• Procedure where the female genitals are deliberately cut, injured or changed for no medical reason. Also known as "female circumcision" or "cutting", and by other terms e.g. sunna, gudniin, halalays, tahur, megrez and khitan. Usually carried out on young girls between infancy and the age of 15, usually before puberty, often against a girl's will without her consent and girls may have to be forcibly restrained.

• Often happens against a girl's will without her consent and girls may have to be forcibly restrained.

• Illegal in the UK and is child abuse. Mandatory reporting duty in England and Wales if girl aged <18 reports FGM. Mother of young child who defends FGM, red flag for safeguarding referral

Four main types of FGM

• Type 1: Clitoridectomy: partial or total removal of the clitoris, and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris)

• Type 2: Excision: partial or total removal of the clitoris and the labia minora (inner folds of the vulva), with or without excision of the labia majora (outer folds of skin of the vulva)

• Type 3: Infibulation: narrowing of the vaginal opening through the creation of a covering seal

• Type 4: All other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterising the genital area

• No health benefits to FGM and it can cause serious harm, including constant pain, pain and/or difficulty having sex, trapped periods, repeated infections, which can lead to infertility, bleeding, cysts and abcesses, problems passing urine or incontinence, depression, flashbacks and self-harm, problems during labour and childbirth

• Questions to consider asking: 'Have you been cut down there?', 'Were you circumcised?'; 'Do you practice FGM in your community? Did you have it? It could affect your pregnancy, sooner we know we can help'; If travelling abroad during the summer 'do you have plans for your holiday?'

• Deinfibulation surgery can be performed to open up the vagina (usually local anaesthetic) and may be recommended for women who are unable to have sex or have difficulty passing urine as a result of FGM or pregnant women at risk of problems during labour or delivery as a result of FGM. Ideally before getting pregnant but can be done in pregnancy or labour

• Where FGM is carried out. Girls are sometimes taken abroad for FGM, but they may not be aware that this is the reason for their travel. Girls are more at risk of FGM being carried out during the summer holidays, as this allows more time for them to "heal" before they return to school. Communities that perform FGM are found in many parts of Africa, the Middle East and Asia. Girls who were born in the UK or are resident here but whose families originate from an FGM practising community are at greater risk of FGM happening to them. Communities at particular risk of FGM in the UK originate from Egypt, Eritrea, Ethiopia, Gambia, Guinea, Indonesia, Ivory Coast, Kenya, Liberia. Malaysia, Mali. Nigeria, Sierra Leone, Somalia. Sudan, Yemen. 95% prevalence in Kurdish community

• Resources: Female genital mutilation: guidance for healthcare staff (gov.uk), Mandatory Reporting of FGM (gov.uk), FGM help and advice (gov.uk). Female genital mutilation (NHS Choices), Female genital mutilation (RCGP), Female genital mutilation (WHO), FGM/C (UNICEF, 2016)​