Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Birth. 2019 Mar;46(1):3-14. doi: 10.1111/birt.12367. Epub 2018 Jun 28.
Female genital mutilation (FGM) is a cultural practice defined as the partial or total removal of the external female genitalia for nontherapeutic indications. Due to changing patterns of migration, clinicians in high-income countries are seeing more women from countries where the practice is prevalent. This review aims to understand the sociocultural and health needs of these women and identify opportunities to improve the quality of maternity care for women with FGM.
We undertook a systematic review and meta-synthesis of peer-reviewed primary qualitative research to explore the experience and needs of migrant women with FGM receiving maternity care. A structured search of nine databases was undertaken, screened papers appraised, and a thematic analysis undertaken on data extracted from the findings and discussion sections of included papers.
Sixteen peer-reviewed studies were included in the systematic review. Four major themes were revealed: Living with fear, stigma, and anxiety; Feelings of vulnerability, distrust, and discrimination; Dealing with past and present ways of life after resettlement; and Seeking support and involvement in health care.
The findings suggest that future actions for improving maternity care quality should be focused on woman-centered practice, demonstrating cultural safety and developing mutual trust between a woman and her care providers. Meaningful consultation with women affected by FGM in high-income settings requires cultural sensitivity and acknowledgment of their specific circumstances. This can be achieved by engaging women affected by FGM in service design to provide quality care and ensure woman-focused policy is developed and implemented.
女性外阴残割（FGM）是一种文化习俗，定义为出于非治疗目的部分或全部切除女性外生殖器。由于移民模式的变化，高收入国家的临床医生现在看到越来越多来自流行这种习俗的国家的女性。本综述旨在了解这些女性的社会文化和健康需求，并确定改善有 FGM 的女性的产妇护理质量的机会。
我们对同行评议的主要定性研究进行了系统综述和元综合，以探讨接受产妇护理的有 FGM 的移民女性的经历和需求。对九个数据库进行了结构化搜索，筛选了论文并评估了纳入论文的研究结果和讨论部分提取的数据的主题分析。
系统综述共纳入 16 项同行评议研究。揭示了四个主要主题：生活在恐惧、耻辱和焦虑之中；脆弱感、不信任感和歧视感；重新安置后应对过去和现在的生活方式；寻求支持和参与医疗保健。
研究结果表明，未来改善产妇护理质量的行动应侧重于以妇女为中心的实践，展示文化安全性并在妇女及其护理提供者之间建立相互信任。在高收入环境中，与受 FGM 影响的妇女进行有意义的协商需要文化敏感性，并承认她们的具体情况。这可以通过让受 FGM 影响的妇女参与服务设计来实现，以提供优质护理，并确保制定和实施以妇女为中心的政策。
