A mother and father have gone on trial for facilitating the female genital mutilation of their 21-month-old daughter.

The couple, who cannot be named to protect the child's identity, have both pleaded not guilty at Dublin Circuit Criminal Court to one count of carrying out an act of female genital mutilation on a girl at an address in Dublin on 16 September 2016.

The 37-year-old man and 27-year-old woman also pleaded not guilty to one count of child cruelty on the same day.

In an opening statement to the jury, prosecuting counsel Shane Costelloe said the two accused arrived at a hospital with their daughter on 16 September 2016 and asked for assistance as she was bleeding.

Mr Costelloe said a paediatric surgeon performed a procedure to stop the bleeding and came to the conclusion that the injury was not sustained accidentally.

He referred the case to gardaí for investigation.

Mr Costelloe told the jury they will hear evidence that the accused suggested that the injury was sustained by the girl falling on a toy.

He told the jury that they will see this toy.

He outlined to the jury the details of the offence of female genital mutilation as defined by legislation.

He also said that for the avoidance of doubt, the legislation outlines that it is not a defence to say that the female genital mutilation was consented to by the girl or woman, or by her parents or guardians, or that is has been done for customary or ritual reasons.

He said it is not the State's case that either accused actually performed the act of female genital mutilation.

He said it is the State's case that they aided, abetted or procured the act of female genital mutilation and that they must have been present for its commission.

A doctor who treated the child told the Circuit Criminal Court that she presented with brisk bleeding which did not show signs of stopping.

Consultant paediatric surgeon Mr Sri Paran said the rate of bleeding when the child was brought to theatre indicated the injury had taken place up to five hours previously.

If it had not been treated the child would have gone into shock within 20 hours, he said. He said a decision was made to cauterise the wound, which he described as a cut, to stop the bleeding.

There were no other injuries to the child, he said. Mr Paran said he spoke to the child's father afterwards and was told by him that the girl had fallen onto a toy and sustained an injury.

Some time later he was shown the toy which was described as a plastic activity toy with a steering wheel, mirror and clutch. Mr Paran said there was no evidence of a crush injury which he would have expected if the girl had fallen on the toy. 

"The story did not match the injury I saw," he said, adding "when the story and the injury doesn't tally we are legally obliged to raise the alarm".

He agreed during cross examination that the girl was otherwise a well-nourished and well-cared for child.

Dr Sinead Harty, a specialist in child protection, said she examined the girl four days after her admission to hospital.

The examination took place with the written consent of the child's father and in his presence. She said the girl was a well-grown child, clean and appropriately dressed and appeared very well cared for and was in reasonably good form.

She noticed a rawness in an area of the girl's genitals where she had surgery. No clitoris was visible. Dr Harty said the injury she saw was not consistent with a fall on a toy as there was no bruising or swelling to the outside and the injury was "internal". 

She said the history did not fit the findings and when the only change to the anatomy was the clitoris was missing, she thought it was caused by female genital mutilation type one which is the partial or total removal of the clitoris.

She subsequently met the girl's mother who brought the toy to the hospital. During cross-examination she agreed that the girl's father had used the word toys, plural, when describing what his daughter fell on.

She agreed that both parents had denied being party to any act of FGM on their daughter. She also agreed that when social workers became involved they had reported that both parents were good parents to their children.

She also agreed that in some cases doctors would look for collateral evidence on legs and arms which would suggest someone was being held and there was no evidence of this on the girl. She also agreed that one area of the genitals had been mildly swollen when she examined the child and said it had looked more swollen when she reviewed a recording made during the surgery.

Dr Beatrice Nolan, a consultant haematologist who saw the girl the following January, said she concluded the girl was not suffering from any bleeding disorder. She agreed during cross-examination that the child's medical notes indicated she had been taken to hospital with vomiting the previous March and there was a concern about blood in her vomit.

However, she said this would not have caused her to change her opinion.