Not guilty verdict in FGM case - what do we think?

[Amethyst24]

www.bbc.co.uk/news/uk-england-31138218

It did seem like an intractable case with which to test the legislation, and it does appear the doctor was put in a position in which he had no idea how best to proceed. But I think it's encouraging that other medical staff are reacting when they see victims of the crime.

"They shared no cultural background at all and there is no culture of FGM in Sri Lanka."

This is not accurate. Sri Lanka is 10% Muslim and they do have FGM as such.

"It is apparent that a form of genital incision is practiced on infant girls four to five weeks after birth on the rationale of circumcision. The practice involves making a tiny incision on some part of the female genital area and is performed by a traditional midwife or female elder to draw blood. Though the women confirmed that their daughters were subject to this ritual, none of those interviewed had participated in the ritual itself nor witnessed the procedure. They said that they felt obliged to follow the custom, even though it distressed them to even talk about the ritual. One mother cried when she spoke about it carried out on her infant daughter. "

It is not comparable to the FGM in Somalia, however - it wouldn't cause childbirth complications.

Agree, chunderella. Sometimes it is necessary for things to be done and should be possible but made clear to all involved. I think too often no thought is given to the most vulnerable people and there is a lack of honesty.

That seems to be one of the problems. I don't think anyone sensible would say these aren't enormously difficult problems which throw up many issues that need specialised knowledge. No one sensible wants trial by social media or mob rule. There is huge pressure on large organisations like the police, nhs and cps and I am glad I am not bloody running one of them. But at the moment I think they don't do themselves any favours.

Seriously? Little girls living in the UK are undergoing FGM now at the estimated rate of 500 per year and rising and this, seriously, THIS is the best they can dig up for a first prosecution? Way to go, CPS. That poor man.

Jesus wept. What a fucking joke. This is the best example of fiddling while Rome burns I think I have ever seen.

I feel really sorry for the doctor and how this miscarriage of justice has ruined him.

Alison Saunders was just under pressure to bring a case. And a lot of the leading Obs profs in this country told her they didn't agree. But the case was still pushed on, to the CPS anyway.

It does make a mockery of our justice system. And I don't think it's done FGM much good either.

Dino, yes I do consider a person who carries out the incorrect procedure, and illegal procedure, to be unprofessional.

When I was a teacher people were lining up to tell us we were unprofessional for not keeping track of every single piece of every child's unlabelled clothing, or for raising our voices slightly now and again.

Certain human mistakes under pressure are understandable. But it is still unprofessional for an obs and gynae doctor not to know the guidance on something so fundamental to his job. Whether that lack of professionalism was down to him or down to a hospital with poor induction and training, remains to be seen. It's not worth prosecuting him for, at all, but it is worth doing something about.

Was listening this morning on BBC R4 of harrowing account from a woman when she was young, initially told how she was having a party as part of her becoming a woman, gifts, dress etc then as things progressed to a room with a bowl of ice water be being pinned by women while one cut her. She is still haunted today by the womans face.

I still wonder how you can fight this, is it just hoped that education will work, though I struggle to see this stopping girls being spirited away on 'holidays'. (same for forced marriage)

The fact that most of FGM goes on in North Africa - Somalia, Egypt and Sudan etc, is presumably where the main issues needs to be addressed. But that is very difficult because it is deeply entrenched in the way they think and view women, marriage, everything.
This is not an easy thing to address.

cailindana, oh, so you have no medical training or experience then?

Perhaps you are not entirely qualified to be calling him 'shoddy and unprofessional' (in the same way that parents called you unprofessional when you taught - your example nicely demonstrates that people sometimes bandy around that word without really knowing what they are talking about)?

So what would you have done with a bleeding wound? How easy is it to tell what wound is fresh or older looking at a perineum that has undergone FGM (and previous surgery to correct it along with another attempt to correct it during labour), just delivered a baby and had an episiotomy?

His behaviour was very professional: fix a bleeding wound in what he considered to be best way to stop the bleeding (with no intention to harm the patient or to do FGM), attend the next patient, review his care with his consultant, who saw no reason to redo the stitches.

As much as you want to make it black and white, it's really not that easy.

chaiselounger, I would hope that this miscarriage of justice hasn't ruined him as he does seem to have the support of a great many eminent Obs folk who are now hopefully looking after and looking out for him. It's not over for him yet though, of course. He still has to go to the GMC.

The CPS tried to turn him into the scapegoat for all those despicable people who are performing FGM here in the UK and those taking their daughters out of the country so that FGM can be performed. Let's hope that the GMC see this case for what it is and that he can get his life and career back on track as soon as possible.

His behaviour was very professional: fix a bleeding wound in what he considered to be best way to stop the bleeding (with no intention to harm the patient or to do FGM), attend the next patient, review his care with his consultant, who saw no reason to redo the stitches.

