A Multidisciplinary Approach to Obstetric Fistula in Africa

1. Front Matter

   Pages i-xxv

   PDF

2. Obstetric Fistula

   1. Front Matter

      Pages 1-1

      PDF

   2. Introduction to Obstetric Fistula: A Multidisciplinary Approach to a Preventable Childbirth Tragedy

      • Bonnie Ruder, Laura Briggs Drew, David A. Schwartz

      Pages 3-5

   3. A Human Rights Approach Toward Eradicating Obstetric Fistula: Expanding Data Collection, Prevention, Treatment, and Continuing Support for Women and Girls Who Have Been Neglected

      • Laura Briggs Drew

      Pages 7-23

   4. Archeological Basis for Obstetrical Fistula: A Condition That Is as Ancient as Human Themselves

      • David A. Schwartz

      Pages 25-36

   5. Obstetric Fistula in Context

      • L. Lewis Wall

      Pages 37-50

   6. Co-occurrence of Obstetric Fistula and Stillbirth in Sub-Saharan Africa

      • Karen D. Cowgill

      Pages 51-75

   7. A Multidisciplinary Approach to Obstetric Fistula in Africa: Public Health, Sociological, and Medical Perspectives

      • Tina Lavender, Sabina Wakasiaka, Weston Khisa

      Pages 77-89

   8. Women Who Lose Their Lives While Giving Life: Exploring Obstetric Fistula as a Public Health Issue in Kenya

      • Kathomi Gatwiri

      Pages 91-103

3. Perspectives and Experiences from Women and Girls with Obstetric Fistula

   1. Front Matter

      Pages 105-105

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   2. Obstetric Fistula: A Case of Miscommunication—Social Experiences of Women with Obstetric Fistula

      • Marielle E. Meurice, Saifuddin Ahmed, René Génadry

      Pages 107-119

   3. The Experience of Childbirth and Obstetric Fistula: Perspectives of Women in Northern Ghana

      • F. Beryl Pilkington, Prudence Mwini-Nyaledzigbor, Alice Abokai Agana

      Pages 121-134

   4. The Experiences of Women Living with Obstetric Fistula in Burkina Faso: From Delivery to Social Reinsertion

      • Marie-Eve Paré, Julie Désalliers, Laurence Bernard, Salam Kouraogo, Jacques Corcos

      Pages 135-152

   5. Girls’ and Women’s Social Experiences with Obstetric Fistula in Tanzania: A Public Health Problem

      • Stella Masala Mpanda, Lilian Teddy Mselle

      Pages 153-166

   6. Physical, Psychological, and Social Assessments of Fistula Recovery Among Women in Nigeria and Uganda

      • Beth S. Phillips, Justus K. Barageine, Dorothy N. Ononokpono, Alison M. El Ayadi

      Pages 167-186

   7. Socioeconomic and Healthcare Causes of Obstetric Fistula in Tanzania: Perspectives from the Affected Women

      • Lilian Teddy Mselle, Stella Masala Mpanda

      Pages 187-203

   8. Health-Seeking Behavior Among Women with Obstetric Fistula in Ethiopia

      • Jordann Loehr, Heather Lytle, Mulat Adefris

      Pages 205-224

4. Fistula Treatment, Management, and Models of Care

   1. Front Matter

      Pages 225-225

      PDF

   2. Classification of Female Genital Tract Fistulas

      • Judith Goh, Hannah G. Krause

      Pages 227-237

   3. Surgical Treatment for Obstetric Fistula: Not an Easy Option

      • Andrew Browning

      Pages 239-254

This book applies a multi-disciplinary lens to examine obstetric fistula, a childbirth injury that results from prolonged, obstructed labor. While obstetric fistula can be prevented with emergency obstetric care, it continues to occur primarily in resource-limited settings. In this volume, specialists in the anthropological, psychological, public health, and biomedical disciplines, as well as health policy experts and representatives of governmental and non-governmental organizations discuss a scoping overview on obstetric fistula, including prevention, treatment, and reducing stigma for survivors. 
 
This comprehensive resource is useful in understanding the risk factors, epidemiology, and social, psychological, and medical effects of obstetric fistula.


Topics explored include:

• A Human Rights Approach Toward Eradicating Obstetric Fistula
• Obstetric Fistula: A Case of Miscommunication – Social Experiences of Women with Obstetric Fistula
• Classification of Female Genital Tract Fistulas
• Training and Capacity-Building in the Provision of Fistula Treatment Services
• Designing Preventive Strategies for Obstetric Fistula
• Sexual Function in Women with Obstetric Fistula
• Social and Reproductive Health of Women After Obstetric Fistula Repair
• Making the Case for Holistic Fistula Care
• Addressing Mental Health in Obstetric Fistula Patients
• Physical Therapy for Women with Obstetric Fistula

A Multidisciplinary Approach to Obstetric Fistula in Africa is designed for professional use by NGOs, international aid organizations, governmental and multilateral agencies, healthcare providers, public health specialists, anthropologists, and others who aim to improve maternal health across the globe. Although the book’s geographic focus is Africa, it may serve as a useful resource for individuals who aim to address obstetricfistula in other settings. The book may also be used as an educational tool in courses/programs that focus on Global Health, Maternal and Child Health, Epidemiology, Medical Anthropology, Gender/Women's Studies, Obstetrics, Global Medicine, Nursing, and Midwifery.

