Female genital mutilation among antenatal care and contraceptive advice attendees in Sweden

Objective. To explore knowledge of, attitudes toward and practice of female genital mutilation (FGM) among women originally from countries where FGM is customary attending antenatal care and contraceptive advice in Sweden. Methods. Women in reproductive age living in Sweden who originate from countries where FGM is practiced coming for antenatal care or contraceptive advice at two maternity welfare centers in Stockholm were asked to participate. Interview administered questionnaires and gynecological examination were used for data collection. The data were analyzed by descriptive statistics. Results. Out of 49 women asked, 40 women agreed to participate, of whom 37 had undergone FGM. Most FGM operations had been performed by doctors or midwives. Half of the Muslim women said FGM was allowed by their religion. All women reporting to have undergone 'sunna', an allegedly mild form, had extensive damage to their genitals. At gynecological examination three cases of reinfibulation were detected, of which two had been performed after delivery in Sweden. Twenty-nine women had daughters and three had let their daughters undergo FGM, all of them before settling in Sweden. Problems related to delivery and sexual intercourse were the most commonly mentioned complications of FGM. Conclusions. The reliability of the self-reported form of FGM is low, which may have implications for research, interventions and health care. Although many women express negative attitudes toward FGM and know about serious complications, the religious justifications, the practice of FGM on daughters, reinfibulation on adults and medicalization of the practice indicate attitudes that favor of the continued practice of FGM.