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Female genital mutilation/cutting, timing of deinfibulation, and risk of cesarean section

Acta obstetricia et gynecologica Scandinavica, 2021-04, Vol.100 (4), p.587-595 [Peer Reviewed Journal]

2021 The Authors. published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG) ;2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). ;COPYRIGHT 2021 Wiley Subscription Services, Inc. ;2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;info:eu-repo/semantics/openAccess ;ISSN: 0001-6349 ;EISSN: 1600-0412 ;DOI: 10.1111/aogs.14111 ;PMID: 33719034

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  • Title:
    Female genital mutilation/cutting, timing of deinfibulation, and risk of cesarean section
  • Author: Taraldsen, Sølvi ; Vangen, Siri ; Øian, Pål ; Sørbye, Ingvil K.
  • Subjects: Adult ; Cesarean Section ; Circumcision, Female - adverse effects ; country of birth ; deinfibulation ; Female ; Female circumcision ; female genital mutilation/cutting ; Genital mutilation ; Health aspects ; Humans ; Medical records ; Norway ; nulliparity ; Obstetrics ; Pregnancy ; Risk ; Somalia ; Somalia - ethnology ; timing of deinfibulation ; Women
  • Is Part Of: Acta obstetricia et gynecologica Scandinavica, 2021-04, Vol.100 (4), p.587-595
  • Description: Introduction The impact of female genital mutilation/cutting on obstetric outcomes in high‐income countries is not clear. In general, women with female genital mutilation/cutting type 3 (infibulation) seem to be most at risk of adverse outcomes such as cesarean section. Deinfibulation is recommended to prevent obstetric complications. Whether the timing of this procedure affects the complication risk is not known. The aims of this study were, first, to examine the association between female genital mutilation/cutting and the risk of cesarean section in Norway, and, second, whether the timing of deinfibulation affected the cesarean section risk. Material and methods This was a historical cohort study of nulliparous Somali‐born women who gave birth in Norway between 1990 and 2014. The Medical Birth Registry of Norway identified the women. Data were collected from medical records at 11 participating birth units. The exposures were female genital mutilation/cutting status and deinfibulation before pregnancy, during pregnancy, or no deinfibulation before labor onset. The main outcome was odds ratio (OR) of cesarean section. Type of cesarean section, primary indications, and neonatal outcomes were secondary outcomes. Results Women with female genital mutilation/cutting type 3 had lower risk of cesarean section compared with women with no female genital mutilation/cutting (OR 0.54, 95% CI 0.33‐0.89 P = .02). Among the 1504 included women, the cesarean section rate was 28.0% and the proportion of emergency operations was 92.9%. Fetal distress was the primary indication in approximately 50% of cases, across the groups with different female genital mutilation/cutting status. Women who had no deinfibulation before labor onset had lower risk of cesarean section compared with those who underwent deinfibulation before or during pregnancy (OR 0.64, 95% CI 0.46‐0.88 P = .01). Conclusions High risk of cesarean section in Somali nulliparous women was not related to the type of female genital mutilation/cutting in the present study. Deinfibulation before labor did not protect against cesarean section. Our findings indicate that nulliparous Somali women are at high risk of intrapartum complications. Future research should focus on measures to reduce maternal morbidity and on how timing of deinfibulation affects the outcomes of vaginal births.
  • Publisher: United States: Wiley Subscription Services, Inc
  • Language: English;Norwegian
  • Identifier: ISSN: 0001-6349
    EISSN: 1600-0412
    DOI: 10.1111/aogs.14111
    PMID: 33719034
  • Source: OVID SP
    MEDLINE
    NORA Norwegian Open Research Archives
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