Obstetric fistula is a debilitating complication of childbirth; in low-income countries, more than 90% of fistula cases occur because of prolonged and unrelieved obstructed labor. Women with obstetric fistula are incontinent of urine, feces, or both; the resulting malodor may lead to avoidance of social gatherings (e.g. markets and churches) and can cause problems at home. Sexual intercourse is often affected, thus putting strain on marital relationships and increasing rates of divorce. As a consequence, affected women may become stigmatized and isolated by their partners, family, and friends.Several medical complications—including fetal loss, pelvic infection,pelvic nerve damage, and subsequent amenorrhea and infertility— can arise as a result of obstructed labor . The medical and social consequences of obstetric fistula are distressing and can have a profound effect on psychiatric health. Women affected by fistula who have been shunned and isolated typically experience intense feelings of shame, self-loathing, and depression. These depressive feelings may affect individual performance of daily activities, worsen interpersonal relationships, and even lead to self-neglect and suicidal thoughts

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Authors: Khisa Weston
Stephen Mutiso
Judy W. Mwangi
Zahida Qureshi
Jessica Beard
Pavithra Venkat