FGM – Recognise, Respond, Refer and Report

Nurses now have a duty to report cases of FGM. By building rapport with women affected they can make a big difference to damaged lives

Female genital mutilation (FGM) has been in the news lately following the introduction of mandatory reporting by all regulated professionals, including nurses, doctors and teachers, of cases of FGM.

As registered health care professionals we have a duty and a legal responsibility to report cases of FGM following the amendment to section 74 of the Serious Crime Act.

FGM is a complete violation of human rights, and constitutes severe bodily harm. If you receive disclosure or suspect FGM, stay open minded, be professional, engage and communicate, remain non-judgemental, build trust and rapport. Allow the patient time, dignity, and privacy, this will extremely difficult for them to discuss with you.

This will take time out of your busy shift, it will be challenging and a difficult journey, but will make an unbelievable difference to a victim’s life.

FGM is classified in four categories, each one illegal, painful, and with a high risk to the individual of bleeding, infection, pain, shock and potential organ damage. The practice is carried out as part of religious or cultural practice, with mutilation/cutting involving the removal of the external genitalia for non-medical reasons. In the UK, this has been recognised as a criminal offence since 1985.

FGM is a hidden form of abuse, associated with shame, guilt, lack of understanding with immediate and lifelong risks. Due to the secrecy of FGM the data and statistics are at best estimated, and probably underestimated.

Currently it is believed around 75,000 women in the UK are living with the effects of FGM.

It is estimated 23,000 girls under the age of 15 could be at imminent risk. Although it can be practised at any age, girls aged 4-8 years are particularly at risk. They can be taken back to family homes abroad for the ritual, without knowledge of the purpose, although it is also illegally practised in UK.

  • Physical signs include difficulty walking, sitting and standing, unexplained blood loss, reoccurring urinary infections, pelvic pain and difficulty with micturition.
  • Emotional signs include fear, anxiety, refusal of health examinations, suicidal tendencies, depression, isolation and embarrassment.
  • The long term effects include depression, infertility, birthing difficulties, bleeding, infections (including HIV), cysts, abscesses, emotional plus mental health problems which may be associated with drug and alcohol abuse.

There are no medical reasons for carrying out FGM. It is abuse, pure and simple.

There are various sources of support – a good starting point is the NSPCC FGM helpline on 0800 028 2550.

About the author

Amanda BurstonAmanda Burston is the RCN Nurse of the Year 2015 and major trauma co-ordinator at Royal Stoke University Hospital

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