The issues around Caesarean section for women affected by FGM are complex, and need to be understood and discussed with Health Professionals in order to share information and support informed consent by the women and their families.
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also see:
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Issues and concerns for women include the following:
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- The rate of C/S in Australia is perceived as being very high, especially when contrasted to the rate believed to occur in Somalia, Eritrea and Ethiopia.
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| - There are concerns that the high C/S rate is due to the lack of experience and expertise amongst Western health personnel in delivering women affected by FGM, and to Western beliefs that African women should limit the size of their families, in order to conform to the Western paradigm. For some women, there are concerns that the de facto limit that is placed on family size by health information that stresses that women will need to avoid too many pregnancies after a C/S, or repeat C/S, carries a genocidal message.
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| - In many communities, women lack good information about the sequelae to C/S, including information and advice about future pregnancies and births.
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| - In many communities, women lack information about their health and their bodies, and do not understand medical indications for C/S.
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| - Reasons for C/S may not be fully and clearly explained to them, with an appropriate interpreter as required.
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| - Many women are unaware of the rate and incidence of C/S in their countries of origin.
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| - Many women report that they do not know about their rights and responsibilities in the health system, and how they can exercise their rights, with especial reference to information and informed consent.
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| - Life and death may be seen as in the hand of God, and the time and place for birth and death may be pre ordained, and not to be interfered with.
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| - Women from remote and rural communities may not have access to medical care in their villages of origin. For the woman who is planning and hoping to return to her country of origin at some stage, it may not be safe to have a scarred uterus, especially if she is contemplating another pregnancy in her own country.
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| - Losing a baby by refusing a C/S, although devastating for all families, may be a lesser evil than losing a mother through a later obstetric complication such as a ruptured uterus - a family may not survive without a mother.
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| - Giving birth is seen as a natural and normal part of woman's life and work, and too much intervention is not seen as helpful or healthy in some communities.
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| - Women expect, and are expected, to give birth without fuss. A C/S may diminish a woman's belief in herself as fulfilling her womanly role, and may reflect poorly on herself and her family.
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| - Finding comparative statistical data on maternal and perinatal mortality and morbidity from the Horn of Africa and other African countries is difficult. Women and communities may not be aware of the true rate and incidence of C/S, or obstetric complications or related deaths in their countries of origin.
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