ABSTRACT
Preconceptual de-infibulation should be aimed for as the ‘gold stan-dard’. De-infibulation should be performed antenatally in pregnancy. However, if de-infibulation has not been performed antenatally, it can be performed in the first stage of labour. Discussion of the possible issues arising at the time of delivery should occur prior to labour, with the offer of examination to see the extent of the female genital mutilation (FGM). Involvement of interpreting and counselling services is often necessary. FGM constitutes a health risk to African women and can hinder the provision of appropriate obstetric/midwifery care. It is carried out sometime between birth and puberty. The degree of mutilation varies and clitoral damage is unpredictable. Classification of FGM is unhelpful and a poor indicator of damage. If FGM is noticed only in labour, the woman should be assessed by a senior specialist registrar or consultant. It is considered best practice to carry out a reversal in the first stage of labour.
