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Researchers Debra Boyer and David Fine (1992)
I likewise found a significant link between childhood sexual abuse and teenage pregnancy among a sample of 535 adolescent mothers in Washington State. Compared with teens who became pregnant but had not been abused, sexually abused adolescents began intercourse a year earlier, were more likely to have used drugs and alcohol, and were less likely to practice contraception. Abused adolescents were also more likely to have been battered by an intimate partner and to have exchanged sex for money, drugs, or a place to stay. The average age at first intercourse for abused women was 13.8 years, compared with the national average of 16.2. Only 28 percent of the abused teens used birth control at first intercourse, compared with 49 percent of their peers.
Health effects of genital mutilation.
The medical complications of genital mutilation can be severe, especially for women who are infibulated. A study from Sierra Leone found that 83 percent of all women circumcised required medical attention at some time for problems related to the procedure (Hosken 1988). The immediate risks of clitoridectomy or infibulation are similar: hemorrhage of the clitoral artery, infection, urine retention, and tetanus or blood poisoning from unsterile and often primitive cutting implements (knife, razor blade, broken glass). And the pain of the operation, often carried out without anesthesia, can cause young girls to go into shock.
Over the long term women who are infibulated generally suffer more severe physical health consequences than women who are excised. Infibulation, because it involves more extensive cutting and stitching, poses significantly higher risks of hemorrhage end infection. And the partial closing of the vaginal and urethral openings leads to more problems relating to retention of urine and menstrual blood, such as chronic urinary tract infections, stones in the urethra or bladder, constant back and menstrual pain, irregularity, and repeated reproductive tract infections. In some cases these infections can lead to sterility, a devastating consequence for women whose worth is defined largely in terms of their ability to bear children.
Infibulation destines a woman to a cycle of pain, cutting, and restitching to accommodate sexual intimacy and childbirth. Infibulated women often must be cut on their wedding night to make intercourse possible, and again for the birth of a child. Intercourse is frequently perceived as painful, a perception that likely has both physical and psychological roots. And at the time of birth, infibulation puts both mother and child at risk. Among 33 infibulated mothers followed et Somalia’s Benadir Hospital all required extensive episiotomies during childbirth, their second-stage labor was five times longer than normal, five of their babies died, and 21 suffered oxygen deprivation because of the long and obstructed labor (Warsame 1988). Most women are reinfibulated after childbirth to reconstruct a small vaginal opening; over time this repeated cutting and stitching transforms the genital area into tough, unyielding scart issue.
Although excised women normally have fewer long-term complications than women who are infibulated, clitoridectomy is not without serious risks. A significant share of excised women face a lifetime of unending infections, pain, bleeding, and abscesses. They also face the possibility of severe psychological repercussions. Little research has been done on the psychological impact of genital mutilation, but clinicians report serious long-term distress and psychological dysfunction in some cases. Based on her experience in Sudan, Dr. Nahid Toubia describes a pattern of vague physical complaints, depression, and lethargy among circumcised women very similar to that common among sexually abused or raped women in the United States:
Thousands of women [in Sudan] come to the Ob/Gyn outpatient clinics with vague chronic symptoms which they metaphorically interpret as originating from the pelvis. These women are perceived by doctors and the hospital authorities as a great nuisance and a drain on the system since they have no medically detectable pathology. Sitting for hours listening to them, it soon becomes clear that the vague symptoms of general fatigue, loss of sleep, backache, headache, pelvic congestion, uttered in a depressed, monotonal voice, are a muted cry for help for a much more deeply felt paint With a little probing, the women talk about fear of sex, the threat of infertility after infection, and fears about the state of their genitals (they have no way of assessing whether they are normal). (Toubia 1993, p. 19)
In 1982 the World Health Organization (WHO) issued a statement warning that genital mutilation should never be carried out by professional health staff. Despite this statement and many similar resolutions crafted by various medical bodies, delegates to the UN Human Rights Seminar on Traditional Practices held in Burkina Faso in 1991 reported that, for reasons of financial gain, medical personnel are performing circumcisions in hospitals in place of the midwives and traditional practitioners who normally carry out the procedure (Dorkenoo and Scilla 19°2). Although “medicalizing” circumcision may reduce the immediate risks of infection, it does not end the abuse of women’s human rights represented by this unnecessary, mutilating surgery. As Aziza Kamil, leader of the Cairo Family Planning Association’s project on female genital mutilation, points out: