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Prevention and Treatment of Fistula: Pathfinder’s Experience in Ethiopia and Ghana

Forty-two percent of women in developing countries deliver their babies without the assistance of a doctor or midwife;1 only 40 percent give birth in a hospital or health center. When complications arise, too often the mother is unable—either physically, financially, or geographically—to seek medical care. In cases of obstructed labor, when the baby is breech, improperly  positioned, or just too large to fit through the mother’s pelvis, women may labor for days. These prolonged labors almost always end in still birth and account for 8% of global maternal mortality.

When the mother survives, she is often left with debilitating injuries, including obstetric fistula. Obstetric fistula is created when the infant’s body is pressed against the mother’s pelvis for an extended period during labor, cutting off blood flow and destroying tissue in between the mother’s vagina and her bladder and/or rectum. This outcome can be made more likely by a mother’s
young age and physical immaturity. The resulting hole allows for the uncontrollable passage of urine and/or feces. Women who develop fistula suffer physically from ulcerations, infections, and kidney disease. Many times the prolonged obstructed labor that led to the fistula also causes nerve damage in the legs, making walking difficult or impossible.

But the emotional and social toll fistula takes on women’s lives might be the most devastating result of the injury. Due to the constant stench of leaking waste, husbands and families often
abandon women with fistula, leaving them to live alone in a small shack in the family compound. Some are banished completely; unable to care for themselves financially, these women become destitute.

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