In Want Of Continence After Childbirth

Nancy Muller Health Pro
  • In developed nations where obstetrical care from trained experts is readily available, we rarely encounter trauma-induced horrors such as fistulas. For those who have never come across the term, as I did just ten years ago, a fistula is an opening between the bladder and/or rectum and the vagina. It is caused by prolonged, obstructed labor when the fetus will not fit through the mother's birth canal. In countries like Niger and other across Africa and Asia, the risks of occurrence are realities that regularly confront the girls and women giving birth.


    Labor may last for five days or even longer. In most cases, the fetus dies from asphyxiation for lack of oxygen. If the mother survives the hemorrhaging or infection, she is destined to living life with a fistula resulting from the tissue damage. It is not unlike a pressure ulcer of internal organs. With continuous leakage of urine through the hole created in the bladder wall, the victim finds herself abandoned by her husband, family, tribe, and society in general. She is shunned and turned out, rejected and discarded. Suffering from utter loss of self-esteem and a means of livelihood, these societal castaways can and do become suicidal.

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    Obstetrical fistulas are curable in the large majority of cases through low-technology surgical repair, but facilities at which this surgery can be accessed are rare in those countries where the incidences are highest and unbridled. Throughout Africa and South Asia, experts estimate that as many as 3.5 million women suffer from this disastrous complication of childbirth.


    Let us not ignore the plight of women who lack access to the obstetrical care in childbirth that they deserve. Instead, let us help bring hope and, more importantly, the means of fistula repair. Above all, let us strive long term to bring advanced obstetrical care to women everywhere so that fistulas become something of the past.


    The World Federation of Incontinent Patients, or WFIP, has selected heightened awareness of the problem and prevalence of obstetrical fistulas as one of its primary objectives on behalf of the millions of women impacted, in the hopes that both the incidence and prevalence can be dramatically reduced. There are numerous, reputable funds through which you can contribute, here in the U.S. and abroad. One of the oldest and best established is the World Fistula Fund, founded by Lewis Wall, MD, DPhil and Steven Arrowsmith, MD.


    To learn more and find out how you can help build its new hospital for fistula repair in Niger and elsewhere, visit

    If you wish to bring help and hope right here in America to those who face problems with bladder and bowel control but don't know how to access answers, call 1.800.252.3337 or write



Published On: January 12, 2009