“Hoping for a Normal Life Again”: Reintegration After Fistula Repair in Rural Tanzania

Abstract

Objective: To explore women’s expectations, worries, and hopes related to returning to their family and community after fistula repair . Methods: We used a concurrent mixed methods design with a hospital survey and qualitative interviews . One hundred fifty-one women completed a questionnaire, eight were interviewed in hospital after fistula repair, and one woman was followed up at home for six months during the reintegration phase . Results: Women were concerned about where they could live and about not being accepted by their husbands and in-laws . While 51% feared that their husbands would not accept them despite full recovery, 53% said their parents would accept them . In the qualitative study women wished to live with their parents, whereas almost one half (49 .7%) of the women in the quantitative study, who had lived with fistula for a shorter time, wished to live with their husbands . All women hoped to have children in the future, although many women, especially those with no children, were worried about whether they could bear children in the future . Despite fears related to economic survival and social acceptance, women were optimistic about regaining a normal social life . Conclusion: Women’s expectations of going home after fistula repair are linked to their history of living with obstetric fistula . For women who have lived with a fistula for many years, reintegration involves re-establishing an identity that is clean and respected . To facilitate this transition, fistula repair needs to be accompanied by psychological and social rehabilitation and assistance in returning to reproductive capabilities .