Obstetric Fistula
NURTURE INFORMATION HUB
Evidence
https://www.who.int/news-room/facts-in-pictures/detail/10-facts-on-obstetric-fistula
WHO – World Health Organization
Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula, an abnormal opening between a woman’s genital tract and her urinary tract or rectum.
Women who experience obstetric fistula suffer constant incontinence, shame, social segregation and health problems.
Education
A fistula is an abnormal passage between two parts of the body that would not normally be connected. When it arises as a complication of childbirth, it is called an obstetric fistula. A fistula is a rare but known complication of third and fourth degree perineal tears.
Soft tissues are caught between the baby’s head and the mother’s pelvic bone, restricting blood flow.
A fistula can happen if an infection occurs, if a tear near the birth area is not identified correctly or if a tear is not repaired properly. A fistula resulting from a complication in the healing of a third or fourth degree tear may be between the rectum and vagina, between the anus and vagina or between the perianal skin and the rectum.
The fistulas most commonly experienced in developing countries are the result of prolonged obstructed labour (often for days) without vital medical care. Obstetric fistulas that occur in developed countries like Australia and New Zealand result from a complication in the healing of a third or fourth degree perineal tear.
Diagnosis of Obstetric Fistula
A fistula may be simple (involving no or minimal muscle) or complex (involving a significant amount of muscle). Treatment will depend on the review of the fistula and should prioritise the ability to control bowel movements.
Symptoms
- Passing gas through the vagina
- Passing of faeces (poo) through the vagina
- Chronic inflammation or recurrent infections of the vagina or urinary tract
- Recurrent abscess
- Foul-smelling discharge
- An opening or wound on the perineum that will not heal
Diagnosis of an obstetric fistula can understandably be extremely upsetting and confronting, especially if you have struggled to receive a diagnosis.
Please know that help is available. Ask your GP or obstetrician for a referral to a specialist colorectal surgeon or gynaecologist who is experienced in managing obstetric fistulas.
What is birth trauma?
Birth Trauma Australia defines “birth-related trauma” as any injury or trauma, whether physical or psychological, sustained at any time in connection with all stages of the birth journey - from conception and pregnancy, through to labour and birth, and in postnatal care - and can affect the mother, birthing parents, partners and even health professionals.
This can present as postnatal depression, postpartum post-traumatic stress disorder, or Obsessive-compulsive disorder.
Women who have suffered from obstetric fistula may require support to cope with the emotional and social impacts of the condition.
If you are concerned about your symptoms or are finding it hard to manage you should speak to your GP. In an emergency, you should call 000.
You can also reach out to organisations such as PANDA. They have highly trained and caring counsellors and peer practitioners who can help you work through and support you in your birth trauma recovery journey.
Birth Trauma Australia offer free resources to new parents, including evidence-based information on birth trauma recovery and healing.
Empowerment
Early diagnosis and prompt treatment are crucial in managing obstetric fistula effectively to restore normal function and improve the quality of life for affected women.
Useful links
Special thanks to Birth Trauma Australia for content sharing and supporting families.
Birth Trauma Australia
https://birthtrauma.org.au/physical-birth-trauma/fistula/
Centre of Perinatal Excellence (COPE)
PANDA – Perinatal Anxiety & Depression Australia
Continence Foundation of Australia
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Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances. To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].
Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances.To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].
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