Thanks to years of campaigning to raise awareness and conduct research, it is now likely that midwives will have heard of and received training on female genital mutilation (FGM). Although cases are concentrated in Africa, the Middle East and Asia (UNICEF, 2016), globalisation and international migration have increased the need for UK health professionals to be trained to care for women and girls with appropriate information and cultural sensitivity.
Despite the increasing awareness of FGM, there have been concerns raised that few people know about the equally harmful practice of breast-ironing (Lazareva, 2019), a tradition that originates in west Africa that has been seen increasingly in the UK. The practice involves a hot stone being applied to girls' breasts in order to delay growth and therefore (according to traditional belief) protect them from unwanted male attention, sexual harassment and rape (Lazaeva, 2019). Although official data have yet to be collected, estimates suggest that some 1000 girls have been affected (Haque, 2019).
Breast-ironing is painful and does little to slow breast development. Instead, women may be left with long-lasting physical and psychological scars and may experience difficulties with breastfeeding due to cysts or infections (Lazareva, 2019).
This increased awareness is likely to result in more cases of breast-ironing being diagnosed and recorded, hopefully allowing effective data collection in future. However, the cases that have already been reported should be a sufficient impetus for the provision of training and tools to professionals with responsibility for healthcare, education and safeguarding. As a result of the campaigns that have increased awareness of FGM, teachers, GPs, and midwives could be trained along similar lines to care for women who have undergone breast-ironing in a way that is proactive, rather than reactive.
Cases of FGM, breast-ironing and other practices where women's rights to their own bodies are limited or overruled highlight midwives' roles as ‘defenders of women's rights'—the theme for International Day of the Midwife 2019. This year, the celebration, which takes place on 5 May, focuses especially on countries where women's rights have been curtailed or subjugated to the control of others, and highlights how midwives do much more than care for women during pregnancy and birth. Midwives may advocate for the rights of women to receive qualified medical care, offer contraception to women in countries or societies where it is banned or limited, or even hold perpetrators of violence against women accountable (International Confederation of Midwives, 2019).
While breast-ironing is uncommon in the UK, traditional practices—like women themselves—are no longer confined to individual countries or regions. International Day of the Midwife is therefore a timely reminder of the global outlook that midwives need in order to care for women with information and sensitivity.