Female genital mutilation (FGM) can have immediate and long-term complications. Although women who have had FGM face numerous health problems, it can be difficult to separate the consequences from the procedure from those caused by poor sanitary conditions and lack of access to medical care. The procedure is painful, especially since anesthesia is rarely used, and may cause excessive bleeding, which can lead to death.

Some of the immediate consequences of female genital mutilation include:

• Severe pain
• Severe bleeding (hemorrhage)
• Shock
• Infection

The number of women who experience long-term complications from FGM is difficult to determine. Women from cultures that practice FGM may be conditioned not to discuss pain, especially any pain associated with their genitals. They may also consider the complications normal. If they were very young when the procedure was performed, they may not remember ever feeling differently.

Longer-term consequences usually affect the urinary and reproductive systems. Some of these long-term complications can include:

• Painful urination and difficulty emptying the bladder (dysuria). This can increase the likelihood of urinary tract infections.
  
  
• Painful menstruation (dysmenorrhea).
  
  
• Blocked menstrual flow. This may lead to a condition called endometriosis. 
  
  
• Scarring at the incision sites. This may make a woman more susceptible to infection with sexually transmitted diseases, including the human immunodeficiency virus (HIV).
  
  
• Pelvic inflammatory disease.
  
  
• Chronic pain.
  
  
• Painful intercourse (dyspareunia).
  
  
• Psychological trauma. This may occur because girls are often taken by surprise and forcibly held down during the procedure.
  
  
• Infertility.
  
  
• Inability to use any intravaginal or intrauterine forms of birth control (e.g., IUDs, female condoms).
  
  
• Difficulty in receiving pelvic examinations.
  
  
• Complications during pregnancy and childbirth. Infibulation makes pregnancy examinations difficult and childbirth more complicated. Women may need their infibulation scar opened to give birth. Surgical opening of the scar (deinfibulation) using regional or general anesthesia is best performed before pregnancy, but can be performed during pregnancy. If deinfibulation is not carried out before labor begins, it can be done during labor to prevent severe tearing. Women with FGM also are more likely to require a Caesarean delivery (C-section).
  
  In addition, women with FGM are at greater risk of having their baby die before or soon after birth than those without the procedure, according to a recent study conducted by African and international researchers. The study, which is the first comprehensive study of the effects of FGM on maternal and child health, involved over 28,000 women giving birth in various African nations where FGM is commonly practiced. Besides increased risk of perinatal death, other complications associated with FGM include greater risk of C-section (as well as complications during such deliveries), maternal hemorrhage during childbirth and longer hospitalization of the mother. The degree of these complications also increases in relation to the extent and severity of the FGM. After delivery, the researchers also found an increased need to resuscitate the babies of mothers with FGM.