Obstructed labor remains a leading
cause of maternal death and disability, responsible
for and estimated eight percent of the approximately
half million maternal deaths. Without prompt medical
attention and access to Caesarean section services,
obstructed and prolonged labor can also lead to
still births, neonatal deaths, and maternal disability.
Obstetric fistula is one such devastating maternal
disability.
During prolonged or obstructed labor, undue, extended
pressure in the birth canal can lead to tissue
damage. If untreated, this tissue damage results
in a fistula — an abnormal opening between
a woman’s vagina and bladder or rectum (or
both).
An obstetric fistula permits the uncontrollable
passage of urine and feces into the vagina, producing
a foul odor and often leading to social isolation.
Women with fistula usually feel shamed or disgraced.
They are often deserted by their husbands and cut
off from family, friends, and daily activities.
The physical and emotional stress of those suffering
from an obstetric fistula is often compounded by
the loss of the baby.
Fistula disproportionately affects young and poor
women. Women most at risk include:
Fistula is treatable, but most women
in the developing world often lack
access to the
required medical
care and the funds to pay for treatment.
Fistula can be surgically repaired
but only where trained
surgeons and good post-operative care
are
available. In Africa, there are only
two health care centers — one
in Addis Ababa and one in Jos, northern Nigeria — that
specialize in fistula care. Surgical
repair costs about US$150, beyond the
means of
most women affected.
