What are the recommended referral pathways for women experiencing complications related to FGM?

Recommended referral pathways for women experiencing complications related to female genital mutilation (FGM):

• Women with ongoing physical or psychological complications from FGM should be offered referral to specialist services, including gynaecologists and psychosexual counselling, based on clinical judgement.

• Referral to a gynaecologist is appropriate for assessment and management of physical complications such as pain, scarring, urinary or vaginal problems, and sexual dysfunction.

• Psychological complications, including anxiety, depression, or post-traumatic stress disorder related to FGM, should prompt referral for mental health support and psychosexual counselling.

• Urgent referral to maternity services is recommended if there are wound healing problems or suspected wound breakdown related to FGM, to prevent further complications.

• Referral pathways should be individualized, considering the woman's symptoms and preferences, and may involve multidisciplinary teams including gynaecology, mental health, and specialist counselling services.

These recommendations align with NICE guidance on postnatal care and management of perineal wounds, which are applicable to FGM-related complications due to similar clinical presentations and risks.