Stop Cutting
The Right to Bodily Integrity

by Jane Beal

[Editor’s note: This is an excerpt of an article which appears in Midwifery Today, Issue 120, Winter 2016. View other great articles and columns in the table of contents. To read the rest of this article, order your copy of Midwifery Today, Issue 120.]

A few years ago, I sat down to talk with a midwife who had returned from West Africa to Wheaton, Illinois. She told me about a night in the village where she served when approximately thirty prepubescent girls, between the ages of five and ten, were ritually cut by a man, a visiting “circumciser,” all with the same knife, one after another, without any kind of painkiller. Their screams filled the night air. As soon as she could, the very next day, the midwife got to each girl, assessed the damage and did repairs. Because she was in a remote location, without sufficient suturing supplies, she told me, “I was sewing them up with dental floss.” I will never forget my sister-midwife’s weariness or the memory of trauma that lingered within her as she leaned her head into her right hand and closed her eyes as she finished telling me this.

Definitions and Complications

According to the World Health Organization, cutting or female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to female genitalia for non-medical reasons. FGM is classified into four types:

Others have made this point before, but it bears repeating: Female genital mutilation takes place in the developed world on a large scale in the form of medically unnecessary episiotomies and caesarean sections, or what could be classified as FGM Types 5 and 6.

Type 1: Often referred to as clitoridectomy, this is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).

Type 2: Often referred to as excision, this is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva).

Type 3: Often referred to as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy).

Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g., pricking, piercing, incising, scraping and cauterizing the genital area.

Jane Beal is a writer, educator and midwife. She has served with homebirth practices in the Chicago, Denver and San Francisco metro areas and in birth centers in the US, Uganda and the Philippine Islands. She is the author of Epiphany: Birth Poems and Transfiguration: A Midwife’s Birth Poems. She currently teaches at UC Davis. To learn more, please visit and

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