Third and fourth degree obstetric tears have high rates of prevalence and mortality in the developing world. An obstetric fistula is an abnormal connection between the rectum and the vagina. Third and fourth degree tears are caused by prolonged, obstructed labor and limited access to emergency c-sections. Un-repaired tears post delivery can cause vaginal leakage, or fecal and urinary incontinence, which creates enormous levels of stress for the women suffering from the tears. Un-repaired tears can be very stigmatizing, causing women to stay home from work and families to be torn apart. According to research conducted by Massachusetts General Hospital (MGH), approximately 32% of 180 women were found to have a third or fourth degree obstetric tears.
Dr. Leeya Pinder of MGH and Ms. Kelsey Natsuhara, a Harvard medical student, are partnering with KMET members including Ms. Liddy Dulo (OBT Manager) and Ms. Monica Ogutto (Executive Director) to conduct a knowledge assessment on obstetric fistulas. Providers in the Siaya County area, including midwifes and birth attendants will be tested to see if they know how to recognize an obstetric tear, if they know how to treat a tear, and if they know where to refer the patient once the tear is recognized.
Picture of Dr. Leeya Pinder to the right and Ms. Kelsey Natsuhara to the left
The assessment Dr. Leeya Pinder and Ms. Kesley Natsuhara have created will be extremely useful for the second phase of the study. After the assessment is complete, a training module will be created for the providers to learn how to properly recognize, treat, and refer cases of third and fourth degree perineal tears to those who are trained to handle them. The training will be helpful in preventing more serious conditions from occurring, reducing the need for expensive surgeries later on due to obstetric tears.