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Guest Blog: Torn and Stitched

June 26, 2020

“You’re leaking.” “What?” I said, as I gazed at the ceiling in my midwife’s office. Just two weeks earlier, I had given birth to my first baby at home. The labor was quick and intense. We had waited to find out the gender, so as I helped pull him out of the water, I breathlessly pronounced that my 9 lb 9 oz baby was a boy. Exhaustion and weakness set in. I don’t really remember being helped into my bedroom during the hemorrhaging. A shot of Pitocin in my leg, an IV drip in my arm, and the black clouds in my vision started to clear. I lay on my bed being stitched up and heard my midwife tell me that I had torn a little more than she thought, and the tear extended to my rectum. This is the story of my journey with obstetric fistula.

The two weeks since I had given birth had been awful. I was exhausted, overwhelmed, and in pain. As I sat in her office, I asked my midwife what she meant by saying that I was leaking. She proceeded to tell me that I had a small hole between my vagina and my rectum causing me to leak fecal matter through my vagina. She then told me that she might be able to fix it by stitching me back up again. For the second time in two weeks, I was stitched up. I had wondered why I felt like I could never get clean, but everything was so sore, I just thought it was part of healing from having a baby. I started leaking again almost immediately. My midwife referred me to a local urogynecologist and I was told that sometimes these things just happen, but that this doctor would be able to fix everything. It was Christmas time, so I had to wait a couple weeks until after Christmas to be seen. I traveled, celebrated, and for the most part looked like everything was fine. I carried around baby wipes everywhere, thankful I had a baby to conceal the other reason why I needed them. I just wanted to be clean. I never felt clean.

During my first appointment with the urogynecologist, I was told that I needed surgery. For the past few weeks I kept hearing the word “procedure” and thought it was something simple that could be fixed in an office. I anxiously waited for the nurse that scheduled surgeries to call me, but the soonest they could operate was in two months. While I waited, I spent some time searching the internet trying to figure out what had happened to me. I finally figured out that what I had was called a rectovaginal fistula, but I only found information about women in developing countries that had experienced this birth injury. I was devastated by what I learned about these women that ended up with obstetric fistula. These women usually ended up with a fistula not from tearing, but obstructed labor, often losing their baby, and then being abandoned by their families and communities. I read articles, watched documentaries, and wept for these women that have to suffer alone and without medical care or even basic hygiene products that I was blessed with. At the same time, I felt confused and even angry when I read articles that said obstetric fistula had been completely eradicated in the United States. I felt thankful that my baby was alive and thriving. I felt thankful that my husband was loving and supportive. I felt hopeful that surgery would completely heal me.

After I woke up from surgery, I was told that the damage had been worse than the doctor thought and he had to do a sphincteroplasty as well as the fistula repair. The recovery was more painful than right after I had given birth. I went home the same day and went right back to caring for my baby with the help of my husband. Four weeks after surgery, I realized I was leaking again. I was scared, confused, and so anxious. My doctor told me that it must be the stitches dissolving because he could not see a fistula anymore, but I knew that wasn’t true because I recognized all the symptoms. He gave me estrogen cream, told me to take fiber and that it would hopefully close on its own. After a couple months of no results, he tried an experimental shot. For two weeks I didn’t leak, I even told a couple friends that I thought I was healed. But I started leaking again and eventually I gave up. I was tired of seeing doctors, I was scared to have another surgery, I just wanted to rest from it all.

My family moved across the country and I got used to living with a fistula. My first surgery had made the fistula much smaller, and it was bearable. It was still annoying, but many people live with things much worse. I found a Facebook group called “Living with Obstetric Fistula”. It is a group of women in developed countries that live with obstetric fistula. Many of these women have had multiple surgeries, some have ended up with colostomy bags, and some have been healed. So many of these women had a similar story to mine, most developed fistulas not from obstructed labor, but severe tearing. I followed all the obstetric fistula non-profits on Instagram. I was encouraged by the healing of other women and loved to see the work these organizations did. I had also decided that if I ever did attempt another surgery, I wanted to find someone that had a lot of experience with obstetric fistula repairs. That’s when I found Worldwide Fistula Fund. One day I saw a picture of Dr. Richter doing work in Africa and saw in the caption that she also worked in Birmingham, AL. This was near where I was originally from, so I traveled for a consultation visit and then scheduled surgery for six months later. My surgery went well, I stayed overnight in the hospital and was given specific instructions for post-operative care. I was no longer nursing, so I was able to recover at my parents for two weeks while my husband looked after our family. I kept waiting for the leaking to start again, but I have healed well and have been fistula free for nearly five months.

While I was recovering, I practiced hand embroidery and was struck with an idea. What if I used art to raise awareness and money for women with obstetric fistula? I came up with the name “Torn and Stitched”. After two years, two surgeries, and being stitched up four times, I am healed. I hope that I can use my story to not only raise awareness and money, but bring comfort to other women who have suffered from birth injuries. I realize that I have been immensely blessed. Even if I had not healed, my husband would not leave me, my community would not cast me out. Not only that, but I was blessed to be financially able to travel across the country for surgery with a specialist. There are many women who aren’t financially able to get the care that they need. I thank God that I have been given a small glimpse into the suffering of millions of women around the world. I pray that one stitch at a time I can use my needle and thread to serve my sisters who live with obstetric fistula.