Abstract In recent decades there has been increased immigration to New Zealand of women from East Africa. These countries have the highest prevalence rates (between 90-97%) of Female Genital Mutilation (FGM) worldwide. FGM therefore has become part of the care experience of some New Zealand health providers. Information on FGM is available on the New Zealand Ministry of Health website. This study captures the experience of a group of East African women in Christchurch who have undergone FGM and given birth in Christchurch Hospitals. Two focus groups, each with ten women, were held so that women could talk about their health services experience. A narrative approach was adopted, listening to their stories in order to explore, to gain insight and to understand how these women felt during reproductive and antenatal care, childbirth and after childbirth. Interviews with three health providers sought their experiences of caring for women with FGM. The study identifies diverse potential explanations with the focus group members telling their stories and identifying issues related to FGM. Several short case histories are presented to illustrate these experiences. The thematic analysis reported four themes: satisfaction with clinical care, concern about infibulation, barriers to knowledge for women, and problems of cross-cultural communication. Health providers reported similar issues, with themes related to their own clinical experience, knowledge gaps, and need for greater cultural understanding and communication. These themes reflect the journey of the East African women with FGM in Christchurch and the challenges faced by them and their providers. This research recommends that women with FGM receive more education and support to manage their relationships with the health system and their own health. Health providers need continuing education and further support in the psychosocial, psychological and physical health needs of East African women living in Christchurch. Service outcomes should be evaluated.

Thesis (M.A.). / Written for the Dept. of Educational and Counselling Psychology. Title from title page of PDF (viewed 2008/01/14). Includes bibliographical references.

Thesis (M.S.)--University of Wyoming, 2007. / Title from PDF title page (viewed on Nov. 3, 2008). Includes bibliographical references (p. 28-31).

Thesis (Ph. D.)--University of North Texas, August, 2008. / Title from title page display. Includes bibliographical references.

Thesis (Ph.D.) in Psychology--University of Maine, 2009. / Includes vita. Includes bibliographical references (leaves 131-151).

Thesis (M.S.) -- Central Connecticut State University, 2006. / Thesis advisors: Connie Tait, James Malley. "... in partial fulfillment of the requirements for the degree of Master of Science in School Counseling." Includes bibliographical references (leaves 71-73). Also available via the World Wide Web.

No description available.

Female genital mutilation (FGM) is defined by the World Health Organisation as the deliberate total or partial removal of the external female genitalia, or other deliberate injury to the female genitalia, which is carried out for non-therapeutic purposes. The practice is widely condemned. Even though the adverse effects of the practice have been well documented in many small studies and case reports, FGM is still common in many countries. The effects of this practice are also being felt in many developed countries due to substantial migration in recent years. One of the limiting factors in encouraging eradication is the availability of high quality evidence of the effects of the practice on the process of childbirth. By highlighting the effects of FGM on the process of childbirth, the objective was to encourage policy makers, in co-operation with many relevant organisations, to work together to eradicate the procedure. This original study investigates the effects of FGM on the process of childbirth using a large international epidemiological case control study involving three centres in three different countries. The inclusion criteria were strict and comprised of agreement by the woman and or her husband to participate in the study, for a normal singleton pregnancy at term with a cephalic presentation which resulted in a normal baby, for the women with and without FGM during the period of study. Women who did not fulfil these criteria were excluded. Maternal outcome measures included length of labour, obstruction to the progress of labour, operative delivery, urine retention, perineal complications, intrapartum and postpartum haemorrhage and blood loss during the process of labour. Newborn outcome measures included birth status at delivery, Apgar scores at 5 and 10 minutes, requirement for resuscitation, admission to special care unit and time taken from delivery to the first breast feed. Psychological sequelae were not assessed. The total number of participants in these three centres was 1,970 women; 526 with no FGM (control) and 1444 with different types of FGM. Every effort was taken to keep confidentiality and not to interfere with management of labour during data collection. The results indicate a highly significant difference between the two groups when comparing length of the process of labour, mode of delivery and the need for instrumental deliveries, episiotomies and tears, blood loss during and after delivery, the need for catheterisation following deliveries and duration of hospital stay following birth. Adverse effects were not confined to women and were found to have extended to the new-borns in the two groups again with highly significant difference with regard to birth trauma, requirement for resuscitation and medical attention. The time taken for the first breast contact was different in the two groups with possible effects which may be difficult to establish and require further research. The data provide clear evidence that the practice of FGM is associated with clinical adverse effects, which are not only confined to women but involve the newborn as well. It is hoped that this systematic and comprehensive collection of evidence will make a substantial contribution to the world wide effort to eradicate this harmful practice.

The aim of this study was to describe the female elf-mutilator's lived experience of cutting herself. A question which would elicit a description of the experience of this phenomenon was formulated. Five self-mutilators were interviewed. The four psychologically richest narratives were chosen for this study. Using the empirical phenomenological method. the four protocols were analysed in detail. Self-mutilation is conceptualized as a cycle wherein the mutilator experiences a diffuse bodily felt-sense that mounts to an unbearable point. She has an irresistible urge to alleviate the distress. She isolates herself and cuts herself with a sharp blade. Upon seeing the blood appear she is overcome with a deep sense of satisfaction. power, and ecstatic pleasure. The blood is perceived to carry the distressing contents out of the body. Concomitantly the self-mutilator recollects a sense of her feelings and her body as belonging to her. Her previously alienated body is felt to be a site of vitality. She also feels removed from further harm. encased in a cocoon of safety that renders her invulnerable to others. However. the cutting can never totally rid the body of distressing feelings. As a result the cycle of cutting wiII be re-enacted. The cutting cycle is conceptualized as a process whereby the self-mutilator suffers from a traumatization of the psyche such that the psychic container is fractured and rendered painfully porous. The act of cutting rids the psyche of unwanted contents such that a sense of going-on-being is restored. The cutting acts to temporarily shore up the rent fabric of the psychic envelope and thereby consolidate a sense of personal boundary. This is a temporary respite from the fracturing of the psychic container in that, once again confronted with interpersonal existence, the self-mutilator begins to feel vulnerable and defenceless. When it seems as if disintegration is again imminent, a cycle of cutting is reconstituted. The findings emergent from the interviews were dialogued with the literature on psychic containers, particularly that which addresses the role of the skin in the formation and functioning of psychic containers.

Thesis (M. Soc. Sc.)--University of Hong Kong, 1998. / Includes bibliographical references (leaves 116-125).