Today it has been decided that Dr Dhanuson Dharmasena is not guilty of the offence of female genital mutilation (FGM).
The Royal College of Obstetricians and Gynaecologists (RCOG) welcomes this verdict.
The case has established the following key facts:
- Dr Dharmasena did not deinfibulate or reinfibulate his patient, known as AB.
- AB had already been deinfibulated at Kingston Hospital before pregnancy.
- There were no difficulties with vaginal examination in labour.
- The urethra was obscured by a band of scar tissue which Dr Dharmasena incised in order to insert a catheter as there were signs that the baby was in distress
- Dr Dharmasena repaired the bleeding edge of the scar tissue with a single figure of eight suture. The vagina was not closed by the single stitch.
- AB had a further baby within the year without need for deinfibulation.
It is clear that Dr Dharmasena did not perform FGM on AB.
This case highlights the complex issues around the care of female survivors of FGM and the resource implications for NHS services, including early identification and referral, better record-keeping and information-sharing between healthcare professionals. It demonstrates the difficulties and pressures that trainee doctors face in busy labour wards in the immediate postpartum period.
It is vitally important for all clinicians to ensure that they are aware of the law and of the relevant guidance from their professional bodies in fulfilling their roles and responsibilities. Similarly, it is also important to distinguish between FGM/re-infibulation and medically-indicated surgical procedures to correct trauma such as the stitching of perineal or labial tears following labour.
Health Education England’s FGM e-learning programme will address some of the current knowledge and skills gaps and should be a mandatory requirement for all O&G trainees. Consultants should also complete the modules as part of their continuous professional development. The full programme will be available by March 2015.