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Female Genital Mutilation, Cutting, Or Circumcision Obstetrics and Gynecology International Female Genital Mutilation, Cutting, or Circumcision Guest Editors: Johanne Sundby, Birgitta Essén, and R. Elise B. Johansen Female Genital Mutilation, Cutting, or Circumcision Obstetrics and Gynecology International Female Genital Mutilation, Cutting, or Circumcision Guest Editors: Johanne Sundby, Birgitta Essen,´ and R. Elise B. Johansen Copyright © 2013 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “Obstetrics and Gynecology International.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Diane C. Bodurka, USA Howard D. Homesley, USA Julian T. Parer, USA C. W. Burger, The Netherlands Shi-Wen Jiang, USA Faustino R. Perez-L´ opez,´ Spain Linda D. Cardozo, UK Marc J. N. C. Keirse, Australia Neal S. Rote, USA Nancy Chescheir, USA Jonathan Ledermann, UK Giovanni Scambia, Italy Robert Coleman, USA Kimberly K. Leslie, USA Peter E. Schwartz, USA W. T. C r e a s m an , U S A Lawrence D. Longo, USA Anil Sood, USA Gian Carlo Di Renzo, Italy Everett Magann, USA Seang Lin Tan, Canada Keith A. Eddleman, USA James A. McGregor, USA WiebrenA.A.Tjalma,Belgium Edmund F. Funai, USA Liselotte Mettler, Germany J. R. Van Nagell, USA Thomas Murphy Goodwin, USA Daniel R. Mishell, USA J. M. G. van Vugt, The Netherlands William A. Grobman, USA Bradley J. Monk, USA Deborah A. Wing, USA Enrique Hernandez, USA John J. Moore, USA Judith K. Wolf, USA Thomas Herzog, USA J. C. Morrison, USA Edward V. Younglai, Canada W. Holzgreve, Switzerland Errol R. Norwitz, USA Contents Female Genital Mutilation, Cutting, or Circumcision, Johanne Sundby, Birgitta Essen,´ and R. Elise B. Johansen Volume 2013, Article ID 240421, 2 pages Providers’ Perceptions of Challenges in Obstetrical Care for Somali Women,JalanaN.Lazar, Crista E. Johnson-Agbakwu, Olga I. Davis, and Michele P.-L. Shipp Volume 2013, Article ID 149640, 12 pages Female Genital Mutilation in Sierra Leone: Forms, Reliability of Reported Status, and Accuracy of RelatedDemographicandHealthSurveyQuestions,OwolabiBjalkander,¨ Donald S. Grant, Vanja Berggren, Heli Bathija, and Lars Almroth Volume 2013, Article ID 680926, 14 pages Midwives’ Experiences in Providing Care and Counselling to Women with Female Genital Mutilation (FGM) Related Problems, Elisabeth Isman, Amina Mahmoud Warsame, Annika Johansson, Sarah Fried, and Vanja Berggren Volume2013,ArticleID785148,9pages Outpatients’ Perspectives on Problems and Needs Related to Female Genital Mutilation/Cutting: A Qualitative Study from Somaliland, Sarah Fried, Amina Mahmoud Warsame, Vanja Berggren, Elisabeth Isman, and Annika Johansson Volume 2013, Article ID 165893, 11 pages The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches, Katherine Brown, David Beecham, and Hazel Barrett Volume 2013, Article ID 324362, 12 pages Female Genital Mutilation/Cutting: The Secret World of Women as Seen by Men,AdrianaKaplan, Babucarr Cham, Lamin A. Njie, Ana Seixas, Sandra Blanco, and Mireia Utzet Volume 2013, Article ID 643780, 11 pages The Obstetric Consequences of Female Genital Mutilation/Cutting: A Systematic Review and Meta-Analysis, Rigmor C. Berg and Vigdis Underland Volume 2013, Article ID 496564, 15 pages Internalizing Knowledge and Changing Attitudes to Female Genital Cutting/Mutilation, Inger-Lise Lien and Jon-Hakon˚ Schultz Volume 2013, Article ID 467028, 10 pages What Works and What Does Not: A Discussion of Popular Approaches for the Abandonment of Female Genital Mutilation, R. Elise B. Johansen, Nafissatou J. Diop, Glenn Laverack, and Els Leye Volume2013,ArticleID348248,10pages Attitudes toward Female Circumcision among Men and Women in Two Districts in Somalia: Is It Time to Rethink Our Eradication Strategy in Somalia?,AbdiA.Gele,BenteP.Bø,andJohanneSundby Volume 2013, Article ID 312734, 12 pages Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2013, Article ID 240421, 2 pages http://dx.doi.org/10.1155/2013/240421 Editorial Female 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, Norway 2 Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, Sweden 3 Norwegian 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 the Creative Commons Attribution 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, or encounteredinhowtoassessthetypesandmagnitudeof female circumcision of