Social Features and Morbidity Patterns of Women with Obstetric Fistulae at an Obstetric Fistula Centre in a University Teaching Hospital in Jos, Nigeria

Abstract

Obstetric fistulae are largely preventable surgical conditions. Literature has shown that it is common among the low income, less privileged and marginalized members of the community. It affects mainly the poor, young, illiterate girls, and women in the remote rural areas of the world, where access to emergency obstetric care, family planning services and skilled birth attendants are unavailable. And when available are poorly utilized due to cost, distance, and other challenges. This study seeks to identify the social features and morbidity characteristics of obstetric fistulae in women at the fistula center in Bingham University Teaching Hospital, Jos, Plateau State, Nigeria. This was a descriptive study done in 2019 among all the patients who attended the obstetric fistula Centre at Bingham University Teaching Hospital. An Interviewer-administered structured questionnaire was used, and it looked at social and health aspects of obstetric fistulae in all 49 patients at the center. Data was analyzed using a computer software; Statistical Package for the Social Science (SPSS) version 20.0. Most of patients had some form of financial support especially from family members, husbands, parents, and friends. Most of the women had their relationships affected. Majority were separated, and relationships strained and had lost financial support from their spouses. Sexual Intercourse was adversely affected. On surgical outcome, 16% became completely dry and leaking had ceased, a third (36.7%) was still leaking urine after the surgery. Almost all the women have had no childbirth after the repair. Women had mental health issues like depression, anxiety, tension headache, fatigue, and suicidal ideation. Participants also had gynaecological morbidities like vulval dermatitis, irregular menstrual flow, abnormal vaginal discharge, and dysuria. These women also had lower abdominal pains, loss of weight, backache, and foot drop. Majority of the children did not survive after the pregnancy that led to the obstetric fistula. Women should seek financial support from family members to avoid delays in seeking help during pregnancy. Communities are encouraged to continue to give moral, emotional, financial, and social support to fistula patients. Healthcare workers should take advantage of the fact that most women attended ANC to educate and enlighten pregnant women on causes, risk factors, social and health consequences of obstetric fistulae. Government should initiate poverty alleviation activities and help reduce out of pocket expenses for healthcare via health insurance.

Challenges and coping mechanisms among women living with unrepaired obstetric fistula in Ethiopia: A phenomenological study

“…Evidence shows that many women and girls with obstetric fistulas faced many psychological problems such as humiliation (reported by 97.2% of victims); abandonment, stigmatization, and loneliness (reported by 95.8%) [ 13 – 15 ]. Similar studies showed that 85% of women experienced separation from their husbands, and 95.4% reported despair [ 15 , 16 ].…”

“…Evidence shows that many women and girls with obstetric fistulas faced many psychological problems such as humiliation (reported by 97.2% of victims); abandonment, stigmatization, and loneliness (reported by 95.8%) [13][14][15]. Similar studies showed that 85% of women experienced separation from their husbands, and 95.4% reported despair [15,16]. Women with obstetric fistulas are often afraid and uncertain about their future with sexual partners, marriage, sex, pregnancy, childbirth, and reintegration into the neighborhood community [17][18][19].…”