Social Experiences of Women with Obstetric Fistula Seeking Treatment in Kampala, Uganda.
BACKGROUND
Obstetric fistula is a preventable and treatable condition predominately affecting women in low-income countries. Understanding the social context of obstetric fistula may lead to improved prevention and treatment.


OBJECTIVES
This study investigated social experiences of women with obstetric fistula seeking treatment at Mulago Hospital in Kampala, Uganda.


METHODS
A descriptive study was conducted among women seeking treatment for obstetric fistula during a surgical camp in July 2011 using a structured questionnaire. Descriptive statistics were computed regarding sociodemographics, obstetric history, and social experience.


FINDINGS
Fifty-three women participated; 39 (73.58%) leaked urine only. Median age was 29 years (range: 17-58), and most were married or separated. About half (28, 47.9%) experienced a change in their relationship since acquiring obstetric fistula. More than half (27, 50.94%) acquired obstetric fistula during their first delivery, despite almost everyone (50, 94.3%) receiving antenatal care. The median years suffering from obstetric fistula was 1.25. Nearly every participant's social participation changed in at least one setting (51, 96.23%). Most women thought that a baby being too big or having kicked their bladder was the cause of obstetric fistula. Other participants thought health care providers caused the fistula (15, 32.61%; n = 46), with 8 specifying that the bladder was cut during the operation (cesarean section). Knowing someone with obstetric fistula was influential in pursuing treatment. The majority of participants planned to return to family (40, 78.43%; n = 51) and get pregnant after repair (35, 66.04%; n = 53).


CONCLUSION
Study participants experienced substantial changes in their social lives as a result of obstetric fistula, and there were a variety of beliefs regarding the cause. The complex social context is an important component to understanding how to prevent and treat obstetric fistula. Further elucidation of these factors may bolster current efforts in prevention and holistic treatment.
['Meurice|Marielle|M|', 'Genadry|Rene|R|', 'Heimer|Carol|C|', 'Ruffer|Galya|G|', 'Kafunjo|Barageine Justus|BJ|']
D000293:Adolescent D000328:Adult D036861:Delivery, Obstetric D005260:Female D006801:Humans D008875:Middle Aged D007744:Obstetric Labor Complications D011247:Pregnancy D036301:Qualitative Research D012006:Rectovaginal Fistula D058992:Social Participation D057545:Social Stigma D011795:Surveys and Questionnaires D014454:Uganda D014624:Vaginal Fistula D014719:Vesicovaginal Fistula D055815:Young Adult
Social experience Obstetric fistula Uganda Genitourinary fistula Maternal health Obstructed labor