WHAT IS OBSTETRIC FISTULA?
Obstetric fistula is a hole in the birth canal. It is the result of a prolonged, obstructed labor in which the mother does not receive emergency medical care, for example a C-SECTION . During an obstructed labor, the baby tries to push her way through the birth canal, eventually causing a hole to form between the mother's vagina and bladder, or between her vagina and rectum. In severe cases of fistula a hole develops between both the vagina and bladder, and the vagina and rectum. This is called "a double fistula." The baby is usually still born, and her mother is left in one of the most devastating conditions imaginable. The World Health Organization (WHO,) calls obstetric fistula “the most frightful affliction of humankind.”
The black areas indicate the area of the obstetric fistula between the vagina and the bladder, or between the vagina and the rectum.
Social Stigma and Consequences
The most devastating aspect of the affliction is the social condition it produces for the afflicted woman. As a result of her incontinence (meaning she cannot control her urine or feces,) she is shunned by her family and ostracized by her community, and subjected to a life of isolation. The social stigma around the illness and exclusion from society, has a profound impact on the woman psychologically. She is made to think of herself of lesser than, an embarrassment to her family, and a disgrace to society. In extreme cases, some fistula sufferers commit suicide. Fistula can cause death if left untreated; this is usually due to infection.
Prevention of Fistula
There are many important ways to prevent obstetric fistula. Clinically, the performance of a C-section upon an obstructed (blocked) labour would be the most viable preventive measure. Still, that gives rise to another problem: access. The women affected by obstetric fistula are poor women who lack access to medical facilities. In order for a C-section to be feasible as a preventive measure, first access to a facility with doctors who have the capacity to perform a C-section would be necessary. However, the issue of fistula is not that linear and it must be assessed multi-dimensionally. It is critical that girls, women, and their families are educated on issues regarding maternity and access to health care in order for them to be empowered to take the steps to ensure their access to good health care. We must also remember that fistula is a poor woman's disease, and that in order for it to be truly eliminated, we must first eliminate poverty.
Source: A Holistic Analysis of Obstetric Fistula, Habiba Diallo, 2012