Online Reporter
Disability Issues
Dr Christine Peta
MANY women recover fully after pregnancy and childbirth.
However, some may acquire disabilities requiring support and management. These disabilities are diverse.
Common disabilities and complications include post-partum depression (PPD), post-traumatic stress disorder (PTSD), long-term anxiety, pelvic floor disorders (PFDs), chronic low back pain and obstetric fistula.
Obstetric fistula is in the spotlight this month because May 23 was the United Nations International Day to End Obstetric Fistula.
The United Nations Population Fund (UNFPA) is leading a global campaign to end obstetric fistula, aiming to transform the lives of vulnerable women and girls.
UNFPA states that this year’s theme, “Breaking the Cycle: Preventing Fistula Worldwide”, underscores the urgent need to address obstetric fistula comprehensively.
This includes emphasising equitable access to quality maternal health services, social reintegration and sustained investment in healthcare systems.
Obstetric fistula is a hole between the birth canal and the bladder or rectum. It is caused by prolonged, obstructed labour without access to timely, high-quality medical treatment.
The sustained pressure of a baby’s head against the mother’s pelvis cuts off the blood supply, causing tissue to die and fall away, leaving a hole called a fistula.
This hole leaves women and girls leaking urine, faeces, or both, often leading to chronic medical problems, depression, social isolation and deepening poverty.
Affected women often struggle to access livelihood opportunities.
There are different types of fistulas.
In scenarios of substandard healthcare and inadequate surgical skills, some fistulas are caused by gynaecological procedures that may have gone wrong, such as hysterectomy (surgical removal of the uterus) and Caesarean section.
Traumatic fistulas are caused by sexual violence, especially in conflict areas; the destruction of the vagina is considered a war injury. Women with obstetric fistula often experience physical and emotional suffering.
Fistulas can also result in kidney disease, infections, painful sores, ulcerations, infertility and even death. Affected women also experience stigma, discrimination, shaming and loneliness.
The smell from continuous leaking of urine and faeces may lead to dislike and abandonment by friends, family and community members. Some women with obstetric fistula may suffer from depression and suicidal thoughts; additional mental health issues may also arise.
Women with disabilities are increasingly becoming pregnant.
However, some disabilities may put them at an increased risk of complications during the perinatal period (pregnancy, labour, delivery and the immediate post-partum period of six to eight weeks as the mother’s body returns to its pre-pregnancy state).
However, the United Nations Convention on the Rights of Persons with Disabilities clearly states that persons with disabilities have a right to decide on the number and spacing of their own children.
Therefore, preventing women with disabilities from having biological children, for example, through forced sterilisation, is a serious violation of their human
rights.
Young mothers, who may be below the age of 20, face an elevated risk of perinatal disabilities because their bodies may not be fully developed, resulting in complications during pregnancy and childbirth.
They are also more likely to experience nutritional deficiencies, inadequate prenatal care and increased stress levels, which can contribute to adverse outcomes for both the mother and the baby.
Additionally, young mothers might be less aware of the risks associated with pregnancy or less likely to seek timely medical attention, thus further increasing their vulnerability.
Social and economic factors like poverty and lack of social support can also play a significant role in exacerbating these risks.
There is a need to support young women, and women with and without disabilities during the perinatal period to prevent the occurrence of disabilities or additional ones
Physical therapy during recovery from injuries and psychosocial support, which includes counselling, is essential.
Reproductive health education, which enhances understanding of potential risks and preparation for pregnancy and childbirth, may be a mitigating factor.
The value of appropriate medical care and mental health support during and after pregnancy should not be underestimated.
Dr Christine Peta is a disability, public health, policy, international development and research expert. She can be contacted on: [email protected]
Online Reporter