Obstetric fistula is a major life threatening condition for many young women when they give birth. It is one of the causes for mortality during childbirth and for some women it can cause disability. In poor settings of childbirth a large hole occurs between the vagina and the bladder giving way for the deposition of urine and feces inside. This hole is called recto-vaginal fistula or simply fistula that develops during labor pain. The child pushes its head constantly on the pelvic bone of the mother thus making a hole.
Obstetric fistula develops as a result of obstructed labor for many days due to the pressure of baby’s head on the pelvis. It ultimately makes the delicate tissues in the pelvic region to die when the blood supply is completely cut off. These dead tissues will then wither and fall down leaving a hole between the bladder and the vagina. Due to the development of this hole, there is mixing of urine and feces inside the bladder thus causing foul smell. Such women cannot have another child and for this reason alone they are abandoned by their partners.
Very often obstetric fistula occurs during childbirth due to repeated pressure forcing the pelvic bone to open. After prolonged hours of tolerating pain the body of the woman gets broken due to childbirth. Due to constant pressure from the baby the tissues on the pelvic bone get torn and die leading to the formation of hole between vagina and bladder and sometimes between rectum and vagina.
Women living in remote locality cannot travel to the hospital in time without right mode of transportation. This can cause fistula during the time of delivery.
Shortage of hospitals and lack of enough doctors and nurses is also a cause for the development of fistula. Statistics say that roughly 5% of women worldwide develop obstetric labor and only few of them are getting treatment.
Women who become pregnant in early ages may not have fully developed pelvic bones and this may give rise to fistula. The girl’s body may not be physically ready for pregnancy or childbirth and putting her bones to maximum tension can make severe damage causing fistula.
Poverty and poor government structure can also cause problems during childbirth for many women who live in under developed countries.
However this can also occur in brutal rape cases where the internal organ or vagina is butchered using wood or iron rods and sometimes even with rifles.
Fistula is visibly seen with a hole in the sex organ of the woman. It causes serious injury and pain for her apart from leakage of feces and urine profusely through the hole. It would cause foul smell from her internal organs and more than that she will get embarrassed due to negligence by her partner and community.
The affected woman will be under psychological trauma and emotional stress apart from physical injury and pain.
Obstetric fistula can be avoided if the woman can afford to surgical procedure for childbirth.
Consequences of Fistula :
Very often, the baby will die due to prolonged labor pressure and even if it survives it may not be healthy. Mother may develop ulcer on her vagina which may lead to the formation of “foot drop” that may cause considerable nerve damage on her lower limbs. This would make her very difficult to walk and she will be in high trauma due to the leakage of urine and fecal particles repeatedly. In many cases, such women are abandoned and separated from the community.
Obstetric fistula can be cured completely by surgery. An expert surgeon can close down the hole intra-vaginally using proper devices. However in many countries it may be difficult for the women to afford for surgery.
Some remote regions of the world may have limited doctors and hospital facilities that prevent many women to visit the center for taking treatment.
Preventing obstetric fistula is fully possible if there is awareness among women about the need for undergoing proper medical care during pregnancy and childbirth. Government should intervene in this matter by setting up clinics and medical centers in villages and by improving transportation to remote regions.
Even now in certain group of communities unwanted traditional practices are followed by cutting the vaginal area. Some culture adopts the practice of female genital mutilation (FGM) and they should be educated about the harmful effects. This kind of brutality should be prevented.
Women living in under developed countries should know about the free medical centers in their area for taking timely treatment during childbirth. Obstetric fistula is highly prevalent in Asian countries and African countries. Reports state that each year thousands of women are developing fistulas during childbirth in Ethiopia.