A 2010 survey in The Gambia among women of reproductive age put the prevalence rate of FGM/C at 76.3%. FGM/C was banned in 2015, but there is no real effort at enforcement of the ban. This study aimed to provide national data on obstetric outcomes to support advocacy and health education. A multicentre observational study to assess the obstetric and neonatal outcomes of parturient women with and without FGM/C was carried out across 4 healthcare facilities in The Gambia. The primary outcome was postpartum haemorrhage (>500ml) and secondary outcomes were caesarean section, perineal tears (including episiotomy), neonatal resuscitation and perinatal death. Of the 1,569 participants recruited into the study, 23% had no FGM/C while 77% had FGM/C of varying severity. The risk of postpartum haemorrhage was doubled for women with type I FGM/C, tripled in type II FGM/C and increased by 5-fold for those with type III and IV FGM/C. Caesarean section and perineal tears were also increased. FGM/C was associated with increased risk for neonatal resuscitation and perinatal death. FGM/C is associated with poor obstetric and neonatal outcomes in the Gambia with degree of risk correlating with the severity of FGM/C.