Challenges in providing quality care for women with female genital cutting in Sweden - A literature review.

Due to migration, health care needs in relation to female genital cutting (FGC) are increasingly emerging in European health care contexts, with Sweden being no exception. Recent estimates suggest that up to 38 000 girls and women with some form of FGC are living in Sweden, the majority from Somalia. Despite receiving high numbers of immigrants from FGC practising countries, health care services in many European countries seem largely unprepared in caring for circumcised patients. This literature review aims to identify challenges involved in providing quality care for circumcised women in Sweden. Two themes were identified; lacking technical skills and communication problems and ethnocentric attitudes. Lacking technical skills involved midwives and gynaecologists feeling insecure in how to technically deal with infibulated women during childbirth, something that often resulted in ad hoc solutions and improvisation. They related this insecurity to a lack of theoretical and practical training of FGC related health problems. In communication problems and ethnocentric attitudes both health care professionals and circumcised women reported facing difficulties in communicating about FGC, largely due to language barriers and perceived sensitivity of the issue. In conclusion, skills among health care professionals in Sweden caring for circumcised patients could be strengthened. This should be taken into consideration when planning midwifery and gynaecology curricula, and in providing in-service training for health care professionals likely to meet circumcised women in their practice.