What is OF?
Obstetric fistula is an uncomfortable topic to discuss. In fact, the entire dialog of an OF conversation is full of words that make most children giggle and some adults blush. If OF is an unsettling topic for us to talk about, imagine what living with it must be like.
Many women and girls in the rural developing world give birth at home. A variety of factors can cause these unattended births to become obstructed and in the absence of emergency obstetric care, these women are forced to endure days of labor. Several days spent trying to deliver a baby results in a suffocated stillborn baby and a mother whose internal soft tissue has endured unimaginable trauma. Compounding the unthinkable sadness of losing a child, these young women often go on to face a debilitating injury called obstetric fistula.
During the attempted labor, the contractions to deliver the baby compress the woman’s soft tissue between the head of her baby and the bones of her pelvis. This extended pressure cuts of the blood flow to parts of that tissue base, causing the flesh to die (necrosis). Eventually, the dead tissues sloughs off and leaves an unnatural gap, or fistula, in the flesh separating the woman’s bladder from her vagina (VVF) or in the flesh separating her vagina from her rectum (RVF).
Both cases pose dire consequences. VVF causes urinary incontinence and RVF causes fecal incontinence. Apart from having to live with an unfathomable stench, these women are forced to endure drastic social isolation. Their husbands usually divorce them and their villages will often times expel them, believing the poor girls to be cursed. Without any hope, these women relocate to the margins of societies, assuming the lives of pariahs begging for their own survival.
But there is hope. A surgical treatment developed in the late nineteenth century has been perfected to deliver success rates higher than 90%. Furthermore, the procedure is fast and relatively cheap meaning that a woman’s life can be completely transformed for a couple hundred dollars.