Fertility desires and the feasibility of contraception counseling among genital fistula patients in eastern Democratic Republic of the Congo

Abstract

Desire for contraception and birth spacing among women with fistula is significant. Basic group contraception counseling and access are feasible and lead to increased contraceptive knowledge and use.

Healthcare providers’ perspectives on the social reintegration of patients after surgical fistula repair in the eastern Democratic Republic of Congo

“…In a country where the fertility rate is estimated at 6.04 children per woman [14], it is not surprising that most healthcare providers believe that most women of reproductive age would like to have children even after the repair of their fistula. This finding is consistent with a previous study at HEAL Africa Hospital [21], in which 75% of women after fistula repair responded that they planned to have children in the future; 65% of these women wished to wait at least 1 year before conceiving.…”

Pregnancy and childbirth after repair of obstetric fistula in sub‐Saharan Africa: Scoping Review

“…Our findings suggest that recurrence of fistula is a common maternal complication of pregnancy after the repair of OF; abortions/miscarriage, stillbirths and neonatal deaths are frequent foetal consequences. As reported in some studies on fistula outcomes , for up to 90% of women who develop an OF, the delivery ends in a stillbirth. This emphasises the need to strengthen and extend follow‐up of women post‐repair in order to preserve the health of the mother and her future babies.…”

“…The overall estimate of the proportion of women who became pregnant during the follow‐up was low but varied widely across studies. Even though evidence is scarce , return to fertility has been reported to be difficult in women after OF repair in a number of studies . It has been stated that women with a previous traumatic birth experience had fewer pregnancies post‐repair than women without such an experience .…”

“…Women treated for OF are usually advised to wait for 3–6 months before resuming sexual intercourse to allow for complete healing. In addition, the fear of fistula recurrence might delay the resuming of sexual activities . Divorce and mental trauma, but also urinary infections or iatrogenic amenorrhoea, which are common among fistula women, might reduce the probability of getting pregnant .…”

Sociocultural and environmental influences on bladder health

“…The eradication of obstetric fistula in low‐ and middle‐income countries is dependent upon building programmes or collaborating with existing programmes that target screening, prevention, treatment strategies and adequate quality of and access to women’s healthcare (78). In parts of Africa, where prevalence of obstetric fistulas that impact bladder function is high, programmes counselling women on contraception after fistula repair demonstrated increased knowledge and indicated that population‐based education is feasible (79).…”