women, the theme addressed in this FGM. special issue has many terms. The short form acronym FGM The phenomenon of FGM is important to gynaecologists is understood by most, and it does contain the notion that for several reasons. Firstly, as it is a harmful practice that we are talking about a traditional practice that is harmful. affects women, OB/GYN professionals may want to partic- The practice affects women in diaspora as well as African ipate in initiatives that lead to its abandonment. As this is countries,andmenareinvolvedasdecisionmakersand a topic that many people feel strongly about, some work on attitude changers. Cutting is a neutral term, and circumcision butfeweractuallyknowhowtohandle,severalarticlesinthis is a more traditional terminology. Each term carries a certain issue may assist those who want to do their share in defining value. But the practice is the same regardless of name. appropriate community interventions that they may want to In order to understand the tradition, assist women engage in. The review of strategies presented here and the who have undergone it, and promote action against it, it paper on attitude change are important contributions to the is important to have solid knowledge. This knowledge is know-how literature. Some may think that harm reduction is partly medical and partly social. Thus, research based on a way forward, and others claim that full abandonment is the a multitude of methods is warranted. This special issue is only way (Gele et al.). indeed a combination of social science and medical research Secondly, as this harmful practice is associated with ondifferentaspectsofthepractice,thatisalsoagenitalhealth health risks that OB/GYN professionals have to manage, hazard for women. many OB/GYN face problems when delivering babies of The special issue addresses FGM from different angles women who have undergone FGM, yet others have to provide and geographical places. Somalis are heavily affected as well different types of care to alleviate the problem, especially the with the most extensive form of FGM, and several studies obstetric consequences and their management. This special presented are from Somalia or about Somalis elsewhere. issue provides evidence for the harmful effects (Berg, Under- There is a paper on health provider issues from Somalia that land). As there may be an increased attempt to medicalize reveals how health workers may view the practice in a country the cutting, and requests for doctors to involve themselves wherecuttingisthenorm(Lazaretal.).Theothersideofthe in “harm reduction” strategies, it is important that OB/GYN issue in Somaliland, the care needed by clients, is described in and nursing professionals are also fully aware of the reasons another paper (Fried et al.). But also in West Africans, where forwantingtobecut,maleandfemaleresistancetochange, most practice less extensive forms of FGM, its gender aspects and knowledge about how harmful this practice is (Isman et is addressed, as the studies from the Gambia and Sierra al.). Leone demonstrate (Kaplan et al. and Bjalkander¨ et al.). In The issue of harm reduction is indeed controversial, as Sierra Leone, as in other countries, there are some difficulties the 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 involving professionals in the procedure will eventually eliminate the practice, it may violate the very reason for medical people to practice “do no harm.” This is an issue that should be transparent and heavily debated everywhere. To perform FGM for “harm reduction” may as well turn into yet another profit operation for some health workers, because consumers ask for it. To have solid evidence on the damage done to women is therefore important. The systematic meta-analysis paper in this issue is the best of that knowledge (Johansen et al.). This special issue tries to link some evidence and expe- rience from the social sciences into clinical obstetrics and gynaecology. We, as OB/GYN doctors, know that culture, social position, and gender also form our work environments, cause disease and complications are determinants for choices we and our patients make. Therefore, we hope you will enjoy this issue and join the growing group of colleagues who take this practice seriously as a step to a better health for girls and
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