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'FGM must now be reported but reinfibulation guidance is needed'

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In an effort to fight against female genital mutilation (FGM), the FGM National Clinical Group was founded just over a decade ago.

Since its inception, it has lobbied for a confidential national reporting system.

There were two reasons for this: the first is that as a group of clinicians, we could not provide effective evidence-based care for women if we did not know how many women had been subject to this abhorrent procedure; the second is that we wanted to provide clinical education for midwives, nurses, health visitors and doctors so that the best care can be provided to women.

With the support of Baroness Rendell, who has been raising questions in the House of Lords for nearly two decades, we met with Jane Ellison MP. It was a real meeting of minds and it was clear that, from this meeting, we would finally make progress when she agreed that it was nigh on impossible for us to address a problem in the UK without knowing the true extent of it.

As such, the FGM National Clinical Group welcomes the moves to make reporting mandatory. As health professionals, it is our responsibility to care for those in society who have been abused - even if they do not realise that they have been abused. It is also our responsibility to educate those who are coming into the country that it is not lawful or acceptable to abuse women and girls in such a way, which has both physical and psychological consequences.

On Friday 6 February the UK government hosted the Zero Tolerance to FGM Summit to mark the international day of action. At this summit, a number of further government commitments were launched, including pledging £1.6m in funding for the next stage of the FGM prevention programme with the proposal that this will improve the NHS response.

FGM National Clinical Group would like to see a greater clinical involvement in this response.

While it is important to work with communities that have been identified as practising FGM, it is equally important to work alongside clinicians to develop effective evidence-based interventions for those women and girls who have already been mutilated and those who have received little or no psychological support.

New mandatory recording requirements from GPs and mental health trusts require them to record FGM incidence by October 2015. This follows a requirement already in place for NHS acute trusts to report cases.

As the election looms closer we hope the fight against, and funding for, FGM will continue and these promised funds become reality to enable services to be developed in the UK and prevention to increase.

The UK government is, quite rightly, involved in the international campaign to eradicate FGM - however, as the saying goes: “You need to sort out your own backyard first”. As we know, health promises and pledges often fail to materialise post-election when the first things politicians appear to be concerned with are not the promises made but cabinet reshuffles.

FGM National Clinical Group would now like to seek clarity for clinicians regarding reinfibulation of FGM; this refers to the resuturing of women with FGM to the FGM state and, contrary to public belief, is not against the law in the UK.

Bearing in mind that this group of women are more likely to have a difficult episiotomy with some significant tearing, suturing is often required. As such, it is important that there is clear guidance and education for clinicians in this area.

There should also be clear pathways for psychological support for those women who have undergone FGM.

Yana Richens is consultant midwife and co-founder of FGM National Clinical Group

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