‘It’s evil’: Breast ironing leaves long-term scars for women in Nigeria

Nearly two decades later, the 27-year-old Cameroonian refugee who grew up in Nigeria’s Cross River State vividly remembers that day – as she grapples with the years of damage the ordeal inflicted.

John said her life changed after her mother forced her to undergo breast ironing in an attempt to shield her from sexual abuse.

Breast ironing, or “breast flattening”, is a cultural practice whereby young girls’ breasts are ironed or pounded down with brutal or heated objects to delay their development or disguise the onset of puberty, according to the Africa Health Organization.

The AHO says communities who practise breast ironing believe it will make girls less attractive to men, thus protecting them from harassment, rape, abduction, and early forced marriage, and also keeping them in school.

However, health bodies and rights groups say it is a form of physical mutilation that harms a child’s social and psychological wellbeing and contributes to the high school dropout rate among girls who suffer from it.

The United Nations (UN) says breast ironing affects some 3.8 million women in Africa and is one of the five most under-reported crimes related to gender-based violence.

Done in secret

In John’s home community in Cross River State in southern Nigeria, the procedure is culturally imposed on most girls and typically performed by their mothers or other maternal figures.

For years after her breasts were ironed, John suffered from pain. Her breasts developed unevenly, and the muscles are still weak and saggy today.

At age 19, the pain was so bad that she had trouble sleeping, she said. Despite visiting doctors, her family did not believe breast ironing was the cause, adhering to their cultural beliefs.

“Before I married, I would buy painkillers for the breast pain, but it worsened after marriage [and pregnancy] when I was trying to breastfeed my child,” she told Al Jazeera.

In 2021, as she was about to give birth, a doctor explained that breast ironing had damaged her glandular tissue, which would make breastfeeding difficult, and suggested a medical procedure that could help her.

“After the doctor told me that the ironed breasts might affect me during childbirth, my husband and I couldn’t afford the treatment, which was $5,700,” she lamented. “I am jobless, and my husband works in furniture,” she explained.

After giving birth, she struggled to breastfeed correctly. The doctor recommended using formula, but the couple could not afford it.

They lost the baby when he was four months old.

Ushakuma Michael Amineka, a gynaecologist at the Benue State Teaching Hospital and the second vice president of the Nigeria Medical Association, explained that breast ironing can leave long-term effects.

“The immediate consequences can include pain because the breast is very soft tissue. If compressed, it can cause pain and even distort the normal anatomy of the breast tissue,” he told Al Jazeera. “Long-term consequences could include difficulties with lactation, as it can destroy breast tissue and lead to infections, causing long-term pain and reduced breast milk production.”

According to 2021 research published by the United States’ National Institutes of Health (NIH), the harmful practice is typically carried out by close female relatives, and sometimes with the help of traditional midwives. It is maintained in secret by female members of the family and community, and typically hidden from men.