**3. Methods**

This project was designed as a qualitative study. According to Morse [53] and Sandellowski [54], qualitative research is particularly useful when collecting information about unknown topics, as it has the potential to provide rich and detailed descriptions of a phenomenon. The descriptive phenomenological approach in qualitative research was used as it can provide deep insights, as discussed by Liamputong [55, 56]. Phenomenology is an approach to qualitative

**35**

codes [63].

Research Ethics Committee.

*Experiences of Sexual and Reproductive Healthcare Professionals Working with Migrant Women…*

research that seeks descriptions of phenomena and how they are experienced by the actors and is effective in bringing to the fore the perceptions and experiences of individuals from their own perspectives [57]. Phenomenology allows researchers to unearth lived experiences of individuals through narratives, whilst the research takes a neutral position with no preconceived ideas of what the outcome might be (see [58–60]). Lopez and Willis [61] also suggested that the phenomenological approach in qualitative studies can examine subjective human experiences by making enquiry efficient without bias and preconceived knowledge, attitudes and values, which must be shed by the researchers prior to conducting

Purposive sampling was applied as a time-saving technique, to avoid the process of searching for specific information in a potentially broad group of possible informants. Coyne [62] suggested that purposive sampling is the most appropriate method when detailed and abundant data are required to investigate a specific phenomenon [62]. Therefore, participants were chosen based on their experiences working with patients living with FGM/C who were seeking sexual and reproductive healthcare services. The research sample was drawn from different healthcare organisations across the Perth metropolitan area, all of whom worked in various

The researchers also applied snowball sampling; six participants who met all the inclusion criteria were interviewed. The number of participants in this study was appropriate, as qualitative research does not seek to generalise but to seek and report on phenomena [63]. They ranged in age from approximately 25–60 years, with mean age of 39 years. The participants comprised four midwives, one nurse and one doctor. All worked for the government public health departments of both

Face-to-face in-depth interviews were conducted at the participants' place of employment. Interviews took 30–60 minutes and were conducted using semistructured questions to guide the process and ensure relevant topics were covered. Participants were provided with a Participant Information Sheet and signed an Informed Consent Form before the interviews commenced. Signing the Informed Consent Form provided permission for the interview to be audio recorded. One joint group interview of four midwives and two individual interviews, one with a doctor and the other with a community nurse, were conducted. The joint interview was facilitated as participants had extreme time restrictions and the only available time could accommodate a joint interview comprising team members of the

The audio-recorded interviews were transcribed within 2 weeks of collecting the data, each line being numbered and printed to allow easy examination of the content. Data reduction was conducted after the transcribing and the data coded afterwards, allowing for the categorisation of emerging themes. The printed transcriptions were examined and constantly compared with the field notes to identify emerging themes. The initial analysis was open, allowing the researchers to develop hierarchal categories across all data sets, including the field notes, to find repeated patterns of meaning. This was followed by axial coding, which allowed the researchers to connect codes, thereby establishing the relationship between all

Open coding was initiated at the beginning of data analysis, with the researchers examining and colour-coding field notes to identify themes and then sequentially numbering all the lines in the transcribed interviews. In coding the data, Nvivo 10 and Microsoft Word were used. This study was approved by the Curtin University

*DOI: http://dx.doi.org/10.5772/intechopen.93353*

sexual and reproductive healthcare organisations.

maternity ward department of a public hospital.

government and private sectors.

interviews.

### *Experiences of Sexual and Reproductive Healthcare Professionals Working with Migrant Women… DOI: http://dx.doi.org/10.5772/intechopen.93353*

research that seeks descriptions of phenomena and how they are experienced by the actors and is effective in bringing to the fore the perceptions and experiences of individuals from their own perspectives [57]. Phenomenology allows researchers to unearth lived experiences of individuals through narratives, whilst the research takes a neutral position with no preconceived ideas of what the outcome might be (see [58–60]). Lopez and Willis [61] also suggested that the phenomenological approach in qualitative studies can examine subjective human experiences by making enquiry efficient without bias and preconceived knowledge, attitudes and values, which must be shed by the researchers prior to conducting interviews.

Purposive sampling was applied as a time-saving technique, to avoid the process of searching for specific information in a potentially broad group of possible informants. Coyne [62] suggested that purposive sampling is the most appropriate method when detailed and abundant data are required to investigate a specific phenomenon [62]. Therefore, participants were chosen based on their experiences working with patients living with FGM/C who were seeking sexual and reproductive healthcare services. The research sample was drawn from different healthcare organisations across the Perth metropolitan area, all of whom worked in various sexual and reproductive healthcare organisations.

