to undergo deinfibulation during labour.
Identifying barriers and facilitators, information about the possible benefits and harms, and the best timing of the procedure guides professionals to design services that can respond the needs of women with FGM and supports the creation of practical guidelines. Evidence-based information is important when guiding the candidates for deinfibulation so that the woman can make informed choice of her care.
The objective of this study is to seek evidence on deinfibulation related practices facilitating the guideline creation process of National Institute of Health and Welfare professionals working with women living with FGM. The research questions of this study are: 1. What are the factors facilitating or barring the use of deinfibulation? 2. What are the advantages and disadvantages of deinfibulation? 3. When is the ideal timing to undergo deinfibulation?
Integrative literature review was used as a method for this study. Data search was conducted in December 2017 by using five databases. After the evaluation process, 22 qualitative and quantitative studies with varying designs were included. Quality of observational studies was assessed with the help of STROBE, qualitative studies were assessed with the help of CASP and systematic literature reviews were assessed with the help of PRISMA. Evidence from the primary studies were extracted, analysed and synthesized by themes.
Women seek deinfibulation for various reasons, pregnancy and health problems caused by FGM being most prevalent. From a health care point of view, themes such as knowledge, management, experience, communication, and clarity and continuity of care were identified as barriers and facilitators. From the viewpoint of women living with FGM, several cultural factors, such as fear of not getting married, value of women’s virginity and virtue, and the value of men’s virility and sexual pleasure emerged from the evidence.
Deinfibulation appears to be a simple procedure with minor complication. Deinfibulation can reverse some adverse health outcomes caused by FGM such as painful periods, urinary tract infections, sexual problems, and obstetric problems such as caesarean section and perineal tears. Overall satisfaction for the procedure was good but part of the women have difficulties accepting the new body image after deinfibulation.
Deinfibulation performed before or during labour is comparable in the terms of obstetric outcomes although the trend was favourable on deinfibulation performed before labour. Women’s preferences of the timing of deinfibulation differs, although most women seem to prefer to undergo deinfibulation during labour.
Identifying barriers and facilitators, information about the possible benefits and harms, and the best timing of the procedure guides professionals to design services that can respond the needs of women with FGM and supports the creation of practical guidelines. Evidence-based information is important when guiding the candidates for deinfibulation so that the woman can make informed choice of her care.