Prevalence and adverse obstetric outcomes of female genital mutilation among women in rural Northern Ghana
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Date
2019-10-21
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Publisher
European Journal of Public Health
Abstract
Background: Female genital mutilation (FGM) is commonly practiced in sub-Saharan Africa and results in adverse
pregnancy outcomes among affected women. This paper assessed the prevalence and effects of FGM on pregnancy
outcomes in a rural Ghanaian setting. Methods: We analyzed 9306 delivery records between 2003 and 2013
from the Navrongo War Memorial Hospital. Multivariable logistic regression analyses were used to determine the
effects of FGM on pregnancy outcomes such as stillbirth, birth weight, postpartum haemorrhage, caesarean and
instrumental delivery. We also assessed differences in the duration of stay in the hospital by FGM status. Results: A
greater proportion of mothers with FGM (24.7%) were older than 35 years compared with those without FGM
(7.6%). FGM declined progressively from 28.4% in 2003 to 0.6% in 2013. Mothers with FGM were nearly twice as
likely to have caesarean delivery (adjusted odds ratios ¼ 1.85 with 95%CI [1.72, 1.99]) and stillbirths (1.60 [1.21,
2.11]) compared with those without. Similarly, they had a 4-fold increased risk of post-partum haemorrhage (4.69
[3.74, 5.88]) and more than 2-fold risk lacerations/episiotomy (2.57 [1.86, 3.21]) during delivery. Average duration
of stay in the hospital was higher for mothers with FGM from 2003 to 2007. Conclusions: Despite significant
decline in prevalence of FGM, adverse obstetric outcomes are still high among affected women. Increased public
health education of circumcised women on these outcomes would help improve institutional deliveries and
heighten awareness and prompt clinical decisions among healthcare workers. Further scale-up of community
level interventions are required to completely eliminate FGM.
Description
Research Article
Keywords
africa south of the sahara, birth weight, episiotomy, fetal death, Ghana