Birth and sorrow: The medico-social consequences of obstetric fistula in Ilesha, Nigeria

Background: Obstetric fistula is an abnormal communication between the epithelium of female genital tract and the bladder and (or) the rectum. It is not just “a hole”; it affects every aspect of the life of the sufferers. Objective: This study examined the etiology, psychosocial and medical consequences of obstetric fistula on the patients. Methodology: It was a cross-sectional study with quantitative and qualitative data collection methods employed. Quantitative data collection was done by the aid of a structured interviewer-administered questionnaire while qualitative data collection was by focus group discussions (FGDs) and in-depth interviews (IDIs). The sample consists of eligible and consenting patients with obstetric fistula admitted for repair at the Wesley Guild Hospital, Ilesha between July 2017 and August 2018. Purposive sampling technique was used to select 86 patients. Results: The mean age of patients was 28.7 years ± 7.5 (SD) with a divorce rate of 40%. Only 10% of them had their first marriage between ages 15 and 20 years. Prolong obstructed labor accounted for 55.8% of all the obstetric fistula in this study. The remaining were either following hysterectomy or cesarean section. Reported medical problems were dermatitis (60%), dyspareunia (25%), recurrent urinary tract infection (UTI) (10%), infertility (5%), and amenorrhea (5%). Socially, 45% felt ostracized, and 50% were economically impoverished by job loss. Some 56.6% respondents suggested that hospital delivery was a preventive measure, while 8% felt that avoidance of early marriage would prevent obstetric fistula. Conclusion: Obstetric fistula is still a major reproductive health problem. Most of these patients understand the role of unsupervised childbirth in its development.