Doctor cleared of FGM and I feel so conflicted about it

[StrumpersPlunkett]

I have looked for a thread but can't find one.
he was the ob/gyn after her birth.
she had been mutilated as a child and upon request (not sure who from) he restitched.

NOW, is it ever right in the first place - no
but after 20+ (guess) years of having been stitched what damage is inflicted through birth and how can it be fixed? IF it was the ladies wish to be restitched (I don't know if that is the case) what should happen?

It was her husband who requested she be restitched, the patient was reluctant at first about being restitched.

she had been mutilated as a child and upon request (not sure who from) he restitched.

That is not what I've read. I read that a tear occurred in childbirth and he sutured it to stop the bleeding.

Presumably the jury listened to the actual evidence here?

I do totally trust the jury system and 7 women and 5 men found him not guilty I am not suggesting they got it wrong, but I do find it uncomfortable.

So truffle has she not been restitched then?

This article implies she was sutured as any woman who had to have an episiotomy would be. It seems that she had to have an episiotomy because she had been mutilated as a child. I've only read accounts whereby he then repaired the wound with a stitch - as he would with any other episiotomy - I haven't read any articles which stated he redid the FGM (she had type 3 - whereby the labia is sewn up).

For sure op there should be far far more investigations and prosecutions for this dreadful child abuse.

Religious practises/cultural norms that break the law should be investigated.

The authorities are being woefully inadequate and neglectful here

Child abuse crosses all cultures and religions and none should be untouchable or above the law.

thank you truffle that is a more informed article than the snapshot I had seen on another site

From that Guardian article alone, I can't understand how the case ever made it to court.

"The charge against Dharmasena was announced in March 2014 in a high-profile statement by the director of public prosecutions, Alison Saunders, following political and media pressure on the police and Crown Prosecution Service at the failure to prosecute anyone for the offence since FGM was outlawed in the UK in 1985."

I think there's your answer, SoupDragon.

It seems clear that there are a hardcore of doctors (or others) performing and facilitating FGM in this country - investigation after investigation has shown this - so I have no idea why they decided to go to this court with this case. I feel so disappointed that a doctor who appears to have done nothing more than repair a wound has been sucked into this when the real perpetrators have been allowed to carry on with business as usual or three decades.

sigh

Something must be done.
This is something.
Something has been done.

ok I guess my post was a bit more of a pondering of a supplemental question.
Does a woman have the right to be restitched (albeit an illegal initial proceedure) if that is what SHE wants after the birth of a child?
or also what state are these poor women left in after the birth of a child is it possible that the return to the previous state (however hideous a thought) is ever the right thing medically?

Not at all sure I have worded any of that correctly I hope you get the direction I am trying to take this..

I thought that what stood out with this case is that a birth complication on a woman who has been mutilated isn't something that many Drs in the Uk had seen before. I thought he had to stitch her to stop her bleeding, as the episiotomy would have cut through more than on an unmutilated woman?

I don't understand who actually claimed this was a crime in the first place to be honest.

Please consider changing the thread title as 'FGM doctor' feels unfair given the not guilty verdict.

It is extremely difficult to stitch an area where there is extensive scarring - as there is after FGM. This doctor was trying to sew up an episiotomy. There would not have been a clear cut distinction between where the tear made in labour stopped and the remains of her FGM started - the entire anatomy is distorted by the scarring from FGM so - as the doctor - you can't simply say "I'm going to suture the birth injury and leave out any of the FGM scar tissue". You have to achieve enough closure to bring the torn area together & stop bleeding.

It is clear from the evidence in this case that he thought he was doing the right thing to leave the patient as comfortable as possible after the birth injury. It is a matter of judgement how much stitching you do in these cases and we don't always get it right - plenty of women without FGM scars end up with too tight sutures because, at the time you are suturing, the area is swollen, bloody and doesn't look the same as it will a few days later. The doctor sought advice from senior colleagues afterwards, who reassured him he had treated her appropriately. Very senior obstetricians backed him, as did the patient herself.

FGM is an appalling crime. However, it is very wrong to subject a HCP to prosecution when it was clear from the outset that he had no intention to subject her to FGM. He was trying to treat her appropriately. You can argue that he should have placed the stitch (a single stitch) slightly differently , but this is a matter of professional judgement, not a crime.

The CPS is embarrassed about its failure to prosecute any actual perpetrators of FGM so went after the soft target of a doctor who was trying to do his best by a patient. I think that is appalling - bordering on corrupt - and am delighted he was acquitted.

Does a woman have the right to be restitched (albeit an illegal initial proceedure) if that is what SHE wants after the birth of a child?

If it's not a necessary procedure then no. She would need to find someone willing to perform the surgery afterwards (illegally).

I think it was fairy clear from the beginning that this doctor was probably in a situation where he had to repair a pretty horrific birth injury and control potentially life threatening bleeding.

In an emergency situation you do your best for the patient. There isn't usually time to weigh up all the ethical and moral aspects, although, most of us try to make the best decision at the time.

I feel sorry for the doctor TBH. I think he was used as a political scapegoat and an easy target.

I think the only way we will stop it is if we outlaw MGM too tbh. That is quite hard for me to say as it is practiced by our religion and my DH had it done. I said no re. both sons, but even though I felt I made the right decision, I did feel a little uneasy about any potential consequences, so whilst I think that it is absolutely abhorrent, I can understand why it is still prevalent.

Unless there's some serious misreporting in the Guardian article, then I'm profoundly depressed that this case was ever prosecuted.

Everything lalalonglegs and Lurking, and good few others, said.

How could this poor woman get to the point of delivery and no one notice that she would need a FGM pathway?

I think the only way we will stop it is if we outlaw MGM too tbh

I don't honestly see what this has to do with the thread, or indeed how stopping MGM will impact on FGM

I assume you are talking about circumcision?

OK DH just home and suggested that by sacrificing this poor young doctor it has pressured NHS trusts to make more of an effort to provide quidance andt training to doctors who may be faced with the after effects of this hideous abuse..

I will ask for thread title to be changed - very fair point.

Good question blushing, but I suppose it is possible that she did not disclose it and did not consent to antenatal examinations, perhaps out of embarrassment.

It is clear from her comments that she was wholly against the case and has been traumatised by it. I realise that alleged victims of crimes do not make the decision whether or not to prosecute but, in this case, surely her views should have been taken into account? Having been subjected to a horrible crime in childhood, she is then traumatised by being dragged into a 5 year court case about her body.

Reading the article, the doctor was not aware of the previous FGM and did the best he could at the time to stitch the lady with the intent of minimizing damage and bleeding, not to 'reclose' her. In the circumstances, I think he did what he could, by the sound of the article. It seems the jury agreed. It does seem odd that the case got to court.

Regardless of the fact that she may not have disclosed her FGM, I think that the hospital was incredibly insensitive in allowing two male HCP to attend her delivery. I can only imagine her horror at being sewn up by a male doctor as another encouraged him.