• obstetric fistula
• incontinence
• obstructed labor
• prolonged labor
• cesarean section
• childbirth injury
• stillbirth
• maternal death
• fistula prevention
• social reintegration
• stigmatization
• reproductive health
• emergency obstetric services
• poverty
• women's health
• maternal morbidity and mortality
• maternal health
• adolescent marriage
• teenage pregnancy
• pregnancy complications

• Office of the Senior Vice President and Provost University of Maryland, College Park, USA

  Laura Briggs Drew

• Terrewode Women’s Fund, Eugene, USA

  Bonnie Ruder

• Perinatal Pathology Consulting, Atlanta, USA

  David A. Schwartz

Laura Briggs Drew, PhD, MPH received her PhD in Maternal and Child Health from the University of Maryland (UMD) School of Public Health in College Park. She was appointed as a Maternal and Child Health Student Fellow with the American Public Health Association in 2016-2017. Laura completed her Master of Public Health in Epidemiology and Interdisciplinary Specialization in Global Health at The Ohio State University. Prior to UMD, she worked with University of North Carolina Project-Malawi on various research studies that aimed to improve the quality of life for women with obstetric fistula at the Freedom from Fistula Foundation’s Fistula Repair Centre at Bwaila Hospital in Lilongwe, Malawi. Laura’s primary research interests focus on the intersection of human rights and reproductive, maternal, and child health outcomes. Her research focuses on birth outcomes, intimate partner violence, female genital cutting, sexual health, infertility, infectious diseases, and gender inequality. Laura’s research has been published in numerous public health journals, including Women’s Reproductive Health, BMC Pregnancy and Childbirth, American Journal of Preventive Medicine, PLOS Neglected Tropical Diseases, and Journal of Women’s Health. Laura’s work has received support and recognition from multiple institutions, including the Maryland Population Research Center and the Delta Omega Honorary Society in Public Health.

Bonnie Ruder, PhD, MPH, CPM holds a PhD in Applied Medical Anthropology and a Master in Public Health in International Health from Oregon State University. She is the co-founder and Executive Director of Terrewode Women’s Fund, a US-based non-profit organization; a senior research consultant with the International Fistula Alliance; and sits on the Board of Governors for Terrewode Women’s Community Hospital. She conducts research on maternal health and obstetric fistula and has worked on projects in Uganda, Somalia, The Gambia, Zimbabwe and the USA. Her research focuses on obstetric fistula, residual incontinence post-fistula repair, maternal and infant health, reproductive justice, traditional birth attendants, social justice and systems of oppression, and community-engaged research. Bonnie is a licensed midwife with over 20 years’ experience, working primarily in the USA. She has also attended births in Haiti after the 2010 earthquake and at a referral hospital in Soroti, Uganda. Her current research examines the COVID-19 pandemic’s impact on gender and maternal health in Uganda.

David A. Schwartz, MD, MS Hyg, FCAP has an educational background in Anthropology, Medicine, Emerging Infections, Maternal Health, and Medical Epidemiology & Public Health. He has professional and research interests in reproductive health, diseases of pregnancy, and maternal and infant morbidity and mortality in both resource-rich and resource-poor countries. In the field of Medicine, his subspecialties include Obstetric, Placental & Perinatal Pathology as well as Emerging Infections. An experienced author, editor, investigator and consultant, Dr. Schwartz has long experience investigating the anthropological, biomedical and epidemiologic aspects of pregnancy and its complications as they affect society, in particular among indigenous populations and when they involve emerging infections. Dr. Schwartz has been a recipient of many grants, was a Pediatric AIDS Foundation Scholar, and has organized and directed national and international projects involving maternal health, perinatal infectious diseases, and placental pathology for such agencies as the US Centers for Disease Control and Prevention, National Institutes of Health, and the United States Agency for International Development, as well as for the governments of other nations. He has published 3 previous books on pregnancy-related morbidity and mortality, the first in 2015 entitled Maternal Mortality: Risk Factors,Anthropological Perspectives, Prevalence in Developing Countries and Preventive Strategies for Pregnancy-Related Deaths; a book published in 2018 entitled Maternal Death and Pregnancy-Related Morbidity Among Indigenous Women of Mexico and Central America: An Anthropological, Epidemiological and Biomedical Approach; and in 2019 a book entitled Pregnant in the Time of Ebola. Women and Their Children in the 2013-2015 West African Epidemic.  Dr. Schwartz is the editor of the Springer book series Global Maternal and Child Health: Medical, Anthropological and Public Health Perspectives, of which this book is a volume. He has been involved with maternal, fetal and neonatal aspects of such epidemic infections as HIV, Zika and Ebola viruses, and is currently researching these issues with the COVID-19 pandemic. Dr. Schwartz serves on the Editorial Boards of several international journals and was formerly Clinical Professor of Pathology at the Medical Collegeof Georgia of Augusta University in Augusta, Georgia.

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