Saima is a 16 year old high school student who presents seeking advice for pregnancy termination. She emigrated to London, Ontario, Canada when she was 4 years old with her family from the Sudan. She has adapted quite well to the culture here and enjoys Canadian life.
Saima became pregnant at a party recently. She and her boyfriend, Kyle, had been getting along well, but she was quite hesitant about engaging in sexual intercourse. She was uncomfortable when the situation was brought up and you understand that this was because she had surgery as a young girl in the Sudan. She asks if you are familiar with female circumcision procedures. Even though she was quite reluctant to pursue sexual intercourse because of this, she became quite drunk at the party and decided to "go all the way". The next morning she had some vaginal bleeding and now she presents with a positive pregnancy test. She would like to hear more information about pregnancy termination.
Please bring your 'PCL Guide' to all PCL sessions. Since this is the first PCL session of Trimester 1, there is an initial 'process' objective
- In your group review expectations how PCL should run in your group;
- Review the 'Peer Assessment' portion of the PCL Guide (Section 3D) and decide as a group with your tutor how this procedure will be done after 3-4 weeks.
- Female Genital Alteration (infibulation, circumcision, excision);
- effects on women's health
- effects on labour, delivery
- demographics, cultural rationale
- physician responsibilites
- Teen pregnancy epidemiology
- Social supports for vulnerable population
Saima returns because she has decided that she would like to proceed with the pregnancy, after undergoing counseling for possible pregnancy termination at the local Women's Clinic. She attends her appointment on her own and you question the involvement of her boyfriend Kyle. She has not yet told him that she is pregnant and would like some advice as to how to proceed with telling him.
The reason that she is worried about this is that her parents discovered her trip to the women's clinic and she admitted her pregnancy to them. They are quite religious and involved with their cultural community and fear the public humiliation of an unplanned teenage pregnancy. They have thrown her out of the house, claiming that she is disowned. She is staying with a friend's family presently but worries about being rejected by Kyle now and could not handle that.
After going over her first antenatal visit, you determine that she has some fairly urgent social needs. She will require a place to live, financial support, nutritional advice and support, information about her pregnancy, just to mention a few things. In addition, she will require some support/counseling regarding the rejection by her family, and potentially, by her faith community.
- Wikipedia:Female circumcision
- Prevalence of Female Genital Mutilation (FGM) in Africa
- Care of women with female circumcision (Campbell; Journal of Midwifery & Women's Health; 49 (4), July-August 2004, Pp 364-365)
- Infibulation in the Horn of Africa (Pieters & Lowenfels; New York State Journal of Medicine; 77 (6), April 1977: Pp 729-31)