l must then remain immobilized for up to three weeks in order to heal properly. In most recent cases, educated families are choosing to have the procedure done in sterile environments such as hospitals and by paramedical personnel. The child is given a local anesthesia, which reduces the pain but because the child does not struggle more unnecessary tissue is removed. This is not the final operation that these women must endure. Re-infibulation is carried out on women who are divorced or who become widowed. When a woman marries or remarries she must be deinfibulated, enlarging the enclosed vulva. In some parts of Africa this must be done by the husband on the wedding night, using a piece of glass or wood. In the northern part of Somalia a midwife opens up the woman on her wedding night in the presence of her husbands relatives. Besides the initial pain of this operation there are long-term physiological, sexual and psychological effects. Unsanitary conditions result in infections of the genital and surrounding areas and often results in the transmission of the HIV virus. Other side effects include: hemorrhaging, shock, painful scars, keloid formation, labial adherence, clitoridal cysts, delayed menarche, genital malformation, urinary infection and pelvic infections. When the woman is older she will most likely have gynecological and obstetric problems including sterility. In cases where death occurs the practitioner is seldom blamed. In these cases, the death is blamed on the act of an enemy, the evil spirits, or is excused as Gods will. Infibulated women experience depression, anxiety, irritability, and reduced feelings of femininity. Sexual and marital problems are very common because women become frigid and do not enjoy sexual intercourse because of the lack of nerve supply in the vaginal region. Pregnant women t...
