Abstract
Summary: The last decades have witnessed a tremendous movement of people from non-western countries to the West, due to wars, conflicts and spreading poverty. In several of these countries, Female Genital Mutilation (FGM) is a highly valued norm forced on all girls without their consent. The result is that the host countries have been faced with responsibilities to provide care to the infibulated girls and women. Norway and the United Kingdom (UK) are among the countries where a significant number of females with FGM reside. There are many complications and risks related to FGM, some of which are likely to appear when these women get pregnant. Therefore maternal health providers have to be able to adequately manage these infibulated women during their pregnancy and childbirth. The aim of this study is to present and discuss existing guidelines for the management of infibulated women giving birth in Norway and the UK, to assess empirical evidence on care provided to the infibulated women giving birth in these countries, and to assess how these services are responsive to the needs of these women. The methodology adopted to address these objectives has been a review of literature. The main findings of the study are discussed in light of the Patient-centered care (PCC) theory. We found that both Norway and the UK have extensive guidelines for the management of infibulated women giving birth. The guidelines in both countries incorporate and contain the procedures for managing infibulated women during prenatal, delivery, postnatal and postpartum periods. The guidelines are found in different levels in the UK as several professional organizations and hospitals. To some extent this is different in Norway, as the guidelines seem to only be available only at a national level with no further adaptation at regional or local levels. Most of the reviewed studies show that UK seems to be actively engaged in building the professional competences of midwives, GPs and gynecologists who deals directly with the infibulated women. In Norway studies conducted prior to 2006 showed that care for women with FGM was still a healthcare problem and a challenge for most of the healthcare workers. In both Norway and the UK, infibulated women still find the encounters to be challenging in terms of communication and stigma. 5 We believe the study will contribute knowledge which can inform policy makers, healthcare professionals and all different organizations dealing with infibulated women who work to achieve the desired solutions for the infibulated women as well as for health workers.
Summary: The last decades have witnessed a tremendous movement of people from non-western countries to the West, due to wars, conflicts and spreading poverty. In several of these countries, Female Genital Mutilation (FGM) is a highly valued norm forced on all girls without their consent. The result is that the host countries have been faced with responsibilities to provide care to the infibulated girls and women. Norway and the United Kingdom (UK) are among the countries where a significant number of females with FGM reside. There are many complications and risks related to FGM, some of which are likely to appear when these women get pregnant. Therefore maternal health providers have to be able to adequately manage these infibulated women during their pregnancy and childbirth. The aim of this study is to present and discuss existing guidelines for the management of infibulated women giving birth in Norway and the UK, to assess empirical evidence on care provided to the infibulated women giving birth in these countries, and to assess how these services are responsive to the needs of these women. The methodology adopted to address these objectives has been a review of literature. The main findings of the study are discussed in light of the Patient-centered care (PCC) theory. We found that both Norway and the UK have extensive guidelines for the management of infibulated women giving birth. The guidelines in both countries incorporate and contain the procedures for managing infibulated women during prenatal, delivery, postnatal and postpartum periods. The guidelines are found in different levels in the UK as several professional organizations and hospitals. To some extent this is different in Norway, as the guidelines seem to only be available only at a national level with no further adaptation at regional or local levels. Most of the reviewed studies show that UK seems to be actively engaged in building the professional competences of midwives, GPs and gynecologists who deals directly with the infibulated women. In Norway studies conducted prior to 2006 showed that care for women with FGM was still a healthcare problem and a challenge for most of the healthcare workers. In both Norway and the UK, infibulated women still find the encounters to be challenging in terms of communication and stigma. 5 We believe the study will contribute knowledge which can inform policy makers, healthcare professionals and all different organizations dealing with infibulated women who work to achieve the desired solutions for the infibulated women as well as for health workers.