Obstetric Fistula: Why expectant mothers must register with skilled birth attendant

With about 500,000 Nigerian women living with obstetric fistula, women need to avail themselves with regular medical check up to prevent health complications, including fistula, which could lead to death of mothers.

As Nigeria, 0n May 23,joined the rest of the world to commemorate the World Fistula day, experts say there is a need for collective action to get appropriate treatment to avoid the needless debilitating conditions and death that could result from pregnancy and childbirth complications in the country.

Obstetric Fistula according to expert is medical condition in which a hole develops in the birth canal as a result of childbirth; between the vagina and rectum or bladder, caused by prolonged, obstructed labour, leaving a woman incontinent of urine or faeces or both.

Research has it that Nigeria records no fewer than 12,000 new cases of fistula annually as a result of complications in childbirth. Most fistulas are as a result of difficult childbirth and obstructed labour lasting more than 24 hours.

Akin Jimoh, Programme Director, Development Communications Network, which currently is implementing the NotAgain Campaign (notagaincampaign.org) to address the needless deaths of mothers due to complications in pregnancy and childbirth in Nigeria asserted that “we need to end obstetric fistula in Nigeria by addressing all factors, from poverty to early childbearing, that predisposes women, especially the girl-child to this debilitating condition,” he said while addressing bloggers and journalists in Lagos yesterday at an event to mark obstetrics fistula day.

According to UNFPA Nigeria, each year some 50,000-100,000 women sustain an obstetric fistula in the act of trying to bring forth new life. It is the most devastating of all pregnancy-related disabilities and Nigeria accounts for 40% of fistula cases worldwide.

Currently, there are about half a million women in Nigeria suffering from vesico vaginal fistula (VVF), according to the Ministry of Health.

To end fistula, a Consultant Obstetrician & Gynaecologist at the Lagos State University Teaching Hospital, (LASUTH), Dr. Yusuf Oshodi, told Nigeria Health Online (NHO) that the only option for women’s labour to be supervised by skilled birth attendant.

“Women should register where there is a skilled birth attendant to monitor their labour, so that if things are not going well they will act promptly and accordingly.

“What causes fistula is long obstructed labour, if labour is going on and it is neglected nobody bothered about how events were going on, whether there is a problem, or a need for intervention. But if they are monitored by a skilled birth attendant like midwife, obstetricians, doctors, those that are trained in that act then fistula will be a thing of the past,” Dr Oshodi said.

How then do we help the women living with Fistula? “About 6,000 fistula repairs are performed every year in Nigeria but more than 148,000 women were on the waiting list for surgery (The Nigerian National Strategic Framework, 2008). Some of the VVF centers do not have enough beds or adequate electricity to operate. Government need to increase the funding allocated to the health sector and implement provisions of various policies to address the needs of women and children,” Mr. Jimo said.

The annual International Day to End Fistula (IDEOF) was set aside by the United Nations, as a day to rally support and draw attention to activities targeting the elimination of fistula around. According to UNFPA, the theme of this year’s IDEOF, “Hope, healing, and dignity for all,” is, at its heart, a call to realize the fundamental human rights of all women and girls everywhere, with a special focus on those most left behind, excluded and shunned by society.

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