Untreated fistula: a condition of shame and shunning. TT -

Abstract

In many developing countries, when a girl first menstruates, she is eligible for marriage and is expected to get pregnant soon afterwards. She will be of small stature, due to her young age, gender-based malnutrition, or just genetics - all factors that vary by region. Her pelvis is usually too small for her baby to be delivered without assistance, and if obstructed labor occurs, it is imperative that help is sought, and that the baby is delivered via caesarean section (C-section). However, in many cases, it is her husband or in-laws who decide whether she may seek emergency obstetric care (EmOC). In cultures where tradition dictates that young women should deliver at home alone, the decision to seek EmOC often occurs too late, if at all. Unattended, obstructed labor can last for up to seven days. During this time, the pressure of the baby's skull cuts off the blood supply to the tissue surrounding the mother's bladder, rectum and vagina, causing a hole, or "fistula" to form. It is almost certain that this will result in a stillbirth. (excerpt)