The Impact of Harmful Traditional Practices on Maternal and Child Health:

A Focus on Female Genital Mutilation (FGM)

Introduction

Harmful traditional practices (HTPs) refer to cultural, social, and religious rituals
that adversely affect the health and rights of individuals, particularly women and
children. These practices often persist despite their detrimental effects, due to
deeply ingrained societal norms and values.

Among these practices, female genital mutilation (FGM) stands out as one of the
most severe, posing significant risks to maternal and child health. FGM involves
the partial or total removal of external female genitalia for non-medical reasons,
and it is a practice deeply rooted in gender inequality and discrimination. This
discussion explores the various dimensions of FGM, highlighting its impacts on
health and the ongoing global efforts to combat it.
1. Definition and Types of FGM

Female genital mutilation is defined by the World Health Organization (WHO) as "all
procedures that involve partial or total removal of the external female genitalia, or other
injury to the female genital organs for non-medical reasons" (WHO, 2020).
The WHO classifies FGM into four main types:

Type I (Clitoridectomy): Partial or total removal of the clitoris and, in very rare cases, only
the prepuce (the fold of skin surrounding the clitoris).
Type II (Excision): Partial or total removal of the clitoris and the labia minora, with or
without excision of the labia majora.
Type III (Infibulation): Narrowing of the vaginal opening through the creation of a
covering seal, formed by cutting and repositioning the labia minora and/or the labia majora,
with or without removal of the clitoris.
Type IV: All other harmful procedures to the female genitalia for non-medical purposes,
such as pricking, piercing, incising, scraping, and cauterizing the genital area.

Prevalence and Geographic Distribution

FGM is practiced in at least 30 countries, predominantly in Africa, the Middle East, and
Asia. According to UNICEF, over 200 million girls and women alive today have undergone
FGM in these regions (UNICEF, 2020). The practice is most prevalent in countries such as
Somalia, Guinea, Djibouti, and Egypt, where the prevalence rates exceed 90% among women
aged 15 to 49.
FGM is also found in certain communities in India, Indonesia, Iraq, and Malaysia, as well as
among diaspora communities in Europe, North America, and Australia.

Cultural, Social, and Religious Justifications

The reasons behind FGM are complex and multifaceted, often intertwined with cultural,
social, and religious beliefs. Key justifications for FGM include:
Cultural Identity: FGM is seen as a rite of passage for girls, marking their transition to
womanhood and community acceptance.
Marriageability: In many communities, FGM is believed to enhance a girl's prospects for
marriage by ensuring her virginity and fidelity.
Religious Beliefs: Some practitioners mistakenly believe that FGM is a religious
requirement, although no major religious texts prescribe it.
Social Norms: The practice is maintained by social pressure, where families fear stigma and
ostracism if they do not conform to the norm.
Gender Roles: FGM is rooted in gender inequality, aiming to control women's sexuality and
reinforce patriarchal structures.

2. Health Impacts of FGM

Immediate Health Risks: FGM poses numerous immediate health risks, many of which can
be life-threatening. These include:
Severe Pain and Bleeding: The procedure, often performed without anesthesia, causes
extreme pain. Excessive bleeding can lead to hemorrhagic shock.
Infections: The use of unsterilized instruments increases the risk of infections, including
tetanus and septicemia.
Urinary Problems: Swelling, pain, and difficulty urinating are common post-procedure
complications.
Wound Healing Issues: Improper wound care can lead to delayed healing, infection, and
scarring.

Long-term Health Consequences

The long-term health consequences of FGM are extensive and can affect a woman's physical,
sexual, and reproductive health throughout her life. These include:

Chronic Pain: Persistent pain in the genital area, as well as pain during menstruation and
urination.
Cysts and Abscesses: The formation of cysts and abscesses can occur as a result of scar
tissue buildup and infections.
Recurrent Infections: Women who have undergone FGM are prone to recurrent urinary
tract infections (UTIs) and vaginal infections.
Childbirth Complications: FGM significantly increases the risk of complications during
childbirth, including obstructed labor, postpartum hemorrhage, and perineal tears.
Sexual Health Issues: Women may experience pain during intercourse, reduced sexual
pleasure, and difficulties with sexual function.
Infertility: Scarring and infections can lead to infertility and complications with reproductive
health.

