Clinical Concerns: CECaring for the Patient Who Has Undergone Female CircumcisionMWANGI, ROSEMARY BSN, RN; SMITH-STONER, MARILYN PhD, RNAuthor Information Rosemary Mwangi, BSN, RN, is a Clinical Instructor, Los Angeles County College of Nursing and Allied Health. Marilyn Smith-Stoner, PhD, RN, is a University of Phoenix Adjunct Faculty, Phoenix, AZ. Address for correspondence: Marilyn Smith-Stoner, PhD, RN, 447 Sherie Court, Beaumont, CA 92223-1543; e-mail: email@example.com. Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional: January 2002 - Volume 20 - Issue 1 - p 30-35 Buy Take the CE Test Abstract An estimated 100 million to 136 million girls and women have been genitally mutilated or circumcised in the world and an additional 2 million girls are at risk annually. Home care and hospice nurses who care for patients from different cultures and countries need to know the implications of this custom and must incorporate appropriate planning into their practice. This article provides an overview of the situation and specific strategies for working with this population. Types of Female Circumcision There are four types of FC: Type one, considered the mildest procedure in female genital mutilation, involves the excision of the prepuce with or without excision of part or the entire clitoris. Type two involves the excision of the prepuce and clitoris together with partial or total excision of the labia minora. Type three, which is more severe, involves the excision of part or all of the external genitalia, and includes a stitching or narrowing of the vaginal opening, also referred to as infibulations. Type four, which is uncommon, involves approximately four processes; piercing, or excision, of the clitoris and or the labia; cauterization by burning of the clitoris and surrounding tissues; scraping of the vaginal orifice or cutting of the vagina; introduction of corrosive substances into the vagina to cause bleeding, or use of herbs into the vagina with the aim of tightening or narrowing the vagina (Affara, 2000; Klingman, 1999). © 2002 Lippincott Williams & Wilkins, Inc.