The researchers also applied snowball sampling; six participants who met all the inclusion criteria were interviewed. The number of participants in this study was appropriate, as qualitative research does not seek to generalise but to seek and report on phenomena [63]. They ranged in age from approximately 25–60 years, with mean age of 39 years. The participants comprised four midwives, one nurse and one doctor. All worked for the government public health departments of both government and private sectors.

Face-to-face in-depth interviews were conducted at the participants' place of employment. Interviews took 30–60 minutes and were conducted using semistructured questions to guide the process and ensure relevant topics were covered. Participants were provided with a Participant Information Sheet and signed an Informed Consent Form before the interviews commenced. Signing the Informed Consent Form provided permission for the interview to be audio recorded. One joint group interview of four midwives and two individual interviews, one with a doctor and the other with a community nurse, were conducted. The joint interview was facilitated as participants had extreme time restrictions and the only available time could accommodate a joint interview comprising team members of the maternity ward department of a public hospital.

The audio-recorded interviews were transcribed within 2 weeks of collecting the data, each line being numbered and printed to allow easy examination of the content. Data reduction was conducted after the transcribing and the data coded afterwards, allowing for the categorisation of emerging themes. The printed transcriptions were examined and constantly compared with the field notes to identify emerging themes. The initial analysis was open, allowing the researchers to develop hierarchal categories across all data sets, including the field notes, to find repeated patterns of meaning. This was followed by axial coding, which allowed the researchers to connect codes, thereby establishing the relationship between all codes [63].

Open coding was initiated at the beginning of data analysis, with the researchers examining and colour-coding field notes to identify themes and then sequentially numbering all the lines in the transcribed interviews. In coding the data, Nvivo 10 and Microsoft Word were used. This study was approved by the Curtin University Research Ethics Committee.

*Psycho-Social Aspects of Human Sexuality and Ethics*

on the extent or the type of the procedure performed.

perpetuates an extremely dangerous practice [38].

circumcision (MGC/M).

child's parents.

procedure [52].

**3. Methods**

According to Almroth et al. [30, 31], there seems to be no known clinical studies that have documented the consequences of FGM/C, and the body of available literature only documents results of survey-based studies [30]. Anecdotal evidence and accounts of the consequences of FGM/C report a correlation between the procedure and adverse sexual and reproductive health outcomes [43]. Immediate and longterm sexual and reproductive health conditions have been reported in women living with FGM/C, although the severity of these conditions is believed to be dependent

Diouf and Nour [44] argued that the adverse effects of Type I, Type II and Type III FGM/C can be short and long term, and possibly increase the risk factors for an HIV transmission due to the use of non-sterile instruments during the procedure. Wakabi [45] documented how surgical equipment is traditionally used numerous times on more than one initiate during the FGM/C procedure without being sterilised, increasing the risk of HIV and other blood-borne viruses (BBVs) being transmitted. Additionally, [46] argued that excessive bleeding is a complication of the FGM/C procedure, which can increase the need for medical attention (i.e., a blood transfusion); this may again increase the risk of potential HIV transmission. Although untraditional, it is based on adverse medical complications of FGM/C that the procedure came to into existence by emulating western medical practices of male genital cutting/

The medicalisation of FGM/C refers to any form of FGM/C being performed by healthcare providers, whether in private or public facilities, in the home or any other place where it may occur, in contrast to the traditional circumcision ceremony, which is usually ritualised and surrounded by public celebrations of the procedure [47]. In Kenya, for example, the medicalisation of FGM/C has become common amongst holidaymakers living in Western countries who originate from this country. Therefore, it is common amongst the Bagusii and the Kuria in the west of the country, where FGM/C is highly prevalent, and Njue and Askew [48, 49] reported that it has become common amongst nurses, midwives and even medical doctors to perform the procedure after consultations with a

However, we opine that the medicalisation of FGM/C raises moral questions pertaining to whether it is a measure to protect the sexual and reproductive health of girls and women or an imperialistic promotion of a dangerous practice [50, 51]. Furthermore, the minimisation of complications during and after the procedure raises questions as to whether the medicalisation of FGM/C reduces harm or

A decade ago, the WHO delivered a joint statement against the medicalisation of FGM/C on the basis that it excuses and perpetuates a harmful practice, and further stated that the medicalisation of FGM/C is a dangerous and criminal practice, requiring strategies to stop healthcare providers from carrying out the

This project was designed as a qualitative study. According to Morse [53] and Sandellowski [54], qualitative research is particularly useful when collecting information about unknown topics, as it has the potential to provide rich and detailed descriptions of a phenomenon. The descriptive phenomenological approach in qualitative research was used as it can provide deep insights, as discussed by Liamputong [55, 56]. Phenomenology is an approach to qualitative

**34**
