Table 3 Reported experience of FGMC in clinical practice

 Kaplan et al. 2013 [22]

Gambia

41 % - had seen a girl with complications of FGM/C

41% - had seen a girl with complications of FGM/C

8 % - had performed FGM/C

NR^a

69 % - FGM/C is practiced in my family/household

 Ali et al. 2012 [23]

Sudan

NR

NR

81 % had performed FGM/C during their career

NR

Each of these midwives had performed 5–88 FGM/C procedures in the previous year

 Rasheed et al. 2011 [25]

Egypt

NR

NR

None of the nurses had performed FGM/C

NR

 Refaat 2009 [26]

Egypt

NR

NR

19 % - performed FGM/C

NR

34 % of those who perform FGM/C reported complications among patients

 Onuh et al. 2006 [28]

Nigeria

NR

NR

7 % - currently practice FGM/C

NR

14 % have practiced FGM/C in the past

58 % - will perform FGM/C in the future if compelled to do so

 Caroppo et al. 2014 [29]

Italy

71 % - never met or assisted a woman with FGM/C despite working in an asylum seeker facility

76 % - stated they would refer the woman for care elsewhere, with many different options provided

34 % were aware of guidelines/procedures for the management of women with FGM/C

 Purchase et al. 2013 [30]

UK

87 % - had been involved in the care of a girl/woman with FGM/C

3 midwives had been asked to perform FGM/C in a child or to re-infibulate after delivery

26 % - had sufficient training in FGMC

20 % - had seen >10 cases

31 % - reported that the hospital/trust had screening for FGM/C procedures

21 % - there was an FGM/C specialist (obstetrician or midwife) at the hospital trust

40 % - had training in de-infibulation

 Relph et al. 2013 [31]

UK

59 % had been involved in the care of a woman with FGM/C

NR

NR

NR

 Moeed et al. 2012 [20]

Australia and New Zealand

76 % see women from African countries and from the Middle East

47 % had seen at least one woman or girl with complications related to FGMC – “most commonly” urinary problems; problems in labour and dyspareunia

21 % - of O&G specialists asked to re-infibulate after birth

NR

75 % saw at least one woman with FGM/C in the last 5 years

“A few” reported psychosexual complications

12 % - of those who had been asked had done so:

Most saw 1–5 women with FGMC in the last 5 years

38 % of the FGM/C workers had heard of re-suturing taking place; one respondent indicated that re-suturing had taken place >50 times

2 (0.5 %) respondents had been asked to perform FGM/C on a baby, young girl or woman

One was asked on 1–5 occasions; the other 6–10 occasions

1 % of the O&G specialists had convincing evidence that the procedure was done in Australia or NZ

10 % of the FGM/C workers were aware of convincing evidence that the procedure was being performed in Australia or NZ

 Hess et al. 2010 [32]

USA

43 % - of certified nurse- midwives had seen women with FGM/C in their practice

Problems associated with FGMC not discussed consistently

NR

20 % discussed circumcision of daughters, nieces, grand- daughters “Often” or “Always”

78 % never discussed infertility

 Kaplan-Marcusan et al. 2009 [33]

Spain

2001

NR

91 % of paediatricians had an interest in FGM/C

NR

6 % - of all HP surveyed had seen cases in practice

42 % of paediatricians were aware of guidelines and protocols

7 % - of paediatricians saw FGM/C

2004

16 % - had seen FGMC in practice

19 % – of paediatricians saw FGM/C

FGM/C was seen by females more often than males

 Leye 2008 [34]

Belgium

58 % had seen women or girls with FGM/C in their practice

Consulted regarding complications:

2 % [6] respondents had been asked to perform FGM/C in Belgium

Most common forms:

1 % - acute complications

4 % [13] had been asked whether FGMC could be performed in Belgium

51 % wanted guidelines on FGM/C

56 – infibulation

1 % - fertility problems

9.5 % [31] gynaecologists had heard that FGM/C had been performed in Belgium

45 % sought more information about FGM/C after seeing patients with FGM/C

40 – Excision

2 % - psychological problems

3 – sunna^b

4 % - fistulae

7 patients , 14 years old

15 % - pregnancy and delivery problems

23 patients 15–18 years old

18 % - chronic pain

The rest were 19 years or older

19 % - urinary tract infections

Patients were from: Somalia, Ethiopia, and other including Nigeria, Egypt, Mali, Senegal

41 % - sexual dysfunction

35 % - of those looking after pregnant women tried to persuade the mother not to perform FGMC if the child was a daughter

65 % - said they would not do any prevention

 Zaidi et al. 2007 [35]

UK

80 % had seen women with FGM/C in their practice

NR

NR

NR

 Tamaddon et al. 2006 [36]

Sweden

60 % had seen at least one patient with FGM/C

39 % - had seen patients with long-term complications of FGM/C

5 % - had been asked about performing FGM/C in Sweden; 4 of these were paediatricians

NR

1 % - had seen patients with complications due to recently performed FGC

10 % - had been asked to perform reinfibulation after birth

2 of these 7 were paediatricians, 4 midwives, 1 gyneacologist

 Jager et al. 2002 [37]

Switzerland

51 % - had seen women with FGM/C in their practice in Switzerland

NR

21 % - had been asked to re-infibulated after birth

FGM/C is not included in the undergraduate medical curriculum

73 % - from the French-speaking region of Switzerland had seen women with FGM/C in their practice

2 gyneacologists have been asked to perform FGM/C in young girls

There is no reporting system for FGM/C

4 gyneacologists were asked where FGMC could be performed in Switzerland

12 gyneacologists said that they knew of FGM/C being performed in Switzerland