Impact on Maternal Health

FGM has a profound impact on maternal health, contributing to higher maternal morbidity
and mortality rates. Pregnant women who have undergone FGM are more likely to
experience:
 Prolonged Labor: Scar tissue and narrowed vaginal openings can obstruct labor, leading to
prolonged and obstructed deliveries.
Increased Need for Cesarean Sections: Many women with FGM require cesarean sections
due to complications during labor.
Postpartum Hemorrhage: The risk of severe bleeding after childbirth is heightened in
women with FGM.
Fistula Formation: The risk of obstetric fistulas, which are abnormal connections between
the bladder, vagina, and rectum, is increased due to prolonged labor and obstructed
deliveries.
Perinatal Risks: The health risks extend to newborns, who are more likely to be stillborn,
suffer birth injuries, or die within the first week of life.

Impact on Child Health

The impact of FGM on child health is significant, affecting both the offspring of women who
have undergone the procedure and the children who undergo FGM themselves. Key impacts
include:
Neonatal Death: Newborns are at a higher risk of death due to complications during labor
and delivery.
Birth Injuries: Babies born to mothers with FGM may suffer from birth injuries such as
fractured bones, nerve damage, and cerebral palsy.
Low Birth Weight: The stress and complications associated with FGM can result in low
birth weight and poor health outcomes for infants.
Respiratory Distress: Babies may experience respiratory distress due to birth complications
related to FGM.

3. Psychological and Social Implications

1. Psychological Trauma and Mental Health Issues

The psychological impact of FGM is profound and long-lasting. Many women and girls who
undergo FGM suffer from severe psychological trauma, which can manifest in various ways,
including:
Depression: Chronic sadness, hopelessness, and loss of interest in life are common among FGM
survivors.
Anxiety: Fear, panic attacks, and excessive worry are prevalent due to the trauma of the
procedure and its long-term consequences.
Post-traumatic Stress Disorder (PTSD): Many women experience flashbacks, nightmares, and
severe emotional distress related to the experience of FGM.Low Self-esteem: The physical and
emotional scars of FGM can lead to feelings of shame, worthlessness, and low self-esteem.
Sexual Dysfunction: The trauma of FGM can result in a lifelong aversion to sexual activity and
difficulties in intimate relationships.
 2. Social Stigma and Discrimination
FGM also has significant social implications, affecting the way women and girls are perceived
and treated within their communities. These implications include:
Social Stigma: Women who do not undergo FGM may face social ostracism, ridicule, and
exclusion from community activities.
Discrimination: Women who have undergone FGM may experience discrimination in various
aspects of life, including education, employment, and healthcare.
Marital Challenges: FGM can affect marital relationships, leading to sexual dissatisfaction,
conflicts, and even divorce.
Gender Inequality: The practice perpetuates gender inequality by reinforcing the notion that
women's bodies need to be controlled and modified.

Impact on Sexual and Reproductive Health Right

FGM is a violation of women's sexual and reproductive health rights, infringing upon their
bodily autonomy and integrity. These practices:
 Violates Human Rights: FGM is recognized internationally as a violation of the rights
of women and girls, including their right to health, security, and physical integrity.
 Infringes on Sexual Rights: Women and girls are deprived of their right to a fulfilling
and safe sexual life, with FGM causing pain, discomfort, and a lack of sexual pleasure.
 Limits Reproductive Choices: The health complications associated with FGM can limit
women's reproductive choices, affecting their ability to have safe and healthy
pregnancies.

Preventive Measures and Education

1. Community Education and Awareness Programs
Preventing FGM requires comprehensive community education and awareness programs that
address the cultural and social roots of the practice. Key components of successful programs
include:
 Engaging Community Leaders: Involving religious and traditional leaders in anti-FGM
campaigns can help shift cultural norms and attitudes.
 Empowering Women and Girls: Education and empowerment programs for women and
girls can help them understand their rights and resist cultural pressures to undergo FGM.
 Public Health Campaigns: Using media, workshops, and community meetings to raise
awareness about the health risks and legal consequences of FGM.

2. Role of Healthcare Professionals

 Healthcare professionals play a crucial role in preventing FGM and supporting affected
individuals. Their responsibilities include:
 Providing Care: Offering medical care and psychological support to women and girls
who have undergone FGM.
  Advocacy: Educating patients and communities about the health risks associated with
FGM and advocating for its abandonment.
 Reporting and Referrals: Reporting cases of FGM to authorities and referring affected
individuals to appropriate support services.

