Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Womens Health (Larchmt). 2023 Apr;32(4):486-493. doi: 10.1089/jwh.2022.0294. Epub 2023 Mar 1.
There has been an increase of women living in the United States who have experienced female genital cutting (FGC). However, limited research exists evaluating the experiences of obstetrician/gynecologists delivering care to this patient population. This study aimed to assess the overall experiences, including barriers and facilitators, of U.S.-based obstetrician/gynecologists (OBGYNs) with delivering care to patients with female genital cutting at a single academic health center in the United States. This is a qualitative study of OBGYNs at a large, U.S., urban, academic health center. OBGYNs participated in a one-on-one semistructured interview. Thematic analysis using a grounded theory approach was conducted to identify predominating themes regarding the overall experiences, barriers, and facilitators to delivering care to patients with FGC. Analysis of 15 study interviews revealed 4 main themes impacting the ability of OBGYNs to deliver care to patients with FGC: (1) limited educational training on FGC, (2) challenges with identifying that a patient had FGC and with using the World Health Organization classification system, (3) questions regarding "normative" anatomy and reinfibulation after vaginal procedures, and (4) navigating affective responses of patient and self when FGC is encountered. The above findings have practical implications, showing that the limited educational experience and lack of a clear policy on how to manage the care of women with FGC lead to variation and even limitations in how care is delivered to these women. We encourage OBGYN professional societies to consider creating education and policy to aid clinicians in caring for patients with FGC.
越来越多的生活在美国的女性经历过女性生殖器切割（FGC）。然而，评估妇产科医生为这一患者群体提供护理的经验的研究有限。本研究旨在评估美国一家学术医疗机构的妇产科医生（OBGYN）提供护理的总体经验，包括障碍和促进因素，以接受女性生殖器切割的患者。这是对美国一家大型城市学术医疗机构的 OBGYN 进行的定性研究。OBGYN 参加了一对一的半结构化访谈。使用扎根理论方法进行了主题分析，以确定与向接受女性生殖器切割的患者提供护理的总体经验、障碍和促进因素有关的主要主题。对 15 项研究访谈的分析揭示了影响 OBGYN 向接受女性生殖器切割的患者提供护理能力的 4 个主要主题：（1）对女性生殖器切割的有限教育培训，（2）识别患者是否接受过女性生殖器切割以及使用世界卫生组织分类系统的挑战，（3）关于“正常”解剖结构和阴道手术后再缝合的问题，以及（4）在遇到女性生殖器切割时如何应对患者和自身的情感反应。上述发现具有实际意义，表明有限的教育经验和缺乏明确的政策来管理接受女性生殖器切割的妇女的护理，导致如何为这些妇女提供护理的差异甚至限制。我们鼓励妇产科医生专业协会考虑制定教育和政策，以帮助临床医生照顾接受女性生殖器切割的患者。