I don't think he should go to jail, but the time to query what to do in the situation is surely then not later? Or even read up on what to do in these circumstances? He admits he fucked up there.

• Or even read up on what to do in these circumstances before he deals with them

I'm not even sure what we're arguing about Dino. He did the wrong thing. He admits it. He should have known what to do in that situation, but he didn't. He tried to rectify it. He was unfortunately prosecuted for it, which is wrong in my view.

If as a teacher, I had manhandled and pupil and injured them because I didn't know how else to deal with the situation, would you not consider that unprofessional? I may have protected that child from hurting themselves (say in a situation where the child was drifting into danger due to misbehaviour) so overall the outcome was good, but I would still expect to have fingers pointed at me for not knowing how to deal with that situation better.

When will this horrible practise be stopped. Putting young babies and children through all of this is not acceptable. Its not cultural, its a horiffic practise that the whole world should rally around and stop. Its also a issue against women and their rights.

This case was not a good one to bring to court. Lets get someone who has actually performed FGM and been caught doing it, dont care whether its a doctor or some deluded person but lets get them up in front of a jury.

I read: Straight after Doctor did it, he was called away. To another emergency - a C-section? He then went to find his senior , telling him that he had done a stitch, a figure of 8, and wasn't sure if he had done the right thing.

The Doctor made a split second decision. Was called to another emergency and then found his senior.
What else/more exactly do we expect him to have done?

Chaise, I presume (though I don't know) that if a doctor is right in the middle of a situation that need immediate attention, such as the bleeding this woman was experiencing, then they can't be called away? What I mean is, if he'd been up to date on what to do, he'd have said he wasn't available to be called away to the C-section as he was still dealing with an ongoing situation with his current patient. That would have given him time to pack the wound and get a consult on what to do (if such a thing was possible).

Now, it might be the case that they were severely understaffed and it's for that reason he made a snap decision - he dealt with the bleeding as quickly as he could and then went to the next emergency. In that case the hospital's organisation is at fault. It should be possible for each patient's case to be dealt with fully and correctly before a doctor has to leave.

Whether or which, it seems to me that the woman presented with a complex emergency. She should have had more time and attention devoted to her than she had. She was given the bare minimum, which turned out to be an illegal procedure. There were multiple failings along the way and it is very unfair this doctor was made to bear all the burden.

He should have said he was not available to be called away to an emergency C section? When he was the obs reg on duty on the labour ward?

Seriously?

What if the mother and baby needing the C section had both died?

Was this women a UK resident and does anyone know whether they are assuming this procedure was done here?

I suspect there is an underground group of people i the UK who are carrying out these horrible acts. Those are the people to catch but tbh - what 6-7 year old girl is going to march into a police station and report what has just been done to her along with names??

It reminds me of people who want to go privately for maternity care at a large teaching hospital because if anything went wrong they would be on site to call on the NHS teams.

Does anyone really think that in the event of an emergency the NHS will be waiting outside the door ready to rush in and save you. They can only be in one place at a time and errors, understaffing is rife.

Before anyone is wondering - I didnt do this!

Also, was this not picked up during routine maternity care? I presume the family didnt want to reveal it had been done and only at the birth was it revealed.

Somalia has a lot to answer for then. I know its one of the main countries to still practise this.

Shame on them

Somalia has a lot to answer for? It doesn't even have a functioning government, does it?

Hillingdon - I made the point on the other thread that the woman may not have had any antenatal care.

I worked in hospital in North London for many years - it is not uncommon for women to just turn up in labour, having been previously unknown to any HCP.

3 - how awful. I understand that Somalia is a troubled country but tbh - that is no excuse. Individuals are making these choices and performing these procedures on their own children. Its I guess nothing to do with the government - its not as though they are telling people to do it.

People of their own accord are inflicting this on their OWN children. I really dont care whether it is cultural, part of their beliefs etc. I dont care whether it sounds racist or I am coming out against their own personal beliefs.

Its a vile thing to do and please no one say they are simple people who are just following the beliefs going back 100's of years. Please dont....

Cailindana you couldn't be more wrong about it being impossible to call a doctor at one emergency away to attend another.

This happens all the time.

It's a case of assessing what's the biggest emergency. In Obs, going to a crash section would trump practically everything else. On a bad day (which it sounds like this was) you will just be dashing from crisis to crisis hoping to finish each one as best and safely as possible with no time to think if every aspect of your management was completely perfect.

Hillingdon - the issue was it was picked up during maternity care but not dealt with effectively. The woman had had surgery to release her labia and vagina to allow her to get pregnant. The midwife had asked her if she was closed up, the woman said no it was all open but instead of referring her to the FGM clinic for proper checks, it was left at that. She turned up in rapidly progressing labour for them to find out it wasn't all open and she needed emergency treatment by a doctor who had never done it before to allow her to deliver her baby. The woman stated in court the doctor had saved her baby's life. She and the doctor were badly let down by the failure of her ante-natal care.