The medical consequences of female genital mutilation are quite grave (El Dareer; Koso-Thomas). In Africa an estimated ninety million females are affected (Hosken). Three levels of health problems are associated with the practice. Immediate problems include pain, shock, hemorrhage, acute urinary retention, urinary infection, septicemia, blood poisoning, fever, tetanus, and death. Occasionally, force is applied to position candidates for the operation, and as a result, fractures of the clavicle, humerus, or femur have occurred. Intermediate complications include pelvic infection, painful menstrual periods, painful and difficult sexual intercourse, formation of cysts and abscesses, excessive growth of scar tissue, and the development of prolapse and fistulae. A fistula is an abnormal passage: a hole (opening) between the posterior urinary bladder wall and the vagina or a hole between the anterior rectal wall and the vagina. Late complications include accumulation of menstrual blood of many months or even years, primary infertility, painful clitoral tumors, recurrent urinary tract infections, and kidney or bladder stone formation. Obstetric complications such as third-degree perineal tear, resulting in anal incontinence and fissure formation, and prolonged and obstructed labor are also known to occur. Psychological problems of anxiety, frigidity, and depression, as a result of the physical inability to have a clitoral orgasm, may also develop.
Women who undergo circumcision suffer various degrees of emotional and mental distress depending on the nature of complications following their operation. Records show that 83 percent of all females undergoing circumcision are likely to be affected by some condition related to that surgical procedure requiring medical attention at some time during their lives. This level of health risk should be of concern to nations with a large proportion of circumcised women, because such women may never make the progress toward the economic and social development required of them.
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