Urge the United States House of Representatives, the United States Senate, and President Obama to pass the Obstetric Fistula Prevention, Treatment, Hope, and Dignity Restoration Act (H. R. 2888).

The Obstetric Fistula Prevention, Treatment, Hope, and Dignity Restoration Act (H. R. 2888) sponsored by U.S. Congresswoman Carolyn Maloney (D-NY 14), would authorize assistance to funding and aid in the prevention and treatment of obstetric fistula in foreign countries, and for other purposes.

What is obstetric fistula?

Obstetric fistula is an injury from child bearing, where a hole or tear that is formed between the bladder and the vagina, or the rectum and the vagina (or both), which causes urine and/or feces pass uncontrollably.  It occurs after a woman suffers from prolonged obstructed labor that usually lasts several days, and neither well trained or adequate medical care wasn't made available to her (usually a Caesarean section to relieve the pressure). 

As a result of the fetus  putting persistent pressure, on the bladder and vaginal or rectal walls of the mother, during the birth,  the blood supply to tissues of the vagina and the bladder (and/or rectum) of the mother, is cut off during the prolonged obstructed labor, and the tissues die and are destroyed.    The baby is then usually still born and then the woman develops fistula which causes her to pass urine and/or feces uncontrollably.

The Problem

Overview

Every minute, one woman dies from pregnancy-related complications. Of these deaths, 99 percent occur in the developing world and 95 percent occur in Africa and Asia. Statistics show that at least 2 million women in Africa, Asia and the Arab region are living Obstetric Fistula, and some 50,000 to 100,000 new cases develop each year.  Obstetric fistula was once common throughout the world, but over the last century was eliminated in Europe, North America, and other developed regions through improved access to medical interventions, particularly emergency obstetric care for those women who need it. 

For every woman who dies from pregnancy-related complications, an estimated 20 women survive but experience pregnancy-related disabilities. One of the most severe is obstetric fistula, which occurs when a woman who needs trained medical assistance for a safe delivery, usually a cesarean section, cannot get it.

Cause of Obstetric Fistula

According to the United States State Department, `The combination of pregnancy at an early age, chronic maternal malnutrition, and a lack of skilled care at delivery can all contribute to the development of obstetric fistula and permanent incontinence.' Obstetric fistula occurs disproportionately among impoverished girls and women, especially those living far from medical services.

Consequences of Obstetric Fistula

The consequences of obstetric fistula are devastating for a woman.  In the majority of cases of obstetric fistula, the baby is stillborn. In addition to the mother, dealing with the loss of her baby, she is left with physical pain as well as social and emotional trauma from living with chronic urinary incontinence (the unintentional loss of urine. The inability to hold urine in the bladder due to loss of voluntary control over the urinary sphincters resulting in the involuntary passage of urine.)

~Social Consequences of Obstetric Fistula~

-The social consequences for and girls women living with obstetric fistula include isolation, divorce or abandonment, ridicule and shame, loss of social belonging and association inability to start a family, illness and malnutrition, risk of violence, and lack of economic opportunities.

-Girls with obstetric fistula are also often unable to continue schooling.

-Victims suffer psychological consequences such as feelings of hopelessness, self-hatred, sadness, depression, and suicide because of stigma and lack of awareness that their condition is treatable.  

-Fistula victims need regular medical attention and an extra supply of soap to keep clean, placing a huge financial burden on already poor families. They also lose property when they are divorced or abandoned by their husbands and family.

-Some lose jobs or are denied work, while others quit their jobs out of shame, leading to deepened poverty and vulnerability to repeat fistulas.

-Left without support, the women are often forced to beg or turn to prostitution to survive.

~Medical Consequences of Obstetric Fistula~

The medical consequences for girls and women living with obstetric fistula are incontinence, but also frequent bladder infections, infertility, and foul odor. When left untreated, fistula can lead to chronic medical problems, including ulcerations, kidney disease, and nerve damage in the legs.

In the majority of obstetric fistula cases, the baby will be stillborn and the mother will experience physical pain as well as social and emotional trauma from living with incontinence as well as the loss of her child.

According to the Human Rights Watch Report, "As the woman begins to recover from the grief and agony of the failed delivery, she discovers that her body is painfully damaged. She might think that she is suffering from temporary, somewhat normal incontinence. But then she begins to smell, her clothing and bedding are constantly wet, her thighs sting, and she might develop ulcers on her vagina. At first, the woman might try to hide her condition, but usually this is impossible. Sex is painful, and her marriage, as a result, might start to fray or even turn violent. She might be thrown out by her husband, her relatives and friends may think that she is bewitched or cursed. In all likelihood, she will stop working, going to market, and participating in social or religious life. She might live in pain and isolation for years, even decades, before learning that surgery could fix her condition. This news will not be enough for many the fistula survivors who lack the resources and autonomy to pursue surgery. For some, however, surgery provides a chance for a new life."

Even though surgery can normally repair the injury, with success rates as high as 90 per cent for experienced surgeons. Not to mention that the average cost of fistula treatment and post-operative care is just $300 American dollars. Sadly, most women with obstetric fistula don't know that treatment is available, and in other cases they cannot afford it.

The Solution

According to the Department of State, `Because of their roles in child rearing, providing and seeking care, and managing water and nutrition, the ability of women to access health-related knowledge and services is fundamental to the health of their babies, older children and other family members. Over the long-term, the health of women enhances their productivity and social and economic participation and also acts as a positive multiplier, benefitting social and economic development through the health of future generations.'.

Obstetric fistula is preventable through medical interventions such as skilled attendance present during labor and childbirth, providing access to family planning, and emergency obstetric care for women who develop childbirth complications as well as social interventions such as delaying early marriage and educating and empowering young women.

Obstetric fistula can also be surgically treated. Surgery requires a specially trained surgeon and support staff, and access to an operating theater and to attentive postoperative care. When performed by a skilled surgeon, success rates can be as high as 90 percent and cost an estimated $300.

What will the Obstetric Fistula Prevention, Treatment, Hope, and Dignity Restoration Act do?

Under the Obstetric Fistula Prevention, Treatment, Hope, and Dignity Restoration Act, it would authorize the President of the United States to provide assistance, including through international organizations, national governments, and international and local nongovernmental organizations; (1) to address the social and health issues that lead to obstetric fistula; and (2) support treatment of obstetric fistula.

The assistance would provide;

 (1) increasing prevention through access to sexual and reproductive health services, including skilled attendance at birth, comprehensive emergency obstetric care, prenatal and antenatal care, and contraception (family planning);

(2) building local capacity and improving national health systems to prevent and treat obstetric fistula within the context of navigating pregnancy in good health overall;

(3) supporting tools to enable countries to address fistula, including supporting qualitative research, development of sustainable financing mechanisms, training of skilled birth attendants, promoting `south-to-south' training, and provision of basic obstetric care at the community level;

(4) addressing underlying social and economic inequities, including empowering women and girls, reducing incidence of child marriage, delaying childbirth, and increasing access to formal and non-formal education; and

(5) supporting reintegration and training programs to help women who have undergone treatment return to full and productive lives.

What can you do to get the Obstetric Fistula Prevention, Treatment, Hope, and Dignity Restoration Act passed?

Please write to and/or call your U.S. Representatives and Senators and President Obama tell them to pass the Obstetric Fistula Prevention, Treatment, Hope, and Dignity Restoration (H. R. 2888). Also ask your U.S. Representatives and Senators to co-sponsor the Obstetric Fistula Prevention, Treatment, Hope, and Dignity Restoration Act.

Also please sign the petition below.