Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Department of Research, American College of Obstetrics and Gynecology Research, Washington, District of Columbia, USA.
J Womens Health (Larchmt). 2022 Mar;31(3):431-438. doi: 10.1089/jwh.2020.8622. Epub 2021 Apr 28.
Female genital cutting (FGC) is a form of gender-based violence with obstetrical and gynecological complications that require recognition and care. Data suggest that United States' physicians are not prepared to care for those who have been affected by this practice. This study evaluated the knowledge and practices of United States' obstetricians and gynecologists to care for patients who have undergone FGC. This was a cross-sectional confidential survey distributed electronically to a sample of clinically active members of the American College of Obstetricians and Gynecologists. The survey consisted of questions characterizing care of patients who had undergone FGC and barriers to optimal support. Five hundred forty-eight participants representing a wide range of years in practice, geographical locations, subspecializations, and patient demographics participated. Sixty-six percent of participants had cared for patients who had undergone FGC. Participants' description of their patient population racial/ethnic composition did not correlate with likelihood of treating this patient population. Forty percent of participants reported some form of education about FGC, more often among women, younger physicians, and those in practice for fewer years. Thirty-one percent of participants were comfortable counseling about and 20% were comfortable performing deinfibulation; these percentages were higher among those who had received education or had recently cared for an affected patient. Participants reported insufficient training as the largest barrier to providing care to women. While most physicians in this national cohort had cared for women who had undergone cutting, a minority had any form of education. However, prior education correlated with indicators of improved care. Physicians require additional guidance in treating this important and growing patient population.
女性生殖器切割(FGC)是一种基于性别的暴力形式,会导致产科和妇科并发症,需要得到识别和护理。有数据表明,美国的医生还没有准备好为那些受到这种做法影响的人提供护理。本研究评估了美国妇产科医生照顾接受过 FGC 的患者的知识和实践。这是一项横断面的机密调查,通过电子邮件向美国妇产科医师学会的临床活跃成员进行了抽样调查。该调查包括了对接受过 FGC 的患者进行护理的问题以及支持最佳护理的障碍。有 548 名代表不同行医年限、地理位置、亚专业和患者人口统计学特征的参与者参加了该调查。66%的参与者曾照顾过接受过 FGC 的患者。参与者对其患者人群种族/族裔构成的描述与治疗该患者人群的可能性没有相关性。40%的参与者报告接受过某种形式的 FGC 教育,这种情况在女性、年轻医生和行医年限较短的医生中更为常见。31%的参与者表示愿意提供关于 FGC 的咨询,20%的参与者表示愿意进行去纤维化,这些百分比在接受过教育或最近照顾过受影响患者的医生中更高。参与者报告缺乏培训是提供护理的最大障碍。虽然本研究中的大多数医生都曾照顾过接受过切割的女性,但只有少数医生接受过任何形式的教育。然而,先前的教育与改善护理的指标相关。医生在治疗这个重要且不断增长的患者群体方面需要额外的指导。