Demystifying obstetric fistula
ALTHOUGH obstetric fistula is one of the most serious childbirth injuries, the condition remain largely unknown.
The United Nations Population Fund defines obstetric fistula as a hole between the birth canal and bladder or rectum, caused by prolonged, obstructed labour, without access to timely, high-quality medical treatment.
The hole leaves women leaking urine, faeces, or both, and often leads to chronic medical problems, depression and social isolation.
While all women of child-bearing age can suffer from fistula, it is the under-aged girls, most of whom are victims of child marriages, female genital mutilation and teenage pregnancies, who face the highest risk.
Dr Melba Sibanda, an obstetrician, explained the medical condition.
“Obstetric fistula is an unpleasant condition which results in constant leakage of urine and faeces through the pelvis.”
Dr Sibanda said those suffering from the condition are often alienated by society.
“In most instances, those with the condition are often shunned by their husbands and families.”
Dr Richard Makunike, another obstetrician, said fistula occurs when a woman goes through obstructed labour.
“The hole is created when a foetus’ head is constantly pushing against the pelvic bone.
‘‘This prevents blood flow, resulting in the creation of a hole,” Dr Makunike said.
Dr Makunike also spoke about the stigma and discrimination that women with the condition encounters.
“A woman with a fistula, who is perpetually leaking urine and sometimes faeces, is often rejected by her husband and shunned by her community because of the foul smell she produces as well as her inability to bear more children,” explained Dr Makunike.
Research has shown that the condition is most prevalent among rural girls where a lack of medical facilities often results in extended labour.
Health experts have stressed the need to improve health education and ante-natal care.
The experts argue that prevention is the key to ending fistula.
Obstetric fistula can be avoided by ensuring that trained midwives are always in attendance during childbirth.
There is also need for the provision of timely and high quality emergency obstetric care for all women who develop complications during delivery.
It is estimated that two million young women are living with untreated obstetric fistula in Asia and sub-Saharan Africa.
According to the Fistula Foundation, between 80 and 95 percent of vaginal fistula can be closed with simple surgery and in about 90 percent of obstructed labour cases, the baby does not survive.
Whilst the extent of obstetric fistula in Zimbabwe is unknown, statistics from the United Nations show that for every woman who dies, approximately 20 suffer serious injury or disability, of which obstetric fistula is one of the serious injuries.
Fistula is a preventable and treatable medical condition that is occuring due to weak health systems, poverty and child marriages.
In the developed world, cases of obstetric fistula are not common.