Social Implications of Obstetric Fistula: An Integrative Review

Abstract

Obstetric fistula is a devastating complication of obstructed labor that affects more than two million women in developing countries, with at least 75,000 new cases every year. Prolonged pressure of the infant's skull against the tissues of the birth canal leads to ischemia and tissue death. The woman is left with a hole between her vagina and bladder (vesicovaginal) or vagina and rectum (rectovaginal) or both, and has uncontrollable leakage of urine or feces or both. It is widely reported in scientific publications and the media that women with obstetric fistula suffer devastating social consequences, but these claims are rarely supported with evidence. Therefore, the true prevalence and nature of the social implications of obstetric fistula are unknown. An integrative review was undertaken to determine the current state of the science on social implications of obstetric fistula in sub-Saharan Africa.

Still living with fistula: an exploratory study of the experience of women with obstetric fistula following corrective surgery in West Pokot, Kenya

“…14 In Kenya most of these findings have been documented in health care facility-based studies, focusing on the period before women have surgery. 5,10 Our study examined survivors' lived experiences 3-36 months following surgery.…”

An Exploratory Study of Reintegration of Women Following Obstetric Fistula Surgery in West Pokot, Kenya

“…Psychologically, women also suffer from depression and emotional loss (Khisa et al, 2011) in addition to loss of dignity and self-identity and interrupted social roles as women (Mselle, Moland, Evjen-Olsen, Mvungi, & Kohi, 2011). Social stigma poses a challenge to the women in addition to economic constraints posed by the illness (Khisa & Nyamongo, 2012;Roush, 2009). Divorce and separation often occur following the illness (Roush, 2009;Yeakey, Chipeta, Rijken, Taulo, & Tsui, 2009), further complicating the lives of women with the condition.…”

“…Social stigma poses a challenge to the women in addition to economic constraints posed by the illness (Khisa & Nyamongo, 2012;Roush, 2009). Divorce and separation often occur following the illness (Roush, 2009;Yeakey, Chipeta, Rijken, Taulo, & Tsui, 2009), further complicating the lives of women with the condition. Thus, their social well-being is compromised as they may no longer freely participate in gender roles as before the illness owing to the physical illness and societal beliefs and stigma that the condition attracts.…”

Influence of Abandonment, Stigmatization and Social Isolation on the Coping Strategies of Women with Vesico Vaginal Fistula in Akwa Ibom State, Nigeria

“…A patient's incontinence and pain render her unable to perform household chores and childrearing as a wife and as a mother, thus devaluing her worth. Other misconceptions about VVF are that it is caused by venereal diseases or that it is divine punishment for sexual misconduct [30]. As a result, many girls are divorced or abandoned by their husbands and partners, disowned by family, ridiculed by friends, and even isolated by health workers [4].…”