Obstetric Fistulae: All that you need to know

May 23 is the International Day to end Obstetric Fistulae. Join us this month as our #impACTivism campaign pivots around awareness and activism to end Obstetric Fistulae.
What is an Obstetric Fistula?
In technical terms, obstetric fistula is a severe medical condition in which a fistula develops either between the rectum and vagina (called rectovaginal fistula), or between the bladder and vagina (called vesicovaginal fistula) after severe or failed childbirth, when adequate medical care is not available. In simpler terms, A fistula is a hole. In obstetric fistula – the word obstetric implies anything with a gynaecological affiliation – this hole occurs between the woman’s birth passage/vaginal cavity and her internal organs – such as the rectum, or her bladder.

Obstetric fistulae occur consequent to obstructed labour, or a premature onset of pregnancy, and also because of sexual violence. In either case, it is preventable, and mostly treatable. If the baby’s head bears down against the mother’s pelvis for an extended period of time, the blood supply is cut off, eventually causing the tissue to die and wear away, leaving a hole between her vaginal cavity and her bladder, and in some cases, her vaginal cavity and her rectum.[1] In many such instances, the mother’s pelvis is in itself, too young and underdeveloped to bear the impact of delivering a child.[2]
For the most part of the developed world, obstetric fistulae have been eliminated: and for an obvious reason – the access to emergency obstetric care and sexual and reproductive health services. But in the developing world, these very services are elusive, although the cure itself is not. Fistulae remain a dangerous threat to maternal health if there aren’t sufficient options provided in the form of birth-spacing, maternal and obstetric healthcare, C-sections, assisted labour and ante-natal consultations. To add to this mix, are traumatic fistulae that come from instances of sexual violence and rape. In the DR Congo, both forms of fistulae thrive unattended – although obstetric fistulae constitute the majority. Nevertheless, both forms have lasting impacts on women’s health: they are left with everything from incontinence that causes a constant leakage of urine and faecal matter, infection, rashes, sexual dysfunction, physical disability and psycho-social effects that include stigma and being disowned by their own families.

Fistulae can be prevented, and where not prevented, they can be treated. All it needs is the right services and healthcare options being made accessible, available and affordable for those in need of them. This month, we are campaigning to bring an end to Obstetric Fistulae. You can support us by blogging and using social media to spread the word and sharing our posts and photos, by donating your time by volunteering with us or even by donating to Channel Initiative to take us closer to achieving our mission in the DRC.
To know more about participating in our month-long campaign, write in to kjayakumar@channelinitiative.org with “OF Campaign” in the subject line.

[1] International Women’s Health Program, A Labour of Loss: Obstetric Fistula, http://iwhp.sogc.org/index.php?page=obstetric-fistula&hl=en_US
[2] BBC World, ‘They thought I was cursed’ http://news.bbc.co.uk/2/hi/in_depth/7050934.stm (October 19, 2007)