Female genital mutilation (FGM/C): WHO Type I-IV classification, antenatal & intrapartum care, deinfibulation and cultural competence (RANZCOG C-Gyn 1)

A woman newly arrived from a high-prevalence country sits in your booking clinic. She does not mention FGM; she may not know the term, or she may associate it with shame, fear, or belonging. Your job is not to extract a confession — it is to ask sensitively, examine carefully, document the WHO type, plan a safe birth, and offer care that is competent across culture and trauma. This topic is the framework for that encounter, from the verbatim WHO classification to the deinfibulation incision to the safeguarding referral.[6][8][10]

Overview and definition

The WHO definition is the anchor of every answer you give on this topic. FGM is defined as removal of female external genitalia, either partial or total, for non-medical purposes. It is embedded in tradition, including cultural beliefs about sexual behaviour, and is recognised internationally as a violation of the human rights of girls and women.[7][12]

Two features make this definition load-bearing. First, "for non-medical purposes" — there is no therapeutic FGM, and WHO and RANZCOG oppose the medicalisation of the practice. Second, "external female genitalia" — the organs affected are normal, healthy tissue; FGM removes and damages them, and it interferes with the natural functions of girls' and women's bodies. The associated risks include haemorrhage, infection, death, dyspareunia, childbirth complications, and psychological issues.[7][12]