Recto-vaginal fistula: A first-time mom’s sad experience

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Two years ago, as I anxiously waited for the arrival of my first child, my labor failed to progress.

The day my water broke, I had gone for a scan and everything seem normal, I was not so worried because it was two weeks before my due date. However, as first time parents, we still waited with bated breath. Surprisingly, my water broke at 2:00 am while sleeping and I woke up panicking. I got my husband’s attention, who was visibly worried, scared and confused. Which was appropriate for a first time dad but he has definitely gotten better in subsequent pregnancies. He then helped me get ready and we drove to the hospital. The midwives examined me and revealed I was 6cm dilated and then prepared for the labor ward at about 6 AM. (10cm is considered as full dilation)

When it was time to push, I had so much difficulty in pushing. I was in distress and recall that I was trying my very best but sadly my midwife was rude and angry at me. She shouted at me every opportunity she got and left me periodically during the process to attend to other patients till I was visibly exhausted and could barely push anymore. It was then she informed me that, a surgical scissors will be use to cut my perineum to enlarge the vaginal openining (Episiotomy) to make it easier for my baby to pass through. I pleaded and cried. It was during this interaction that a doctor came in and used a vacuum to extract the baby. Finally! my misery ended and I felt a sign of relief although a exhausted and in pain. However the joy of having a baby boy, overshadowed everything that had happened!

Mayo clinic explains that vacuum extraction or vacuum-assisted delivery is a procedure sometimes done during the course of vaginal childbirth, where, a health care provider applies the vacuum — a soft or rigid cup with a handle and a vacuum pump — to the baby’s head to help guide the baby out of the birth canal. This is typically done during contraction while the mother pushes. The process of extracting a baby with a vacuum happens when the labour meets certain criteria. The criteria include when the cervix is fully dilated, the membranes have ruptured and the baby has descended into the birth canal headfirst, but the mother is not able to push the baby out.
(Source:Mayo Clinic)

Sadly, I had laboured for 10 hours and I showed signs of stress, anxiety and exhaustion, thus the appropriate solution to save me and my child’s life.

I went home happy with my healthy son but after some weeks, I realized when ever I passed out watery stool, I would find some pieces of stool coming from my vagina. As a first time mom, I assumed it was normal after birth and it would eventually stop but this never happened. I informed my mom who advised we go back to the hospital to inform the doctors and this was when I relized it was an actual problem!

Although I visited the hospital throughout the progression of my pregnancy. At no point did anyone take me through the birthing process especially on how to progress labor or how to breath in and out in between labor. I had done my own reading and expected atleast the midwife to guide me but rather ended up with a mean, rude and unbothered midwife. Additionally, it should be noted that before I got discharged from the hospital I had been told that I had a third degree tear on my vagina opening and they had gotten it stitched.

I visited the hospital where I had my baby and complained to them about what was happening to me. That was when I realized it wasn’t normal. I had Recto-Vaginal Fistula. Even though my condition could be considered mild compared to other cases, where mothers actually had visible and large stool leakage in to their vagina. Leading to other complications. My situation warranted surgery and treatment.

According to Mayo Clinic Recto-Vaginal Fistula is an abnormal connection between the lower portion of your large intestine — your rectum — and your vagina. Bowel contents can leak through the fistula, allowing gas or stool to pass through your vagina. The common causes of rectovaginal fistula mostly result from injuries during child birth and the other causes being crohn’s disease. Some of the symptoms, depending on the fistula’s size and location, you may have minor symptoms or significant problems with continence and hygiene. Signs and symptoms of a Recto-vaginal fistula may include:
Passage of gas, stool or pus from your vagina
Foul-smelling vaginal discharge
Recurrent vaginal or urinary tract infections
Irritation or pain in the vulva, vagina and the area between your vagina and anus (perineum)
Pain during sexual intercourse.
(Source: Mayo Clinic)

I was booked to have surgery to correct the anomality but after some weeks of waiting. I came to the hospital and was prepared for surgery. On the day of surgery, I waited all day to be taken to the theater, however the doctors came back with some new faces to examine my condition and realized I had a small hole on the layer that connects the anus and the vagina and said they couldn’t work on it as it needed a specialist. Thus I was referred to a specialist at Korle-bu teaching hospital.

Could you imagine my anxiety, the distress and confusion as a new mother? I was experiencing separation anxiety from my child and now I was sitting through a waiting room of an operating theater only to be told my surgery wasn’t going to happen that day? .

The following week, I followed up but to my disappointment, I was told the specialist was not reachable.

I knew I needed to take action as this was my health on the line. I reached out to a friend who happened to work at the Korle Bu teaching hospital about my situation. She helped me get in touch with the specialist eventually. The waiting period was filled with boots of anxiety, fear, anger, depression and shame. I finally had the surgery in June and was told not to have vaginal delivery again. This is because of the likelihood of another tear. My second child was by Caesaren Section which was a smoother and better delivery experience.

Recto-vaginal fistula affects your self confidence and causes you emotional distress. I am thankful in my case I had a concerned husband who went all out to get me the needed help and medical attention.

Maybe my story could have been different if I had a midwife who took her time with me, maybe not but I believe midwives have to be more careful and professional in dealing with women who have come to deliver their children. We are having children via our vaginas, we are not just peeing!

Source : Anonymous


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