Female genital mutilation/cutting: knowledge, attitudes, and practices among key caregivers: a French national survey

Background Female genital mutilation/cutting (FGM/C) is a prevalent traditional practice affecting over 230 million women globally. Gynaecologists and obstetricians (OB/GYN), midwives, and infectious disease (ID) specialists frequently encounter migrant women affected by FGM/C. This study aimed to evaluate these caregivers' knowledge, attitudes, and practices related to FGM/C. Methods The questionnaire, designed by an international multidisciplinary team, included 30 questions divided into 5 sections (demographics, practices, knowledge, attitudes and training). It was disseminated via LimeSurvey. All questionnaires completed, were included in the analysis. Results From September 2021 to March 2022, we included 1,142 questionnaires, 963 of which were completed and analysed. The respondents were primarily ID specialists (180/963, 19%), OB/GYN (291/963, 30%) and midwives (233/963, 24%). Fifty-four percent of the caregivers (523/963, 54%) had already cared for an FGM/C-affected woman. Sixty-three percent (609/963, 63%) of caregivers discussed FGM/C during consultations. Of these, 47% (284/609) had received initial training, compared to 31% (110/354) among those who never addressed the subject. A higher theoretical knowledge score was observed among providers with more clinical experience and greater self-confidence. An undergraduate education was reported by 41% (394/963) of the caregivers, with midwives showing higher training rates than professionals in other specialties (149/233, 64% p < 0.001). Conclusions The main challenge for caregivers is to address the issue of FGM/C to meet women's needs and guide them towards a tailored healthcare pathway. Discussion of the topic was correlated with level of knowledge and self-reported confidence. These results highlight the need for further training, with a special focus on the relational aspects of care.