What is Obstetric Fistula? Obstetric fistula is a hole between the vagina and bladder or between the vagina and rectum that occurs after a woman experiences prolonged and obstructed (blocked) labour. The difficult labour is usually due to malpositioning of the fetus in the uterus or a pelvis that is too small compared to the size of the fetal head. The fetus will apply pressure to the uterus in its struggle to get out, causing a fistula to develop. In severe cases, a fistula can occur between both the vagina and bladder and the vagina and rectum (double fistula).
The baby is usually stillborn and the mother constantly leaks waste products (urine or feces) from her privates. Obstetric fistula is entirely preventable by a C-section. However, due to poverty and other barriers, women who experience fistula are unable to receive a C-section when their labour becomes complicated.
Types of Obstetric Fistula
Vesico-vaginal Fistula (VVF)
A fistula between the bladder and the vagina. This results in involuntary discharge of urine. Vesico-vaginal fistula is the most common type of obstetric fistula.
Recto-vaginal Fistula (RVF)
A fistula between the rectum and the vagina. This results in involuntary discharge of feces.
Other Types of Fistula
A fistula that occurs as a result of rape or sexual violence. This type of fistula can exist between the vagina, bladder, rectum, or both.
Fistula can sometimes result from surgical accidents such as during a caesarean section if the surgeon accidentally cuts the bladder or rectum.
Effects of Obstetric Fistula
In most cases, the pressure that creates the fistula also kills the child, leading the mother to give birth to a stillborn. The fistula leaves the woman incontinent: involuntary excretion of urine, feces or both. Due to the smell created by incontinence families, friends, and communities almost always outcast the victim. The traumatic experience, as well as social segregation leads to depression and low self-esteem in the patient. Physical effects of fistula range from skin infections, kidney disorders to worst case scenarios, death.