By Katherine Rausch
Monday, June 6, 2011
Medical care in the United States for women with female genital cutting is lagging and many women don't trust doctors who appear to frown on their condition, say advocates. A specialized clinic in Phoenix provides a culturally sensitive approach.
Johnson says when women need a Cesarean section because of fetal distress during birth many resist the idea. She says her patients--many from Somalia in east Africa--fear a long recovery time that will keep them from caring for their family. Others worry the surgery will prevent them from having more children and some see surgery of any kind as a sign of impending death.
Johnson says there's also social pressure from family members not to have the surgery and she tries to help the women consider their options in a way that's free from family pressure.
"Trust is a major issue," Johnson said in a phone interview with Women's eNews. "Engaging in open dialogue without judging women affected by this practice is key. Building trust takes time and often may require multiple visits and good continuity of care."
In 2008, the United Nations released an updated statement on ending the practice of female genital cutting while addressing the strong impact it has on the cultures that practice it.
The World Health Organization classifies genital cutting into four categories, with the first three increasing in severity of cutting, though there can be exceptions.
The first three all consist of removal of genital tissue while the fourth category consists of harmful procedures for non-medical purposes, such as piercing.
Type I is partial or total removal of the clitoris or the clitoral hood, while type II is partial or total removal of the clitoris and the labia minora, sometimes with the labia majora, also.
Type III consists of narrowing the vaginal opening, which Johnson says she sees most commonly with complications.
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Katherine Rausch is an editorial intern at Women's eNews and a freelance writer with a degree in journalism.
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