This is the extreme form of FGM, involving removal of almost 2/3rds of the female genitalia. This constitutes 15% of mutilations performed. Type IV consists of all the unclassified forms of FC/FGM including pricking piercing incising the clitoris and or labia, cauterization by burning of clitoris and surrounding tissues; scraping (angurya cuts) of the vaginal orifice or cutting (gishiri cuts) of the vagina to cause bleeding or herbs into the vagina with the aim of tightening or narrowing the vagina; any other procedure which falls under the definition of FC/FGM given above. .
There is no question that FC/FGM is a potentially harmful and painful procedure. Depending on the degree of mutilation, FGM can have a number of short-term health implications including: severe pain and shock infection, urine retention, injury to adjacent tissues, and immediate fatal hemorrhaging. Long-term implications can entail: extensive damage of the external reproductive system, uterus, vaginal and pelvic infections, cysts and neuromas, increased risk of vesico vaginal fistula, complications in pregnancy and child birth, psychological damage, sexual dysfunction, and difficulties in menstruation. African women report instances where their vaginal area, due to being sewn up for so long, is not a sufficient size to accommodate giving birth to a child. Thus, the child's head becomes stuck in the vagina, and the surrounding tissue becomes deteriorated. The final result is that the baby dies and the woman's vaginal area is so destroyed that she begins to have a constant flow of urine or feces out of her vagina. Women are then ostracized from society and most likely divorced for their husbands. This case may seem extreme, but unfortunately it is not uncommon in African countries practices Type III circumcision. One can clearly understand the health risk that accompanies this practice, the main argument for its discontinuance.
