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To strengthen action against female genital mutilation (FGM), this study assesses the prevalence of childbirth complications due to FGM in Gourma Province, Burkina Faso. This cross-sectional study is both descriptive and analytical. It was conducted between June 15 and August 15, 2007. The sampling was comprehensive, incorporating all of the women who gave birth in the four maternity wards in Fada N’gourma, the provincial capital. The survey included an interview, a clinical examination, and an analysis of documents in archives and records. Of the 354 respondents, 58% were under 25, and 78% of all participating women were illiterate. FGM was 28% Type I, 28% Type II, and 3% Type III. Obstructed labor occurred in 29% of cases and a caesarean section was performed in 7% of cases. Of all normal vaginal deliveries, 24% required episiotomies, 18% experienced obstetric hemorrhaging, 20% had uterine retroversion, and 3% needed blood transfusions. Among the newborns, 5% were resuscitated, and 4% were stillbirths. The occurrence of FGM statistically increases the proportion of dystocia (OR = 11.5), cesarean section (OR = 17.6), episiotomy (OR = 6.4), perineal tears (OR = 10, 2), postpartum hemorrhaging (OR = 13.0), retroverted uterus (OR = 14.7), blood transfusions (OR = 8.0), and stillbirths (OR = 10.2). Women with Type II and III FGM were more prone to dystocia (OR = 5.7) and cesarean delivery (OR = 5.2) than those with Type I FGM. FGM constitutes an important risk factor for complications during childbirth and should be eradicated for the sake of health of the mothers, newborns, and children in Burkina Faso.