Obstetric Fistula


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A presentation developed through collaboration between the University of Michigan Taubman Health Sciences Library and Pioneer High School in Ann Arbor, MI. This work is discussed in more detail in "Synergism between a Teacher and Librarians in a High School Setting" by Merle Rosenzweig, Anna Ercoli Schnitzer, and Katy Mahraj.

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  • There is more to global health, public health, medicine than saving people from death Warning: disturbing material, prepare yourselves mentally
  • Vesicouterine- between the uterus and the bladder Vesicovaginal- between the bladder and the vagina - easiest to repair, most common fistula Urethrovaginal- between the urethra and the vagina Rectovaginal- between the rectum and the vagina
  • Although OF can be caused by trauma (especially in war torn areas)
  • Obstructed labor can last for days and will result in the suffocation of the fetus if immediate c-section is not aquired. The head puts pressure on the bladder and rectum (along the dotted lines) weakening the tissues, when the fetus dies, its liquids corrode this area causing the fistula channels to form. Often results from narrow pelvis. Interesting- male babies are more likely to cause this than female babies
  • Primipara more likely to get obstetric fistula
  • Women in the developed world can get obstetric fistula, and can develop minor incontinence, due to the effective obstetric care, there is little damage compared to these women
  • These women live in areas that only value them for their ability to give birth and have a child
  • This is five to ten times as much as people in these countries make in a year Even if a woman has the funds, she may not know about her surgical options
  • Low socio - women not valued in their communities 2. Malnutrition - boys usually get most healthcare, money and education 3. Early marriage- ethiopia (25), uganda (42), mali (45) girls married and give birth by 18 4. Genital mutilation - weakens tissue 5. Obstructed labor - at the mercy of the local healer, overhydration 6. Lack of emergency - no transportation, limited options 7. Incontinence 8. Stigma - they smell bad 9. Footdrup - nerve damage from urine causes women to not be able to tell where there foot is 10. Isolation - hut story 11. Worsening - marginalizing the marginalized, forced to become beggars or prostitutes, they lose the little control they had
  • Obstetric Fistula

    1. 1. Obstetric Fistula A Near Miss of Maternal Mortality A Huge Hit for Maternal Morbidity
    2. 2. Obstetric fistula - a channel that develops between any of the organs in the vaginal area
    3. 4. Obstructed labor - occurs when the fetus is stuck inside the mother during birth, usually resulting from underdeveloped hips Obstetric fistula - a channel that develops between any of the organs in the vaginal area
    4. 5. Bladder Rectum Cephalo-Pelvic Disproportion
    5. 6. Obstetric fistula - a channel that develops between any of the organs in the vaginal area Obstructed labor - occurs when the fetus is stuck inside the mother during birth usually resulting from underdeveloped hips Parity - the number of babies a mother has had Primipara/Primiparous Multipara/Multiparous Incontinence - the inability to control urination and/or defecation
    6. 8. Who Has Obstetric Fistula? -NOT your moms, sisters and teachers -marginalized women and girls -at least 2 million women with 100,000 new cases each year
    7. 9. These Marginalized Women Usually… <ul><li>Live in poor, isolated, rural areas </li></ul><ul><li>Have little to no education </li></ul><ul><li>Are subsistence farmers </li></ul><ul><li>Have no control over their health or finances </li></ul><ul><li>Are married and pregnant at a young age </li></ul>
    8. 10. How much does it cost for a woman with obstetric fistula to get transportation, surgery and rehabilitation?
    9. 11. $300
    10. 12. This chart shows the systemic and infrastructural flaws that contribute to obstetric fistula.
    11. 13. There are two ways to combat obstetric fistula: 1.Treatment 2. Prevention
    12. 14. Treatment Fecal and urinary incontinence can be partially or fully treated through surgery Mental health can be preserved through support groups
    13. 15. Prevention Education for girls Education for healers Family planning Better transportation
    14. 16. How you can help
    15. 17. Nicholas D. Kristof and Sheryl WuDunn
    16. 18. www.kiva.org
    17. 19. www.endfistula.org
    18. 20. Thank you for your time and attention!
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