Background. The hazards of FC/FGC have been revisited over the past two decades, prompting efforts to eradicate the practice. Yet, there is little systematic evidence for much of the content of education programs and advocacy efforts.

Objectives. To (1) examine individuals' perceptions of the opposite sex's beliefs with respect to attitudinal support for FC/FGC among couples, (2) explore women's empowerment as a correlate of FC/FGC among their daughters, and (3) investigate FC/FGC in relation to two acute outcomes women may face at delivery: episiotomy and overt postpartum urinary retention (PUR).

Methods. Secondary analysis of data from the 2003 Nigeria Demographic and Health Survey was performed for 465 couples (1) and 1968 women (2), and on the Nigeria subsample of the WHO (2006) multi country study on FC/FGC and obstetric outcomes, for episiotomy (4766 women) and overt PUR (4743 women) (3). For all objectives, multivariate logistic regressions were used. For the couple level analysis in (1), multivariate multinomial logistic regressions were also employed.

Results. (1) Twenty-four to 25% of women and men were in favor of FC/FGC continuing. At least one spouse supported the continuation of FC/FGC in 38% of cases. Both men's and women's perceptions underestimated the true levels of opposition to the continuation of FC/FG in the opposite sex. Individuals had significantly lower odds of favoring FC/FGC if they thought the opposite sex wanted the practice to be abolished. Equity in partnerships was statistically significantly related to attitudinal support for FC/FGC only in terms of joint decision making regarding visits to family (at the individual level, for men). (2) Nineteen percent of women had cut daughters. As measured by sole say in daily household purchases, empowerment as responsibility was associated with higher odds of having a cut daughter, in contrast to joint say children's health care. Surprisingly, empowerment as freedom, as indicated by sole say in women's own health care and not condoning wife beating, meant greater odds of having a cut daughter. (3) About 86% of women had types I (61%), II (25%) and III (1%) FC/FGC; 30.8% needed episiotomy and 15.8 developed overt PUR. Cut women were more likely than uncut women to have these outcomes.

Conclusion. This multi-pronged research on FC/FGC has utility in informing potential areas for policies and programs in Nigeria, by determining specific entry-points (targets and content) for interventions aimed at reducing the incidence of FC/FGC and at managing health complications as a result of FC/FGC