A Maternal Near-Miss: A Case Report of Prolonged Labour Due to Female Genital Mutilation at the Bole District Hospital, Ghana

Abstract

Introduction: Ghana continues to grapple with the complex issue of female genital mutilation/cutting (FGM/C), a practice marked by notable regional disparities. Driven by multifaceted motivations, including deeply ingrained cultural values, perceived benefits for the girl child, and efforts to curb sexual promiscuity, FGM/C poses significant health risks. This article presents a near-miss case of a 19-year-old woman who experienced prolonged labour and postpartum haemorrhage (PPH) due to complications arising from FGM/C. Case Presentation: A 19-year-old woman with a history of FGM/C presented with prolonged labour and PPH. Physical examination revealed Type 3 FGM/C (infibulation) complicated by multiple perineal and vaginal tears. A vaginal delivery was facilitated by bilateral episiotomy, and the episiotomies and lacerations were subsequently repaired. Due to significant blood loss from PPH, the patient received 2 units of whole blood. Fortunately, the mother recovered physically well, with normal urinary and faecal continence, and the baby pair is doing well. However, true recovery in this case will require an enabling environment and supportive care to address her psychosocial needs. Conclusion: We strongly recommend a comprehensive approach to eradicate FGM/C, including awareness creation, strengthening anti-FGM/C laws, and providing a supportive environment that promotes the physical, psychological, and social well-being of victims. Collective efforts by all stakeholders are crucial to achieving this goal and ensuring that women and girls are protected from the harmful effects of FGM/C.