Obstetric Fistula is a childbirth injury that destroys a woman’s life. I once put up a social media questionnaire asking people whether they’d prefer to have bad breathe or fistula, only to have many of them choose fistula. Most said it’s because in their opinion, fistula can be cured unlike bad breathe, while others said bad breathe has several homemade remedies like brushing your teeth or chewing gum. We were at a stalemate and this made me realize that perhaps it time we really got to understand what fistula actually is.
According to Wikipedia, fistula in itself is an abnormal connection between two hollow spaces eg. Blood vessels or intestines caused by an injury, surgery or as a result of an infection or inflammations. Obstetric fistula occurs in childbirth where a woman goes through prolonged labor without any medical attention.
During labor, the mother’s contractions continually push the child’s head against the pelvic bone which aids in its opening up for the baby to push through (to be birthed). However, where women undergo prolonged labor, soft tissue caught between the baby’s head and pelvic bone become compressed, restricting normal blood flow. Without adequate blood flow, the tissues soon die and leave holes between the mother’s vagina and her rectum or bladder which leads to uncontrolled leaking depending on where the fistulae formed. This means that, if this goes untreated, the woman will involuntarily pass urine or stool for the rest of her life. Some women who have gone through this, have reported to have had to use up to 4 pampers a day so as to avoid soiling themselves.
Data shows that every year at least 50,000 to 100,000 are affected by obstetric fistula. A number largely accredited to poverty conditions in developing countries and lack of access to proper medical care. However, while this may be true, it is now paramount that we also evaluate how negligence in hospitals has also contributed to this number. If you have had the privilege of going through labor, then you know that normally, the doctors’ advice you to go to the hospital once your contractions are close together. Understandably so, because no one wants to spend a whole three days at most, hearing a mother wailing in pain yet there is nothing much you can do. I have seen cases where women have been asked to go home and wait till the labor pains are closer together after which they can comeback. However, for some, by the time their labor pains are that close, it is too late.
The question here then would be how long should a mother be in labor before the medics decide that it’s probably safer that they opted for other delivery methods? Is it person specific as we have seen based on individual experiences? How does patient negligence contribute to the increasing number of fistula cases in women? And how best can we correct our systems so that we can ensure that pregnant women are given the maximum care when going into labor and how can we educate women on this so that they can take care of themselves when in labor.
It is sad to see women have to separate themselves from other people because they are leaking. It is sad to be looked at like you have some kind of disease because of a condition you probably have no control of. Far more disappointing is sitting down on the floor, looking at your dreams fall away because of the negligence of another human being.
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