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| FGM: Top gynaecologist hits out at ‘political’ prosecution for female genital mutilation | FGM: Top gynaecologist hits out at ‘political’ prosecution for female genital mutilation |
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| A leading gynaecologist has launched a devastating attack on the decision to bring the first prosecution against a doctor for female genital mutilation (FGM) in Britain. | A leading gynaecologist has launched a devastating attack on the decision to bring the first prosecution against a doctor for female genital mutilation (FGM) in Britain. |
| Dr Katrina Erskine, consultant gynaecologist and head of obstetrics at Homerton Hospital, Hackney, said she was angered by the case selected for the first prosecution because it gave a “misleading” impression of FGM, and risked deterring other doctors and midwives from giving appropriate care to affected women. | Dr Katrina Erskine, consultant gynaecologist and head of obstetrics at Homerton Hospital, Hackney, said she was angered by the case selected for the first prosecution because it gave a “misleading” impression of FGM, and risked deterring other doctors and midwives from giving appropriate care to affected women. |
| Dr Erskine accused the Director of Public Prosecutions (DPP), Alison Saunders, of putting politics before the welfare of women by announcing the historic prosecution days before she is due to appear in front of the Home Affairs Select Committee at its hearing on FGM on Tuesday. | Dr Erskine accused the Director of Public Prosecutions (DPP), Alison Saunders, of putting politics before the welfare of women by announcing the historic prosecution days before she is due to appear in front of the Home Affairs Select Committee at its hearing on FGM on Tuesday. |
| The DPP had been under intense pressure to explain why there have been no prosecutions in Britain despite 140 referrals to police in the last four years. “I cannot help suspecting she needs something to say,” Dr Erskine told The Independent. | The DPP had been under intense pressure to explain why there have been no prosecutions in Britain despite 140 referrals to police in the last four years. “I cannot help suspecting she needs something to say,” Dr Erskine told The Independent. |
| Ms Saunders announced last week that the Crown Prosecution Service (CPS) had decided there was sufficient evidence to press ahead with the case against Dr Dhanuson Dharmasena, 31, a registrar in obstetrics and gynaecology at the Whittington Hospital, London, for allegedly carrying out FGM on a patient. Hasan Mohamed, who is believed to be a relative of the patient, has been charged with aiding and abetting the doctor. | Ms Saunders announced last week that the Crown Prosecution Service (CPS) had decided there was sufficient evidence to press ahead with the case against Dr Dhanuson Dharmasena, 31, a registrar in obstetrics and gynaecology at the Whittington Hospital, London, for allegedly carrying out FGM on a patient. Hasan Mohamed, who is believed to be a relative of the patient, has been charged with aiding and abetting the doctor. |
| FGM is normally carried out on young girls, but the charges in this case relate to an adult woman who had just given birth. The woman had previously undergone FGM and it was alleged that in repairing her vagina following the birth, Dr Dharmasena carried out FGM himself, the CPS said in a statement. | FGM is normally carried out on young girls, but the charges in this case relate to an adult woman who had just given birth. The woman had previously undergone FGM and it was alleged that in repairing her vagina following the birth, Dr Dharmasena carried out FGM himself, the CPS said in a statement. |
| Campaigners have already hailed the first case as a breakthrough in their battle to drive out the practice, which is estimated to affect 140 million women worldwide. | Campaigners have already hailed the first case as a breakthrough in their battle to drive out the practice, which is estimated to affect 140 million women worldwide. |
| But Dr Erskine’s criticisms, coming from a senior gynaecologist with wide experience of FGM, will alarm the CPS – which urgently needs a successful prosecution. | But Dr Erskine’s criticisms, coming from a senior gynaecologist with wide experience of FGM, will alarm the CPS – which urgently needs a successful prosecution. |
| Dr Erskine said other obstetricians were outraged over the decision to prosecute and warned it would distract attention from the real problem of FGM – the removal of the outer genitals – as opposed to the repair of the vaginal opening after a woman who had previously undergone FGM gave birth. “I am really cross about this. We have a very high prevalence of women with FGM at the Homerton and we are used to dealing with it. FGM is horrendous and barbaric and no one is trying to pretend it is not. | Dr Erskine said other obstetricians were outraged over the decision to prosecute and warned it would distract attention from the real problem of FGM – the removal of the outer genitals – as opposed to the repair of the vaginal opening after a woman who had previously undergone FGM gave birth. “I am really cross about this. We have a very high prevalence of women with FGM at the Homerton and we are used to dealing with it. FGM is horrendous and barbaric and no one is trying to pretend it is not. |
