Landmark FGM case: Doctors found not guilty

A landmark criminal case in London in which two doctors were prosecuted for performing and abetting female genital mutilation (FGM) has resulted in the speedy acquittal of both. Dr Dharmasena was charged with re-infibulation—restoring FGM after the birth having previously performed defibulation to allow for the baby to be born. A second doctor was charged with abetting the procedure.

The woman (known as AB), aged 24 and expecting her first baby, originally had the Type 3 FGM procedure performed at 6-years old in her native Somalia. Type 3 refers to infibulation, which the World Health Organization (WHO, 2014) defines as ‘narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris’.

A revision of the procedure was carried out on AB in 2011. During the pregnancy she apparently told a midwife, ‘It's fine, it's opened’, with reference to this second procedure (Laville, 2015). The midwife did not verify this. The relevant hospital's procedure on FGM (in line with National Institute for Health and Care Excellence guidance (NICE, 2014) was to identify it as early as possible during the pregnancy through sensitive enquiry, and then to plan intrapartum care, which in cases of extensive FGM may mean defibulation prior to the birth. However, this did not happen and AB arrived at the hospital in labour in November 2012. Dr Dharmasena, an obstetric registrar, cut through the scar tissue to facilitate the birth and prevent significant tearing. After the birth, he re-sutured the labia in what was described as a ‘figure of eight’ continuous stitch (Bloom, 2015). The midwife present at the birth observed this and noted privately to Dr Dharmasena that this was illegal as it constituted re-infibulation. Dr Dharmasena referred to the consultant obstetrician who said it would be ‘painful and humiliating’ to have the stitch removed, so it was left in situ.