Female genital cutting (FGC) & cervical screening: A guide for practitioners

CANCER COUNCIL VICTORIA & WOMEN’S HEALTH WEST FARREP
PROGRAM, First published 2017

The World Health Organization defines female genital cutting (FGC) as ‘all procedures that include partial or total removal of female genital organs or other injury to female genital organs for non-medical reasons’.

‘Female genital mutilation’ is the term used in Australian and Victorian legislation, but the preferred way to refer to the practice using culturally sensitive language is ‘female circumcision’ or ‘traditional cutting’. The age at which this occurs varies from infancy to 15 years.

The practice is referred to as FGC throughout this document.

This 2-page guideline document includes facts about prevalance, type, appropriate questioning, examination technique, and more.

 

Decision-making about infant feeding among African women living with HIV in the UK

“It pains me because as a woman you have to breastfeed your baby”: decision-making about infant feeding among African women living with HIV in the UK

Sex Transm Infect 2016;92:331-336 doi:10.1136/sextrans-2015-052224

Abstract

Objectives UK guidance advises HIV-positive women to abstain from breast feeding. Although this eliminates the risk of postnatal vertical transmission of HIV, the impact of replacement feeding on mothers is often overlooked. This qualitative study examines, for the first time in the UK, decision-making about infant feeding among African women living with HIV.

Methods Between 2010 and 2011, we conducted semistructured interviews with 23 HIV-positive African women who were pregnant or had recently given birth. We recruited participants from three HIV antenatal clinics in London.

Results Women highlighted the cultural importance of breast feeding in African communities and the social pressure to breast feed, also describing fears that replacement feeding would signify their HIV status. Participants had significant concerns about physical and psychological effects of replacement feeding on their child and felt their identity as good mothers was compromised by not breast feeding. However, almost all chose to refrain from breast feeding, driven by the desire to minimise vertical transmission risk. Participants’ resilience was strengthened by financial assistance with replacement feeding, examples of healthy formula-fed children and support from partners, family, peers and professionals.

Conclusions The decision to avoid breast feeding came at considerable emotional cost to participants. Professionals should be aware of the difficulties encountered by HIV-positive women in refraining from breast feeding, especially those from migrant African communities where breast feeding is culturally normative. Appropriate financial and emotional support increases women’s capacity to adhere to their infant-feeding decisions and may reduce the emotional impact.

Read article (open access) here