The Haamla Service and Perinatal FGM Service

in Leeds

Sarah BennettSpecialist Midwife, BME women

Bi-lingual Maternity Support Workers

Haamla Midwives

VolunteerDoulas

Haamla Antenatal

Groups

Perinatal FGM Service

Health Needs

AnalysisTraining

Research & Audit Evaluation

Bi-lingual Maternity Support Workers

• Ward visits• Home visits• Feeding support• Bereavement support• Advocacy support

Volunteer Doulas

• 12 weeks training course• Open College Network accredited• Antenatal/Birth/ Postnatal support • Regular supervision• On-going training She was very nice

and supported. She help me a lot in labor. I am very thankful to her

She was amazing. This project is

something really good for women

Antenatal Groups

• Women only• Community based• Interpreters provided• Women led topics• Attachment focussed

The information provided was very useful for me that I

knew what to expect and have an idea

what to do with my baby

I enjoy coming every week and have opportunity to

discuss what I want and talk to other pregnant women

Please keep alive this

program for all new Mums in

the future

Haamla Midwives

• Caseload:Asylum seekersDestitute asylum seekersHomeless womenGypsy TravellersSome new migrants

There is not enough words to explain how much I

satisfied with your midwife team. I feel I was in safe

hands

I thank you for all your wonderful

support you gave me during that period

Perinatal FGM Service

“All procedures which involve, partial or total

removal of the female external genitalia, or any

other injury to the female genital organs, for

non-therapeutic reasons”

Also:IndonesiaMalaysiaAfghanistanIranIsraelOmanPalestineUnited Arab EmiratesIndiaPakistan

(UNICEF 2013)

Reasons/Beliefs Sustaining FGM• It brings status and respect to the girl. It is a rite

of passage.

• It preserves a girl’s virginity/chastity. It is part of

being a woman.

• It gives a girl social acceptance, especially for marriage.

• It upholds the family honour. It perpetuates a

custom/tradition.

• It cleanses and purifies the girl. It is

aesthetically desirable.

• It gives the girl and her family a sense of belonging to the community.

• It fulfils a religious requirement believed to exist.

• It helps girls and women to be clean and hygienic.

• It is mistakenly believed to make childbirth safer for the infant.

• It rids the family of bad luck or evil spirits.

Rationale for FGM service Physical, Psychological, Sexual Health Consequences:Short Term

Pain, severe bleeding, urine retention, infection, broken bones, death

Long TermChronic pain, cysts, abscesses, ulcers, scarring, recurrent infections, sexual

dysfunction, subfertility, chronic anxiety, phobias, depression, PTSD

Pregnancy/Childbirth Mother Increased risk of: recurrent urine infections, LSCS, severe

perineal or vaginal trauma, severe bleeding, extended hospital stay Baby Increased risk of: poor condition at birth, low birth weight, SB, NND

Leeds Midwife led FGM ServiceAims Reduce FGM morbidity & mortality

Improve women’s maternity care experience

Prevent FGM/Protect children

Meet midwives/obstetricians training need

ElementsTraining

FGM Clinic

LTHT FGM Clinical Guidelines/Care Pathway

Training Pre-registration training at University of Leeds undergraduate midwives

Mandatory training for postgraduate midwives

Shadowing/observation in FGM clinic

Colleagues in other departments

Leeds Safeguarding Children Board

LTHT Maternity Care Pathway

Prevalence FGM Clinic Data 2014 (n133)

New estimates, commissioned by BHI, using the 2011 Census data indicate that between 1,003 and 2,667 women and girls in Leeds have undergone, or are at risk of, FGM

What do the women say?

Is very nice service, I really

love it, thank you very much. God

bless you

It was good to see you today, we learned a lot. We can now share the knowledge we have with our community to help

protect girls and stop circumcision from happening

Everything is now good

Friendly service, very informative

On-going support services• Black Health Initiative (BHI)• Solace• Psychology Services

• City wide FGM Steering Group

• Gaps in provision – Opportunities for funding….

Contact details

sarah.bennett4@nhs.net

0113 2066392

Any questions?

ReferencesWaugh M. 2010. Mothers in Exile. Womens Health Matters: Leeds.Bennett S, Scammell J. 2014. Midwives caring for asylum-seeking women: research findings. Practising Midwife. 17:1 pp9-12.RCM. 2013. Tackling FGM in the UK – Intercollegiate recommendations for identifying, recording and reporting RCM London https://www.rcm.org.uk/sites/default/files/FGM_Report.pdf.HM Government. 2011. Multi-Agency Practice Guidelines: Female Genital Mutilation https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216669/dh_124588.pdf .Macfarlane A, Dorkenoo E,. 2014. FGM in England and Wales: Updated statistical estimates of the numbers of affected women living in England and Wales and girls at risk Interim report on provisional estimates. City University, London.HM Government. 2013. Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children. London: Stationery Office.NMC. 2008. The code: Standards of conduct, performance and ethics for nurses and midwives http://www.nmc-uk.org/Documents/Standards/The-code-A4-20100406.pdf.West Yorkshire Consortium Procedures Manual. 2014 http://westyorkscb.proceduresonline.com/chapters/contents.html