Female genital mutilation and other harmful practices
Health consequences of female genital mutilation
Perinatal complications among ethnic Somalis in Norway
From 1986 to 1998 there were 1733 births in Norway to women of Somali origin. The aim of this study was to examine the risk of perinatal complications among women of Somali origin compared with ethnic Norwegians. In particular, the study aimed to assess to what extent perinatal outcome was related to FGM.
Data was extracted from the Medical Birth Registry in Norway on all births to women born in Somalia between 1986 and 1998, and on the 700,000 births to ethnic Norwegian women during the same period. Maternal age, parity, level of education and place of delivery differed between the groups.
For instance, the Somali women were younger and had more children than the Norwegians (57% of the Somali women were under 25 years of age, while 51% of the Norwegians were aged 2534 years when they had their first child. Some 30% of the Somalis had three or more previous deliveries compared with 6% of the Norwegians. Only 4% of the Somali women had completed 12 years of schooling, compared with 30% for the Norwegians. Only 1% of the Somalis had lived in Norway for more than 10 years.
Significantly higher risks for nearly all the complications were seen among the Somalis. Compared with Norwegians, specifically high prevalences were found of fetal distress, operative deliveries, low Apgar scores and perinatal deaths, which were all increased by a factor of 2-3. The overall use of caesarean section was approximately double compared with Norwegians, while elective cases were triple.
The risk of pre-labour fetal deaths was more than double among Somalis vs. Norwegians, though no significant difference was observed in intrapartum deaths and deaths within the first 7 days of life. Also, induction of labour, secondary arrest, prolonged second stage of labour, delivery by forceps and vacuum, and postpartum haemorrhage were more frequent among the Somalis. The risk of perineal injury was similar in both groups.
The researchers concluded that infibulations could have played a role in the perinatal complications experienced by the Somali women, since most Somali women in Norway have been found to have undergone this type of FGM. However, the researchers said, Somali women in Norway may be exposed to other adverse factors – including low social status, suboptimal perinatal care, mental stress, and a larger burden of intercurrent diseases – which could all influence their health during pregnancy and delivery. Whatever the cause (FGM or otherwise) “Somali immigrant women represent a high-risk group in obstetrics”, the researchers concluded.
1. Vangen S, Stoltenberg C, Johansen EB et al. Perinatal complications among ethnic Somalis in Norway. Acta Obstetricia at Gynecologica Scandinavica 2002; 81:317322.