The pendulum swings in one direction, and then it swings back again. Last night I was awash with guilt and worried that I hadn’t done the right thing. Today, as I continue to process and sift through my thoughts on this subject, I am beginning to change my mind on some of it. The circumcision v. mutilation question is one that I’ve firmly figured out in terms of advocacy: when talking about FGM, when discussing it in class or with colleagues or other health professionals, I will absolutely refer to it as mutilation, because that’s what it is. But is telling a woman she’s been mutilated, and calling it “mutilation” to her face, the right thing to do? On reflection, probably not. Especially if she doesn’t view it that way at all. And as for always addressing it every time I see it…I don’t know that that’s the right call either. The more I think about yesterday, the more I think that maybe I did do the right thing by not pursuing it: she was making it very clear that she didn’t want to talk about it, tackling this issue was in no way relevant to the current exam or her current situation as a postpartum woman with a new baby, and as a student in a clinic, chances are good that I will never, ever see this woman again. So was it my place to try to get her deal with something she didn’t want to deal with at that time? Absolutely not. And yes, FGM is something that can’t be ignored in the clinical setting, and is absolutely something that shouldn’t be tip-toed around, especially when discussing this issue in general, and educating and advocating against FGM in public…but in terms of doing the best thing for the women we serve, bringing up painful memories or turning FGM into an “issue” for her (when in fact it might not be) is definitely not the right call. So, I guess the motto should be: follow her cues. And if this is something that’s going to be addressed, it’ll need to be done over the course of several months, in a situation where the woman and midwife will be able to establish a trusting relationship, especially since it’s such a delicate subject. It might take several visits before she’s even able to talk about it. Who knows what I’ll say next time I see it, but at least I have a better idea of where I stand now.
And with that, I’m off to cook dinner, and then work on my neverending modules.