Intended for healthcare professionals

Practice A Patient’s Journey

Living with obstetric fistula

BMJ 2011; 342 doi: (Published 09 June 2011) Cite this as: BMJ 2011;342:d2881
  1. Fatima Aliyu, patient 1,
  2. G Esegbona, obstetric gynaecologist specialist 2
  1. 1Kano, Nigeria
  2. 2Laure Fistula Centre, Murtala Muhammad, Specialist Hospital, Kano, Nigeria
  1. Correspondence to: G Esegbona gesegbona{at}
  • Accepted 13 March 2011

During the birth of her first child in 2000, Fatima Aliyu developed two fistulas: vesicovaginal fistula and a rectovaginal fistula. She is not yet fully cured and anticipates further surgery.

When we arrived at the clinic I was just at the beginning of labour. I stayed there for a day and the pain kept increasing. One of the nurses asked me to push so as to increase the labour. I continued pushing with no sign of delivery. The next day a doctor came and told me that the labour was not progressing. He said I should be induced so that I could deliver.

There was no sign of delivery except the kicking of the baby in my womb. During my third day at the hospital the nurse on duty heard me screaming because of the terrible pain. She said “You are the only one giving us a problem and it is because you are so lazy. It is as if you are not a woman. Can’t you see all the other mothers have delivered and gone home with their babies?” She told me to stand up and start going up and down. The nurse said that moving this way might help me to deliver. I started doing as she said and then something burst out of me. Black water started trickling down my legs. She said “Maybe now you are going to deliver.” For over 30 minutes I was pushing on the bed but nothing progressed. On the fourth day when I felt like urinating nothing came out, only blood. By now I couldn’t walk, my legs were very heavy as if they were frozen.

On the sixth day I started losing consciousness and my mother was terrified that I might not survive. My parents asked the management staff to …

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