Obstetric outcome of female genital mutilation in the Gambia – an observational study

Background: A 2010 survey in The Gambia among women of reproductive age put the prevalence rate of FGM/C at 76.3%. FGM/C was banned in 2015, but there is no real effort at enforcement of the ban. This study aimed to provide national data on obstetric outcomes to support advocacy and health education.A multicentre observational study to assess the obstetric and neonatal outcomes of parturient women with and without FGM/Cwas carried out across 4 healthcare facilities in The Gambia. The primary outcome was postpartum haemorrhage (>500ml) andsecondary outcomes were caesarean section, perineal tears (including episiotomy), neonatal resuscitation and perinatal death.Of the 1,569 participants recruited into the study, 23% had no FGM/C while 77% had FGM/C of varying severity. The riskof postpartum haemorrhage was doubled for women with type I FGM/C, tripled in type II FGM/C and increased by 5-foldfor those with type III and IV FGM/C. Caesarean section and perineal tears were also increased. FGM/C was associated withincreased risk for neonatal resuscitation and perinatal death.FGM/C is associated with poor obstetric and neonatal outcomes in the Gambia with degree of risk correlating with the severityof FGM/C. Keywords: Female genital mutilation; obstetric outcome; Gambia