The effect of intrapartum deinfibulation on obstetric outcomes and postpartum sexual function in pregnant women with Type 3 Female Genital Mutilation/Cutting.

Purpose: Female Genital Mutilation/Cutting (FGM/C) is a surgical intervention that is still performed in large numbers worldwide and has severe effects in terms of both obstetric and sexual consequences. Due to the increase in immigration, it has become more frequent in many countries. This study aims to compare the labor performance, complications, and postpartum sexual function of Type 3 Female Genital Mutilation/Cutting (FGM/C) pregnant women undergoing deinfibulation with Type 3 FGM/C patients without deinfibulation.

Methods: This is a prospective study of pregnant women with Type 3 FGM/C and puerperium patients at Nyala Turkish Training and Research Hospital in Sudan over 4 years, from September 2018 to September 2022. Type 3 FGM/C patients who underwent deinfibulation were compared with those who did not, considering age, parity, and obstetric and neonatal outcomes and the Female Sexual Function Index (FSFI) scores at 3 months.

Results: In our homogeneous Type 3 FGM/C group mainly consisting of primiparous women, it was found that more episiotomy procedures were performed. The second stage of labor was significantly prolonged, and perineal damage was greater in the group without deinfibulation. In addition, postpartum hemorrhage and hospitalization of mother and baby were longer in the group without deinfibulation. In the second part of our study, we compared the FSFI scores between the deinfibulation group and the episiotomy subgroup. The results indicated that the deinfibulation group exhibited higher scores across all FSFI domains.

Conclusion: Type 3 FGM/C is definitely associated with poor obstetric and sexual outcomes. It is essential to include partners in family discussions and to protect the perineum by performing deinfibulation and episiotomy at appropriate times and in the correct manner during labor.

What does this study adds to the clinical work: The contribution of the deinfibulation procedure, which is recognized for its obstetric benefits, should also be communicated to families and spouses in terms of its long-term impact on sexual performance. By sharing this information, the devastating effects of Female Genital Mutilation/Cutting (FGM/C) can be mitigated, both obstetrically and sexually.