Obstructed, high risk labors are very common in genitally mutilated women. One of my practical approaches was to deliver such women via Caesarian Sections. The most common complications, if allowed to deliver, were high degree of perineal tears, formation of recto vaginal and vescico vaginal fistulas. In Somaliland there are special departments that deal with fistulas only. My thoughts are why should we allow to spend so much money on fistula hospitals if we could stop FGM!
osmanart
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