Background It was estimated that 66,000 mainly African women aged 15–49 resident in England and Wales in 2001 had undergone female genital mutilation (FGM) and 24,000 girls under the age of 15 largely from African communities were at risk of WHO Type III FGM, the severest form. These estimates were widely quoted to demonstrate the need for appropriate care for affected women and to protect their daughters from FGM. Because there has been extensive migration to England and Wales since 2001 from countries where FGM is practised, a project was commissioned to update and extend estimates.

Objectives To produce indirect estimates of:

• Numbers of women with FGM living in England and Wales as a whole and in each local authority area in 2011.

• Numbers of women with FGM living in England and Wales and in each local authority area giving birth each year from 2000 to 2013.

• Numbers of daughters born to women born in FGM-practising countries resident in England and Wales and in each local authority area.

Methods Data from standardised surveys undertaken in the FGM practising countries were used to derive proxy estimates of prevalence rates and applied to the numbers of women born in those countries who were enumerated in the 2011 census or who registered births in England and Wales. In addition to country of birth and age group, the new estimates drew on other factors recorded in the census, including ethnicity, religion, first language and age on arrival in the UK.

Results In 2011, an estimated 103,000 women aged 15–49, 24,000 women aged 50 and over 10,000 girls aged under 15 with FGM and born in FGM practising countries were living in England and Wales. Three fifths of these women were born in countries where FGM is nearly universal. Although many lived in Greater London and major cities, there were women born in these countries living in every local authority district. An estimated 1.5 per cent of women giving birth in England and Wales since 2008 had undergone FGM. And an estimated 60,000 girls aged 0–14 in 2011 were born to mothers with FGM.

Conclusion These estimates have a number of limitations, which will be discussed, but they indicate an urgent need for appropriate services to support women who have undergone FGM and to safeguard their daughters.