| “We heard about the prosecution on Friday and everyone is up in arms. It will put off midwives and doctors involved in caring for women with FGM and it distracts from where our main focus should be which is on driving out the real practice of FGM which is barbaric. I cannot help suspecting this has something to do with the DPP being up before the Home Affairs Select Committee and she needs something to say.” | “We heard about the prosecution on Friday and everyone is up in arms. It will put off midwives and doctors involved in caring for women with FGM and it distracts from where our main focus should be which is on driving out the real practice of FGM which is barbaric. I cannot help suspecting this has something to do with the DPP being up before the Home Affairs Select Committee and she needs something to say.” |
| FGM is carried out in varying degrees, normally before puberty. The most extreme “Type III” involves cutting the clitoris and labia minora (inner lips of the vagina) and sewing together the labia majora (outer lips) to leave a small hole through which urine and menstrual blood can pass. | FGM is carried out in varying degrees, normally before puberty. The most extreme “Type III” involves cutting the clitoris and labia minora (inner lips of the vagina) and sewing together the labia majora (outer lips) to leave a small hole through which urine and menstrual blood can pass. |
| Dr Erskine said: “The size of the opening varies. I have seen women with just a pinhole. It is usually big enough to have sex but not big enough for a baby to come out.” | |
| At Homerton Hospital, women who have undergone this FGM are offered the opportunity to have the opening extended in preparation for the birth before the baby arrives in a process called defibulation. However, in some cases this is not done until after labour has started. After birth, stitching can be necessary to stem the bleeding, Dr Erskine claims. | At Homerton Hospital, women who have undergone this FGM are offered the opportunity to have the opening extended in preparation for the birth before the baby arrives in a process called defibulation. However, in some cases this is not done until after labour has started. After birth, stitching can be necessary to stem the bleeding, Dr Erskine claims. |
| “There is a world of difference between slicing off a woman’s clitoris and labia minora and putting some stitches in if a woman is still bleeding [after giving birth]. What do you do? You have to stop any bleeding and that inevitably involves some suturing [stitching]. It would be completely misleading to call this FGM. The end result might look like FGM but it is not. This is conflating FGM with how to treat women post-labour.” | “There is a world of difference between slicing off a woman’s clitoris and labia minora and putting some stitches in if a woman is still bleeding [after giving birth]. What do you do? You have to stop any bleeding and that inevitably involves some suturing [stitching]. It would be completely misleading to call this FGM. The end result might look like FGM but it is not. This is conflating FGM with how to treat women post-labour.” |
| FGM is widely practised in parts of Africa and the Middle East but the scale of the problem in Britain is hard to assess. The Metropolitan Police has reported receiving 140 “references” to FGM in the four years from 2009-13, and the National Society for the Prevention of Cruelty to Children launched a helpline last year after claiming 70 women and girls a month were seeking treatment for FGM. | FGM is widely practised in parts of Africa and the Middle East but the scale of the problem in Britain is hard to assess. The Metropolitan Police has reported receiving 140 “references” to FGM in the four years from 2009-13, and the National Society for the Prevention of Cruelty to Children launched a helpline last year after claiming 70 women and girls a month were seeking treatment for FGM. |
| Dr Erskine said: “I have yet to see anyone born in the UK who has had FGM. I know it happens, but it is rare. All the women I have seen with FGM were born outside the UK and were cut before they arrived here.” | |
| The mistaken beliefs around FGM included that it was more hygienic, that a woman was guaranteed to be a virgin when she married, that it preserved fertility and that it made women more attractive. “Mothers inflict it on their daughters because they believe they won’t get a husband without it ,” she said. | The mistaken beliefs around FGM included that it was more hygienic, that a woman was guaranteed to be a virgin when she married, that it preserved fertility and that it made women more attractive. “Mothers inflict it on their daughters because they believe they won’t get a husband without it ,” she said. |
| “This is where we should be putting our efforts – helping women to understand why it is wrong. Not on some poor doctor who may or may not have put some stitches in the wrong place.” | “This is where we should be putting our efforts – helping women to understand why it is wrong. Not on some poor doctor who may or may not have put some stitches in the wrong place.” |
| A CPS spokesperson said: “The decisions to charge Dr Dharmasena and Hasan Mohamed were made in accordance with the Code for Crown Prosecutors following careful consideration of all the available evidence” | A CPS spokesperson said: “The decisions to charge Dr Dharmasena and Hasan Mohamed were made in accordance with the Code for Crown Prosecutors following careful consideration of all the available evidence” |