Sequela of female genital mutilation on birth outcomes in Jijiga, somali region, eastern ethiopia: a prospective cohort Study

Abstract

Background: in Ethiopia female genital mutilation (FGM) remains a serious concern and has affected 23.8 million women and girls, with the highest prevalence in somali regional state. Even though fgm is reported to be associated with a range of obstetric complication, however in the region particularly in jijiga little is known about its effects on childbirth. Objective: the objective of this study was to test the hypothesis that female genital mutilation is a contributing factor to the increased risk of complication during childbirth. Methods: Facility based cohort study was employed on 142 exposed and 139 unexposed parturients from March 10-May 12, 2014. The study participants were recruited by convenience sampling technique. Data were collected using a structured interviewer administered questionnaire and observational checklists. After the data had been carefully checked, cleaned and edited, they were analyzed using SPSS (version 16) and STATA (version 11). Result: - The existence of FGM was significantly associated with Perineal tear [RR=2.52 (95% CI 1.26-5.02)], Postpartum blood loss [RR=3.14 (95% CI 1.27-7.78)], Outlet obstruction [RR=1.83 (95% CI 1.19-2.79)] and Emergency caesarean section [RR=1.52 (95%CI 1.04- 2.22)]. FGM type I and FGM type II did not demonstrate any association with prolonged 2nd stage of labor, Emergency caesarean section, postpartum blood loss, and APGAR score < 7. FGM type III however was significantly associated with prolonged 2nd stage of labor [RR= 2.47(95% CI 1.06-5.76)], Emergency caesarean section [RR=3.60 (95% CI 1.65-7.86)], Postpartum blood loss [RR=6.37 (95% CI 2.11-19.20] and APGAR score < 7[RR=4.41(95% CI, 1.84-10.60)]. FGM type II and type III were significantly associated with Perineal tear [RR=2.45(95%CI 1.03- 5.83)], [RR=4.91(95% CI 2.46-9.77)] and Outlet obstruction [RR=2.38(95%CI 1.39-4.08)], [RR=2.94(95% CI 1.84-4.71)] respectively. Conclusion & Recommendation: Women with FGM are significantly more likely than those without FGM to have adverse obstetric outcomes. Risks seem to be greater with more extensive form of FGM. This means that FGM is likely to be responsible for substantial numbers of additional causes of adverse obstetric outcomes. Adverse obstetric outcomes can therefore be added to the known harmful immediate and long-term effects of FGM. It should be eradicated for good health of the mothers in Ethiopia