COMPLICATIONS OF FEMALE GENITAL CUTTING

COMPLICATIONS OF FEMALE GENITAL CUTTING
There are many possible complications of female
genital cutting; the ones that are commonly
encountered can be classified into two broad groups;
early and late
Early Complications
Haemorrhage
Among the early complications , bleeding and
infection can be particularly dangerous
As was shown in the photograph, the cutting is done
without preparations to control or arrest bleeding .
Compared with adults, children do not have the
amount of blood reserve that adults and pregnant
women commonly have in situations of bleeding from
wounds. Under the conditions of bleeding from open
wounds created during cutting of the clitoris, prepuce
and labia minora, the child may go into hemorrhagic
shock and die from there. If she survives that period,
damage to certain organs of reproduction as a result
of the blood loss will manifest later by way of primary
infertility , starting with menstrual problems. This is
further complicated by the fact that unlike what is
done in Hospitals, no laboratory tests are done to
know the level of haemoglobin(Hb) and to know if the
child has an underlying bleeding disorder.
Infections
As concerns infections, the real danger is Tetanus, but
apart from that, using locally made cutting
instruments that are not sterilized places the child at
the risk of contracting Hepatitis B and the dreaded
HIV/AIDS. Despite the much talked about ATS
(antitetanus serum), only few cases of established
tetanus infection survive, and of course, Hepatitis B
and HIV/AIDS both have no cure; they can only be
treated.
The clitoris is so intimately related to the urinary
tract opening that infection (ascending) of the
urinary tract is almost always associated with female
genital cutting. The blind nature of the operation and
the poor conditions of hygiene under which it is done
increases the likelihood of urinary tract infection,
pyelonephritis, nephritis , kidney damage and failure
When death occurs either from infections or
haemorrhage, the truth is hidden, and the victim
buried secretly to conceal primary cause of death
Late Complications
Chronic pain
Among the late complications, chronic pain is one
common feature. Affected women often find it
difficult to describe the pain or where it is coming
from. However, many of them complain of pain during
sex(dyspareunia) even with husbands who according to
them are endowed with phallic organs below average in
size. Other women complain of pain during sexual
excitation, during sex and even after
Abnormal sensation
Other complaints include the following;
Sensation of something being present inside the vagina
Sensation of the womb coming down or trying to fall
out
Excessive reaction to pain, and crying about pain even,
when there is obviously no source of pain
Inability to hold urine(urinary incontinence) during
sex; the bed is flooded with urine during sex or every
five or so many minutes, wife interrupts the coitus to
go and void
Abnormal sensation of sweet tingly, prickly or pins and
needles pain
Inability to achieve orgasm in addition to a situation
of sexual arousal that refuses to ebb or go down even
days after sex, creating tension and the restless pubis
syndrome.
Several medical terms including vaginismus, par
aesthesia dyspareunia, hyperalgesia, allodynia, etc
have been used to describe these abnormal sensations
,which can be understood from the fact that the
clitoris is richly blessed with abundant supply of
delicate nerve fibres that are better left alone. The
clitoris is one of the few organs in the body designed
with double nerve supply ;the pudendal nerve and the
perineal branch of the posterior femoral cutaneous
nerve. The organ also contains fibres from the
sympathetic and parasympathetic chains of the
autonomic nervous system .Recently scientists have
been able to map the area of the brain(cerebrum)
which receives, registers and controls activities of the
clitoris and have found that the clitoris, nipple and
other parts of the female body share commonalities in
many respects.
Psycho social issues:
As told in medical sociology, even in churches; behind
closed doors, how a couple wants to have sex, where,
how and for what reasons are purely and truthfully
for them to decide. No one , is expected to meddle in
the matrimonial affairs of any pair in legitimate
relationship.
Sexual needs and identity begin early in life . Indeed
by the time a child reaches the age of five(earlier in
some and later in others),she will have passed the
initial rungs of the ladder of psycho sexual
development as espoused by Sigmund Freud and will
have begun to appreciate sexual identity. This identity
takes many issues into consideration and will not be
discussed here because doing so might not be
appropriate for some children who though very young
are able to assess information of sensitive nature
from the internet. From this age of five, older or
younger as discussed , any inappropriate physical
activity of what ever nature or assault on the genitalia
is likely to be written down in her mental diary and
will remain there for the rest of her life. What ever
she knows about her self in general and about specific
parts of her body will be recorded, played and
compared several times over in her brain as she grows
and matures, interacting with her environment and
exposed to positive and negative reinforcement,
depending on many other factors. It thus becomes a
huge problem with far reaching ramifications when a
child is allowed to grow into adulthood with the
knowledge that she is different in one particular part
of her body compared with other women. In most of
the situations in Nigeria, where in accordance with the
rules and regulations of a church, intending partners
are not allowed to come into any significant degrees
of intimacy until union is solemnized, pre marriage
counsellors may have issues with partner disclosure
status ,with physical examination presenting matters
of their own specific nature.
Social issues:
For women who have had the clitoris amputated ,a
wide range of dysfunctional sexual responses have
been documented. To begin with, no responsible man
would want sex with his wife or partner to assume the
form of rape ,and so for legitimate marital or spousal
sex, one reason for foreplay is to adequately prepare
a woman for reception and avoid vaginal hostility .
Conscious of the fact that down below, she is not quite
as complete as she should be, an affected woman may
want to hide that part of her body considering herself
inadequate before her husband ; intra psychic
conflicts declare themselves, and with the mind
searching for ways to cope with her seeming
incompleteness, response might come in ways that may
be interpreted as primitive, hostile(mind body
disconnect), unusual, bizarre or inappropriate. She
may even find herself unable to respond at all.
In any marriage or successful relationship, a partner
finds fulfilment in being desired and this can be
projected(at least to a large extent) by way of verbal
and non verbal communication. While in bed, coldness,
unusual demands and responses could be easily
misunderstood and misinterpreted. It only takes a
little miscalculation thereafter for affected couples to
start filing papers for divorce sighting what they
commonly refer to as irreconcilable differences.