3. Empowering Women and Girls

Empowering women and girls through education and advocacy is essential to foster change and
protect their rights. Key strategies include:
Education Programs: Providing formal and informal education to girls and women,
emphasizing their rights and the health risks of FGM.
Economic Empowerment: Supporting women’s economic independence through vocational
training and income-generating activities.
Legal Aid and Protection: Offering legal aid and protection services to women and girls at risk
of FGM, ensuring they have access to justice and support.

Recommendations
To effectively combat FGM and mitigate its impact on maternal and child health, a multifaceted
approach is needed. Key recommendations include:
1. Strengthening Legal Frameworks and Enforcement
Adopt Comprehensive Laws: Countries without specific FGM laws should adopt
comprehensive legislation that criminalizes all forms of FGM and provides for the protection of
victims.Enhance Enforcement: Strengthen the enforcement of existing laws through training
for law enforcement officers, judiciary, and healthcare professionals to ensure perpetrators are
held accountable.
Support Survivors: Establish support systems for survivors, including medical care,
psychological support, and legal aid.
2. Increasing Education and Awareness
Community Engagement: Implement community-based education programs that engage
religious and traditional leaders, parents, and youth in dialogues about the harms of FGM.
School Curricula: Integrate information about FGM and its health risks into school curricula to
educate young people from an early age.
Media Campaigns: Use media platforms to raise awareness about the dangers of FGM and
promote positive cultural practices.
Empowering Women and GirlsEducation Programs: Expand access to education for girls and
women, emphasizing the importance of their rights and bodily autonomy.
Economic Opportunities: Provide economic opportunities and vocational training to women,
enabling them to gain financial independence and reduce their vulnerability to harmful practices.
Support Networks: Establish support networks and safe spaces for women and girls at risk of
FGM, offering counseling, protection, and legal aid.
3. Enhancing Healthcare Services
Training Healthcare Providers: Train healthcare providers on the management of FGM
complications, respectful care for survivors, and advocacy against the practice.
Comprehensive Care: Develop integrated healthcare services that address the physical,
psychological, and reproductive health needs of FGM survivors.
Reporting Mechanisms: Establish reporting mechanisms within healthcare facilities to identify
and refer at-risk individuals and provide them with necessary support.
Promoting Research and Data Collection
Conduct Research: Encourage research on the prevalence, health impacts, and social dynamics
of FGM to inform policy and program development.
Data Collection: Improve data collection systems to accurately monitor FGM prevalence and
the effectiveness of intervention programs.
Share Best Practices: Facilitate the sharing of best practices and successful intervention models
across countries and regions.
4. International Collaboration and Support
Global Partnerships: Foster partnerships between international organizations, governments, and
civil society to coordinate efforts and share resources in the fight against FGM.
Funding and Resources: Secure funding and resources for anti-FGM programs, particularly in
high-prevalence countries and underserved communities.
Policy Advocacy: Advocate for the inclusion of FGM elimination in international development
agendas and human rights frameworks.
Conclusion
Female genital mutilation is a deeply harmful practice with profound health, psychological, and
social impacts on women and children. The practice violates human rights, perpetuates gender
inequality, and poses significant risks to maternal and child health.

While global efforts have made progress in reducing the prevalence of FGM, much work remains
to be done. A comprehensive approach that includes legal frameworks, community education,
empowerment of women and girls, improved healthcare services, research, and international
collaboration is essential to eradicate FGM.
Continued efforts are vital to ensure that future generations can enjoy their rights to health,
dignity, and autonomy. Collaborative actions from international organizations, governments,
communities, and individuals are necessary to achieve this goal and create a world free from the
harms of female genital mutilation.
References
United Nations. (2015). Sustainable Development Goals. Retrieved from UN.org

UNICEF. (2016). Female Genital Mutilation/Cutting: A Global Concern. Retrieved from

UNICEF.org
UNICEF. (2020). Female Genital Mutilation (FGM) Statistics. Retrieved from UNICEF.org

UNFPA. (2017). The State of World Population 2017. Retrieved from UNFPA.org
WHO. (2018). Care of women and girls living with female genital mutilation:
A clinical handbook. Retrieved from WHO.int
WHO. (2020). Female Genital Mutilation. Retrieved from WHO.int