Doctors give policy on female genital cutting
TORONTO - The Society of Obstetricians and Gynaecologists of Canada says information about treating patients who have had female genital cutting or mutilation should be integrated into the curriculum of medical schools.
The recommendation is part of a policy statement on the subject published in the February edition of the Journal of Obstetrics and Gynaecology Canada.
"I think there's a greater understanding that we need to be culturally competent when we're offering treatment for women. We see a lot more immigrant women from Africa ... and many of them have had this cutting procedure done when they were children," said Dr. Margaret Burnett, chair of the social and sexual issues committee.
"So what that means for us as physicians in Canada is we're kind of confronted with this kind of anatomical difference, and we need to know how to treat them," she said Tuesday in an interview from Winnipeg.
Medical students, for the most part, don't know what to do when offering care for these women, Burnett indicated.
The policy statement said an estimated 100 million to 140 million girls and women worldwide live with female genital cutting/mutilation.
The society first issued an official policy document against the practice in 1992, and this statement is an update.
It reminds members that female genital cutting/mutilation, or FGC/M, is a criminal offence in Canada, and reporting it to child welfare protection services is mandatory when it's suspected it has been done to a child, or that a child is thought to be at risk.
Burnett said that she and her colleagues haven't had a lot of requests to perform such illegal surgeries, but there are times when it's an issue in treating a woman who had it done as a child.
"One of the biggest things that we see is that sometimes the labour is obstructed because the opening isn't big enough for the baby's head to come through," she explained.
"So we have to know what episiotomy to make, how to repair that, in order that these ladies can have normal deliveries.
"And one of the things that we want to emphasize to our members is, for example, that it's not necessary to do a caesarean section when someone has had a cutting procedure done."
Through it all, she said, obstetricians and gynecologists must be sensitive to cultural differences.
"We need to be aware that although this is very different from what we see — it's not our custom in Canada — that we need to still treat these women with respect and be very sensitive that they're self-conscious and may not actually seek health care in Canada because they're perhaps self-conscious about the way their genitals look."
The statement encourages physicians to counsel families against having genital cutting or mutilation performed on family members, and to advocate for culturally competent support and counselling.
"Education is very important. We need to emphasize that there's no medical reason for this to be done," Burnett said.