Obstetric Fistula - Prevention

Prevention

Prevention comes in the form of access to obstetrical care, support from trained health care professionals throughout pregnancy, providing access to family planning, promoting the practice of spacing between births, and supporting women in education and postponing early marriage. Fistula prevention also involves many strategies to educate local communities about the cultural, social, and physiological factors that condition and contribute to the risk for fistula. One of these strategies involve organizing community-level awareness campaigns to educate women about prevention methods such as proper hygiene and care during pregnancy and labor. Prevention of prolonged obstructed labor and fistula should preferably begin as early as possible in each female’s life. For example, improved nutrition and outreach programs to raise awareness about the nutritional needs of female children to prevent malnutrition as well as improve the physical maturity of young mothers, are important fistula prevention strategies. It is also important to ensure access to timely and safe delivery during childbirth: measures include availability and provision of emergency obstetric care as well as quick and safe Cesarean sections for women in obstructed labor. Some organizations train local nurses and midwives to perform emergency Cesarean sections to avoid vaginal delivery for young mothers who have under-developed pelvises. Midwives located in the local communities where fistula is prevalent can contribute to promoting health practices that help prevent future development of obstetric fistulas. NGOs also work with local governments like the government of Niger to offer free Cesarean sections, further preventing the onset of obstetric fistulas.

Promoting education for girls is also a key factor to preventing fistula in the long term. Former fistula patients often act as "Community Fistula Advocates" or "Ambassadors of Hope," an UNFPA-sponsored initiative, to educate the community. These survivors help current patients, educate pregnant mothers, and dispel cultural myths that obstetric fistula is caused by adultery or evil spirits. Successful ambassador programs are in place in Kenya, Bangladesh, Nigeria, Ghana, Cote d'Ivoire, and Liberia.

There are currently several organizations that have developed effective fistula prevention strategies. One of them is the Tanzanian Midwives Association, which works to prevent fistula by improving clinical health care for women and delaying early marriages and childbearing years, as well as help the local communities advocate the rights of females.