Socio-demographic and reproductive health profile of women who experienced signs of obstetric fistula: Results from Pakistan Demographic and Health Survey (PDHS) 2006-2007

Midwifery. 2017 Nov:54:61-66. doi: 10.1016/j.midw.2017.08.002. Epub 2017 Aug 18.

Abstract

Objective: to examine the socio-demographic profile of women experiencing signs of obstetric fistula and factors contributing to the development of this condition in Pakistan.

Methods: secondary data analysis of Pakistan Demographic and Health Survey 2006-07, which for the first time measured signs of obstetric fistula, using a questionnaire at a population level. For the present study, questions directly related to obstetric fistula signs were used to construct a dependent variable. Data were analysed by descriptive and logistic regression analysis, to examine factors associated with development of fistula.

Findings: among women of reproductive age (n = 9134, aged 15-49 years), some 277 (3.0%, 30 per 1000 women who ever gave birth) experienced obstetric fistula signs, whereas 103 (1.1% of all women) were still experiencing the condition at the time of survey. In a logistic regression model, women from the Punjab region (OR = 5.67, 95%CI = 2.10-15.31), women who delivered by caesarean section (OR = 1.91, 95% CI = 1.06-3.42) and reported having complications during pregnancy were more likely to develop obstetric fistula (OR = 1.96, 95%CI = 1.19-3.16).

Conclusions: Obstetric fistula is one of the neglected public and reproductive health concerns in Pakistan. To eliminate this preventable tragedy, there is a need for better emergency obstetric care facilities and the availability of a fistula repair service throughout the country.

Keywords: Maternal health; Obstetric fistula; Obstructed labour; Pregnancy complications; Reproductive health.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Fistula / epidemiology*
  • Humans
  • Logistic Models
  • Middle Aged
  • Obstetric Labor Complications / epidemiology
  • Pakistan / epidemiology
  • Pregnancy
  • Reproductive Health / standards*
  • Risk Factors
  • Rural Population / statistics & numerical data
  • Social Class*
  • Surveys and Questionnaires
  • Urban Population / statistics & numerical data