What Is Obstetric Fistula?
A devastating childbirth injury from prolonged, obstructed labor where tissue separating the vagina and urinary tract or rectum is destroyed or damaged.
What Causes It?
Prolonged pressure of the fetus compresses the mother’s soft tissue against her pelvic bones, cutting off blood supply.
Tissue separating the urinary tract or rectum from the vagina is destroyed leaving a hole that uncontrollably leaks urine or feces through her vagina.
Can a Fistula Heal on Its Own?
No. A fistula can only be repaired through surgery.
How Many Women and Girls Suffer from Fistula?
Approximately 1 million.
How Many Cases Occur Each Year?
Between 50,000 to 100,000 new cases develop each year.
What Are Risk Factors for Obstetric Fistula?
Limited access to skilled obstetric care, and early marriage, followed by adolescent pregnancy.
A teenage mother with an underdeveloped pelvis may have difficulty delivering a full term baby through her birth canal. Also, it is also traditional in these areas to give birth at home with no medically trained professional present.
How Many Cases Of Adolescent Pregnancy Occur In Developing Nations?
20,000 girls under the age of 18 give birth everyday in the developing world.
How Long Does Obstructed Labor Last That Leads to Fistula?
Labor typically lasts 2 or more days.
Why Is Fistula Not Common In Developed Nations?
Affluent countries have better access to obstetric care and emergency obstetric care.
In the event of an obstructed labor, a Caesarean section or other emergency procedures can be performed.
What Happens After an Obstetric Fistula?
The woman is typically rejected by her husband, shunned by her community and forced to live in isolation.
Lack of knowledge about fistula often results in women suffering for years before receiving treatment. Labor leading to a fistula often causes nerve damage that limits mobility and range of motion as well as pelvic floor muscle weakening, making daily activities difficult, if not impossible.
What Happens to the Baby?
Over 90% of babies from an obstructed labor are stillborn.
Can These Women Still Have Children?
For women who get fistula in their first pregnancy, 70% end up with no living children.
After a successful fistula repair surgery, a woman may still give birth, although c-sections are recommended to prevent re-opening the fistula.
How Much Does Fistula Surgery Cost?
Surgery averages $450.
How Successful Is It?
The majority of fistula closures are successful. About 15% continue to leak due to problems with the bladder and urethra.
Many women and girls who suffer fistula have other related injuries including nerve damage, partial paralysis and traumatic pelvic conditions that require ongoing physical therapy.
What Happens After Surgery?
Physical therapy is needed to improve range of motion and avoid re-opening the fistula, counseling and support is used to address the rejection and isolation these women and girls have faced.
WFF established a rehabilitation advisory council to encourage physical therapy best practices into the recovery program. Through literacy and vocational skills training women and girls can generate income by producing her own products once she returns home.
Do women with fistula need multiple surgeries?
Depends on difficulty level. 40% of patients treated at DFC have had 2 or more prior, unsuccessful surgeries elsewhere.
Where should I go if I live in the US and have a fistula?
Seek help at augs.org.