title: Social and economic consequences of obstetric fistula: life changed forever?
abstract: OBJECTIVE
  To summarize the social, economic, emotional, and psychological consequences incurred by women with obstetric fistula; present the results of a meta-analysis for 2 major consequences, divorce/separation and perinatal loss; and report on improvements in health and self-esteem and on the possibility of social reintegration following successful fistula repair.
  
  
  METHODS
  We conducted a review of the literature published between 1985 and 2005 on fistula in developing countries. We then performed a meta-analysis for 2 of the major consequences of having a fistula, divorce/separation and perinatal child loss.
  
  
  RESULTS
  Studies suggest that surgical treatment usually closes the fistula and improves the physical and mental health of affected women.
  
  
  CONCLUSIONS
  With additional social support and counseling, women may be able to successfully reintegrate socially following fistula repair.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. sahmed@jhsph.edu
authors.forename: S
authors.initials: S
authors.lastname: Ahmed
authors.forename: S A
authors.initials: SA
authors.lastname: Holtz
mesh_terms: D000293:Adolescent; D000328:Adult; D003906:Developing Countries; D004243:Divorce; D005260:Female; D006262:Health; D006801:Humans; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000191:economics* / Q000523:psychology* / Q000601:surgery; D011247:Pregnancy; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012944:Social Support; D016896:Treatment Outcome; D014624:Vaginal Fistula / Q000175:diagnosis* / Q000191:economics* / Q000523:psychology* / Q000601:surgery