Chapter 19: Advanced skills for pregnancy and birth
Emergency care for FGC
A girl whose genitals were recently cut can have serious problems including
bleeding and infection, both of which can lead to shock — which is an emergency.
Girls whose bleeding cannot be stopped need medical help right away. Midwives
can help these girls by stopping the bleeding, treating for shock, and watching for
signs of infection.
Bleeding and shock
Wa r nin g sig ns of shock (one or more of the following):
• severe thirst
• pale, cold, and damp skin
• weak and fast pulse (more than 100 beats a minute)
• fast breathing (more than 20 breaths a minute)
• confusion or loss of consciousness (fainting)
What to do for bleeding or shock
• Get medical help immediately.
• Press firmly on the bleeding spot right
away. Use a clean, small cloth that will
not soak up a lot of blood. Keep the girl
lying down with her hips elevated while you take her to get medical help.
• Help her drink as much as she can.
• If she is unconscious and you are far from help, you may need to give her
rectal fluids (see page 342) or IV fluids (see page 350) before transporting her.
If a cutting tool is not sterilized before and after each use, germs on it can cause a
wound infection, tetanus, HIV, or hepatitis.
Wa r nin g s ig n s
• wound infection: fever, swelling in the genitals, pus or a bad smell from the
wound, and pain that gets worse
• tetanus: tight jaw, stiff neck and body muscles, difficulty swallowing,
• shock: (see the list above)
• infection in the blood (sepsis): fever and other signs of infection, confusion,
WARNING! If a girl begins to show signs of tetanus,
shock, or sepsis, get medical help right away.
A Book for Midwives (2010)