What does Fistula Care do to prevent fistula?
Fistula Care emphasizes the importance of prevention everywhere it works. Prevention is complex, however, and the project recognizes that many needs lie beyond its scope.
Fistula Care provides technical assistance for four prevention interventions:
- Use of the partograph, a visual tool, when a woman is in labor
- Family planning counseling and provision of contraceptives or referrals
- Immediate catheterization of women who are experiencing, or who have recently experienced, prolonged or obstructed labor
- Quality cesarean-delivery services
Within communities, Fistula Care stresses the importance of antenatal care, birth planning/family planning, and skilled delivery care—all of which help to prevent fistula.
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What other issues need to be addressed if fistula is to be prevented?
Many factors contribute to the incidence of fistula. Here are some examples:
- A small pelvis is a common precursor to obstructed labor and the development of fistula. Improved nutrition for girls and pregnant women is necessary for proper growth. Also, where girls attend school and delay childbearing, the incidence of fistula declines.
- Several factors may prevent a woman in labor from reaching skilled care. Examples include poor roads and transportation and inadequate health care infrastructure and staffing.
- Traumatic fistula can result from sexual violence. As long as women are at risk of sexual violence, they are at risk of fistula.
- When providers of obstetric and gynecological services are poorly trained, they are more likely to cause iatrogenic fistula when performing cesarean sections, hysterectomies, operative vaginal deliveries, and other procedures.
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