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Preferences for deinfibulation (opening) surgery and female genital mutilation service provision: a UK qualitative study
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  • Laura Jones,
  • Benjamin Costello,
  • Emma Danks,
  • Kate Jolly,
  • Fiona Cross-Sudworth,
  • Alison Byrne,
  • Meg Fassam-Wright,
  • Pallavi Latthe,
  • Joanne Clarke,
  • Ayan Abdi,
  • Hodo Abdi,
  • Hibaq Abdi,
  • Julie Taylor
Laura Jones
University of Birmingham

Corresponding Author:[email protected]

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Benjamin Costello
University of Birmingham
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Emma Danks
University of Wolverhampton
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Kate Jolly
University of Birmingham
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Fiona Cross-Sudworth
University of Birmingham
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Alison Byrne
University Hospitals Birmingham NHS Foundation Trust
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Meg Fassam-Wright
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Pallavi Latthe
Birmingham Women's and Children's NHS Foundation Trust
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Joanne Clarke
University of Birmingham
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Hibaq Abdi
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Julie Taylor
University of Birmingham
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Objective: To explore the views of female genital mutilation (FGM) survivors, men, and healthcare professionals (HCPs) on the timing of deinfibulation surgery and NHS service provision. Design: Qualitative study informed by the sound of silence framework. Setting: Survivors and men were recruited from three FGM prevalent areas of England. HCPs and stakeholders were from across the UK. Sample: 44 survivors, 13 men and 44 HCPs. 10 participants at two community workshops and 30 stakeholders at a national workshop. Methods: Hybrid framework analysis of 101 interviews and three workshops. Results: There was no consensus across groups on the optimal timing of deinfibulation for survivors who wished to be deinfibulated. Within group, survivors expressed a preference for deinfibulation pre-pregnancy and HCPs antenatal deinfibulation. There was no consensus for men. Participants reported that deinfibulation should take place in a hospital setting and be undertaken by a suitable HCP. Decision making around deinfibulation was complex but for those who underwent surgery it helped to mitigate FGM impacts. Whilst there were examples of good practice, in general, FGM service provision was sub-optimal. Conclusion: Deinfibulation services need to be widely advertised. Information should highlight that the procedure can be carried out at different time points, according to preference, and in a hospital by suitable HCPs. Future services should ideally be developed with survivors, to ensure that they are clinically and culturally appropriate. Guidelines would benefit from being updated to reflect the needs of survivors and to ensure consistency in provision. Study registration number ISRCTN 14710507
20 May 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
27 May 2022Submission Checks Completed
27 May 2022Assigned to Editor
31 May 2022Reviewer(s) Assigned
18 Sep 2022Review(s) Completed, Editorial Evaluation Pending
24 Sep 2022Editorial Decision: Revise Minor
27 Oct 20221st Revision Received
30 Oct 2022Submission Checks Completed
30 Oct 2022Assigned to Editor
30 Oct 2022Review(s) Completed, Editorial Evaluation Pending
09 Nov 2022Editorial Decision: Accept