• Call us now: 0300 303 0444
  • Call us now: 0300 303 0444

You are here

FGM management guideline updated

10 July, 2015

FGM management guideline updated

Updated guidelines for healthcare professionals on how to best care for women with FGM were published today (10 July) by the RCOG.

Pregnancy presented a key opportunity for professionals to identify women with FGM, provide information and advice, address healthcare needs and assess the risk to the unborn child or other female family members, said the RCOG. 

The green-top guideline provides evidence-based advice on the clinical care of women with FGM before, during and after pregnancy, including legal and regulatory responsibilities.

There should be a lead consultant and/or midwife responsible for the care of women with FGM in all hospitals, the RCOG said.

The guideline addresses de-infibulation and clitoral reconstruction. It says that women who are likely to benefit from de-infibulation should be counselled and offered the procedure before pregnancy and ideally before first sexual intercourse.

Clitoral reconstruction should not be performed because current evidence suggests that there are associated complication rates without conclusive evidence of benefit, it says.

The RCOG said that clinicians must be aware of the short- and long-term complications of FGM, including scarring, urinary infections, menstrual difficulties, impaired sexual function, painful sexual intercourse, obstetric complications and psychological trauma.

The guideline emphasises that all healthcare professionals must be aware of the FGM Act 2003 in England, Wales and Northern Ireland, and the Prohibition of FGM Act 2005 in Scotland.

In order to ensure a consistent approach to data monitoring, the Department of Health has implemented the FGM enhanced dataset in England, which requires all acute trusts, general practices and mental health trusts to record data about women with FGM on a monthly basis.

The RCOG said that healthcare professionals must understand the difference between recording FGM (for the purpose of the FGM Enhanced Dataset) and reporting FGM (making a referral to the police or social services) and their responsibilities with respect to each of these.

Dr Naomi Low-Beer, lead author of the guideline, said: ‘We must be aware of our pivotal responsibility to provide accessible advice, treatment and support whilst ensuring that children are protected.’

RCM professional policy advisor Janet Fyle said: ‘These updated guidelines are welcome and provide good information for health professionals working in maternity services.

‘FGM is abuse and violence against girls and women. It is illegal and we need to ensure that the momentum to end this practice here in the UK and globally is kept up in the interest of girls and women.

‘Midwives have a pivotal role to play in identifying and supporting women who have undergone FGM. Meeting a midwife is often the first time that many of these women will engage with health services. Consequently, we must ensure that midwives have the training, time and knowledge of the services needed to support women through what can be a difficult and distressing time.

‘Trusts and other employers need to ensure that their staff have the appropriate training on FGM with clear national guidelines and pathways in place, and mechanisms for monitoring their effectiveness. This training should be mandatory and employers must ensure that their staff are given the time for training on FGM issues.

‘Health professionals now have to record all cases of FGM, so that we can better map the incidence of FGM and provide health care and support for women. There is a need to see mandatory reporting of FGM come into effect with clear and concise guidance for health professionals.’

View the FGM and its management guideline here

The Intercollegiate report Tackling FGM in the UK: intercollegiate recommendations for identifying, recording and reporting is available here.

Health Education England has developed an e-FGM educational programme for healthcare professionals available here


Printer-friendly version