'Birds of the same feathers fly together': midwives' experiences with pregnant women and FGM/C complications - a grounded theory study in Liberia

Tarr-Attia, C.K. ; Boiwu, G.H. ; Martinez-Perez, G. (Universidad de Zaragoza)

Resumen: Background: In Liberia, approximately 70% of the women of the North-Central and North-Western regions could have undergone female genital mutilation/cutting (FGM/C) in their childhood during a traditional ceremony marking their entrance into Sande, a secret female society. Little is known about FGM/C from Liberian women's perspective. This study aimed to understand the health implications of FGM/C as perceived by qualified female midwives.
Methods: This qualitative study was conducted in 2017 in Monrovia, Liberia's capital. Twenty midwives were approached. Of these, seventeen consented to participate in in-depth interviews. A thematic guide was used to gain insights about their knowledge on FGM/C and their experiences attending women victims of FGM/C. A feminist interpretation of constructivist grounded theory guided data generation and analysis.
Results: The midwives participants described how clitoridectomy was the most common FGM/C type done to the girls during the Sande initiation ceremonies. Sexual impairment and intrapartum vulvo-perineal laceration with subsequent hemorrhage were described as frequent FGM/C-attributable complications that some midwives could be unable to address due to lack of knowledge and skills. The majority of midwives would advocate for the abandonment of FGM/C, and for the preservation of the traditional instructions that the girls in FGM/C-practicing regions receive when joining Sande. The midwives described how migration to urban areas, and improved access to information and communication technologies might be fuelling abandonment of FGM/C.
Conclusion: Liberian midwives need tailored training to provide psychosexual counseling, and to attend the obstetric needs of pregnant women that have undergone FGM/C. In spite of FGM/C being seemingly in the decline, surveillance at clinic-level is warranted to prevent its medicalization. Any clinic- or community-based training, research, prevention and awareness intervention targeting FGM/C-practicing populations should be designed in collaboration with Sande members, and acknowledging that the Liberian population may place a high value in Sande's traditional values.

Idioma: Inglés

DOI: 10.1186/s12978-019-0681-1

Año: 2019

Publicado en: Reproductive Health 16 (2019), 18 [12 pp]
ISSN: 1742-4755

Factor impacto JCR: 2.177 (2019)

Categ. JCR: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH rank: 56 / 170 = 0.329 (2019) - Q2 - T1
Categ. JCR: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH rank: 90 / 193 = 0.466 (2019) - Q2 - T2

Factor impacto SCIMAGO: 1.223 - Reproductive Medicine (Q1) - Obstetrics and Gynecology (Q1)

Tipo y forma: Article (Published version)

Área (Departamento): Área Enfermería (Dpto. Fisiatría y Enfermería)