The prevalence of Obstetric fistula in Nigeria have over the years become a great cause for concern. Research showed that more than 2 million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa and Nigeria has the highest number of cases in the world.
This deadly disease have contributed to high maternal mortality rate and apart from suffering from constant incontinence, women suffering from obstetrics fistula have been scorned, shamed and segregated from the community in which they live in.
WHAT IS OBSTETRIC FISTULA?
It is a medical condition in which a fistula (hole) develops between either the rectum and vagina, a ureter and the vagina, or between the bladder and vagina after prolonged, severe or failed childbirth.
It is usually caused by prolonged and obstructed labour without prompt medical intervention especially an emergency Caesarean section. During labour, if the mother is left unattended to, the sustained pressure of the baby’s head on the mother’s pelvic bone damages soft tissues, creating a hole (fistula) between the vagina and the bladder and/or rectum. The pressure deprives blood flow to the tissue, leading to necrosis. Eventually, the dead tissue comes away, leaving a fistula which causes a constant leaking of urine, faeces and blood through the vagina. The acid in the urine, feces, and blood causes severe burn wounds on the legs from the continuous dripping. Nerve damage that can result from the leaking can cause women to struggle with walking and eventually lose mobility.
- Flatulence, urinary or fecal incontinence, which may be continual or only happen at night
- Foul-smelling vaginal discharge
- Repeated vaginal or urinary tract infections
- Irritation or pain in the vagina or surrounding areas.
- Pain during sexual activity
WHO IS AT RISK?
Obstetric fistula most commonly occurs among women who live in under-devloped countries, who give birth without access to medical help as a result of poverty or lack of adequate funds to seek emergency obstetric care. Young and poor women living in rural areas are particularly at risk as most of them are forced into early marriages and as such, they often lack the power to choose when to start bearing children or where to give birth.
Childbearing before the pelvis is fully developed, as well as malnutrition, small stature and generally poor health, are contributing physiological factors to obstructed labor. Older women who have delivered many children are at risk as well.
Obstetric fistula can also be caused by poorly performed abortions, and pelvic fracture, cancer, or radiation therapy targeted at the pelvic area, inflammatory bowel disease (such as Crohn’s disease and ulcerative colitis). Other potential causes for the development of obstetric fistulae are sexual abuse and rape, especially in conflict/postconflict areas and other trauma, such as surgical trauma
- Delaying the age of first pregnancy;
- Cessation of harmful traditional practices
- Timely access to obstetric care.
- Ensuring skilled birth attendance at all births
- Providing emergency obstetric care for all women who develop complications during delivery
- Access to health services and education – including family planning, gender equality, higher living standards, child marriage, and human rights must be addressed to reduce the marginalization of women and girls.