Midwives’ experiences of providing intrapartum care to women with female genital mutilation

Abstract

Due to increasing numbers of migrants from countries where female genital mutilation is performed, local midwives are facing challenges when providing intrapartum care to women affected by female genital mutilation. Since these challenges have not been explored in Malta for a substantial number of years and never through a qualitative approach, this study aimed to explore midwives’ experiences of providing intrapartum care to women with female genital mutilation. The objectives of this study were to explore the midwives’ views and knowledge of female genital mutilation, to understand the midwives’ experiences of providing intrapartum care to women with female genital mutilation in Malta and to identify the needs of local midwives when it comes to caring for women with female genital mutilation. To fulfil this, a qualitative study was carried out, using a self-designed semistructured interview schedule consisting of open-ended questions. The sample consisted of six midwives working at the delivery suite of the local general hospital and the sampling technique chosen was purposive sampling. The data generated through these interviews were analysed using thematic analysis. The findings of this study indicate that midwives working within the local setting lack knowledge of female genital mutilation, which leads to a lack of confidence when providing care to women with female genital mutilation. Midwives acknowledged this lack of knowledge and brought forward recommendations to raise further awareness of female genital mutilation and receive more education on the topic. The overall experiences of midwives providing intrapartum care to women with female genital mutilation, was described as being challenging. Midwives experienced feelings of shock, uncertainty and fear when providing care to these women. Among challenges faced when providing care to women with female genital mutilation was difficulty when performing procedures such as catheterisation and vaginal examinations. Midwives specifically associated fear with performing deinfibulation. Another challenge encountered by all midwives was the issue of communication and language barriers. Results from this study were critically discussed and compared with other studies on the topic. Recommendations from this study include the need for midwives to increase their awareness and knowledge of female genital mutilation as well as overcoming communication and language barriers that hinder optimum care provision to these women. Recommendations for further research include the conduction of a similar study using a mixed methodology approach using a larger number of participants, formulation of subsequent in-depth studies on the separate objectives and the exploration of perspectives of mothers, doctors, obstetricians, and other local health care providers on the care of women with female genital mutilation. Exploring the psychological impact on both the women and healthcare providers would also be interesting, taking into consideration the strong emotions that were mentioned in the findings.