Doctor sheds light on a dark subject

A woman tends to an infant in a hospital which treats obstetric fistula, portrayed in the PBS documentary Half the Sky, based on the book of the same name by Nicholas Kristof and Sheryl WuDunn.

By Megan Pendagast

Dr. Catherine Belford-Budd is coming to Rider on Thursday, Nov. 15 at noon in Wright Hall to speak about obstetric fistula, a taboo subject paramount to women’s health, especially in developing nations.

Belford-Budd, who worked for years in obstetrics and gynecology at Thomas Jefferson Hospital in Philadelphia, has been teaching and advocating for awareness and prevention since 2000.

An obstetric fistula is a hole or tear in the birth canal caused by difficult childbirth and results in incontinence and other health problems as well as societal problems; those who suffer from this often face social segregation and shaming by their peers. It mostly affects young women and girls, particularly in developing nations. This severe medical condition is often considered to be a disease of poverty.

According to the World Health Organization (WHO), between 50,000 and 100,000 women worldwide are affected yearly and an estimated 2 million others live with untreated obstetric fistulas.

Belford-Budd did not realize the severity of the problem until she came across research on the subject matter.

“An article in The New England Journal of Medicine really opened my eyes to the problem,” Belford-Budd said. “It really becomes apparent with immigrants who come into the country. Countless medical students have encountered women who were living with this debilitating condition. I realized how important it was that everyone in medicine is aware of it and how to treat it. It’s an issue for all medical personnel.”

The WHO ranked preventing and managing obstetric fistulas as the fifth Millennium Development Goal of improving maternal health, but according to Belford-Budd, there isn’t enough public awareness.

She says that lack of education is a major problem in both preventing and treating the condition.

“In terms of the obstetric fistula population, most people in this country don’t realize how prevalent this problem is in developing countries,” Belford-Budd said. “It’s just not on our radar. In many places people aren’t trained because they don’t have exposure to this problem.”

Dr. Mary Morse, the director of the gender and sexuality studies program, believes the issue of obstetric fistula is underpublicized and misunderstood.

“I think it’s an important women’s health issue that we are very unaware of in this country,” Morse said. “It’s a consequence of cultures that encourage early childbirth. We don’t even know how common it is in other parts of the world. People don’t want to know about it.”

Morse recommended that Belford-Budd come to Rider to speak about the issue.

“I wasn’t aware that there was an entire hospital dedicated to helping women with these fistulas until Dr. Budd showed me her presentation,” Morse said. “These young girls’ bodies are not mature enough to handle these complications.”

Immature bodies often can’t cope with the physical strain of childbirth. Delaying the age of pregnancy as well as having timely access to obstetric care available gets to the root of the problem. Understanding that this is a medical issue could potentially go a long way in ceasing the social ostracism afflicted women often face.

If there is one thing that Belford-Budd wishes to get across, it is that this condition is entirely avoidable.

“It’s a preventable problem,” she said. “There is a pretty simple solution to a complex situation. It’s a contradiction — simple in terms of basic education and health care, but in terms of women’s rights and issues, it can be very difficult.”

According to Belford-Budd, there are many ways to get informed about obstetric fistulas and how to prevent and treat them. She recommends reading Half the Sky by Nicholas Kristof and Sheryl WuDunn or watching the PBS documentary based on the book in order to understand the issue.

“It isn’t a problem that takes a lot of money,” she said. “It takes planning and educating and taking care of women in the community and in childbirth with complications and sending more highly trained people. There needs to be a lot of education about fistula. The people in the medical community are the best people to get this across.”

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