Abstract
BackgroundObstetric fistula is a hole between the vagina and bladder, and/or between the vagina and rectum, triggered by prolonged obstructed labor. The World Health Organization has estimated that at least 50,000 to 100,000 cases of obstetric fistula occur every year, and that over two million women with obstetric fistula in developing countries remain untreated. Research on women’s lived experiences of obstetric fistula is limited. This study aimed to explore the lived experience of women with obstetric fistula at Bahir Dar Hamlin Fistula Center, Amhara Regional State, Ethiopia.MethodsA qualitative study design, drawing from a phenomenological approach, was employed to explore the lived experience of purposively-selected sample of ten women with obstetric fistula. In-depth interviews were conducted in the local language (Amharic) using an interview guide. Interviews were transcribed and translated into English, and transcripts were entered as primary documents into Atlas.ti 7 software. Thematic categories were identified, and transcripts were coded accordingly.ResultsParticipants perceived that the contributing factors to obstetric fistula were: instrument-assisted delivery; inappropriate physical examination and care; early marriage; and long duration of labour. As a result of obstetric fistula, the patients suffered from uncontrolled dripping of urine and/or faeces (and associated offensive odours), ostracization by their family and community members, and feeling hopeless and isolation from the community. Patients used different coping mechanisms, including frequent washing of clothes and changing of underwear; they also expressed that they preferred to be alone.ConclusionWomen with obstetric fistula experienced urine incontinence and associated bad odour; social and psychological problems like isolation, divorce and fears were commonly reported. Our findings from perspectives of Ethiopian setting suggest that integrated services for women with obstetric fistula are warranted, including physical therapy, psychological support and social reintegration.
Highlights
Obstetric fistula is a hole between the vagina and bladder, and/or between the vagina and rectum, triggered by prolonged obstructed labor
In Ethiopia, an estimated 9000 women develop obstetric fistula each year, and 1200 of these women are treated by Hamlin Fistula Hospital
This research drew from a descriptive phenomenological qualitative study design; to explore the lived experience of women with obstetric fistula at Bahir Dar Hamlin Fistula Centre in Bahir Dar, Amhara Regional State
Summary
Obstetric fistula is a hole between the vagina and bladder, and/or between the vagina and rectum, triggered by prolonged obstructed labor. Obstetric fistula is a condition characterized by a hole in the bladder and/or rectum that opens into the vagina, through which urine or faeces leak uncontrollably. It is typically acquired when there is a delay to intervene in a prolonged and obstructed labor [1]. Fistula tends to occur more often in places where access to and use of obstetric care is limited It affects remote regions where there is strong stigmatization of the condition and its complications [2]. Obstetric fistula affects about two million women in developing countries, and an estimated 50,000 to 100,000 new cases occur each year [3]. Almost all cases of fistula seen at Hamlin Fistula Hospital were caused by obstetric complications related to prolonged and obstructed labor [5,6,7]
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