Intrapartum Care

Careful management during the intrapartum period is necessary as FGM has been associated with negative obstetric outcomes. 40 The cause of this is unknown, but thought to be due to the presence of inelastic scar tissue which could cause increased risk of obstruction, caesarean section and a prolonged second stage. This in turn can lead to postpartum haemorrhage, perineal trauma and increased need to resuscitate the neonate. Vaginal assessment can be very difficult to perform on women with type III FGM in particular and may not be possible at all without deinfibulation. 49

The Royal College of Obstetricians and Gynaecologists 2009 recommend:

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“Any repair carried out after birth, whether following spontaneous laceration or deliberate defibulation, should be sufficient to appose raw edges and control bleeding, but must not result in a vaginal opening that makes intercourse difficult or impossible” 15a

Next Topic: Postnatal Care