Partners in the Suffering: African Male Spouses Stories and Experiences Living with Obstetric Fistula Women

Nyarko Mensah O1, Vormawor A2, Cudjoe R2, Eshun E3, Oduro-Kwarteng V4

Research Type

Clinical

Abstract Category

Female Stress Urinary Incontinence (SUI)

Abstract 210
On Demand Female Stress Urinary Incontinence (SUI)
Scientific Open Discussion Session 18
On-Demand
Fistulas Female Male
1. Nursing and Midwifery Training College, Kumasi- Ghana; Ghana College of Nurses and Midwives, Ghana, 2. Komfo Anokye Teaching Hospital Kumasi- Ghana, 3. Garden City University , Kenya's-Kumasi , Ghana, 4. Nursing and Midwifery Training College, Kumasi- Ghana
Presenter
O

Olivia Nyarko Mensah

Links

Abstract

Hypothesis / aims of study
Introduction
Male involvement in maternal health issues such as obstetric fistula care is currently drawing the attention of organizational bodies and governmental agencies and stakeholder globally. The increasing advocacy to eradicate obstetric fistula worldwide have identified the need to consider the involvements of male partner in interventional efforts, especially in the goal of prevention, treatments and reintegrating of the woman back into community after repair .
Obstetric Fistula is deeply an unpleasant condition, resulting in constant leakage of urine and faeces through the vagina. For more than three decades the condition has been labelled as one of the silent epidemics in Africa which is still making headline as a remarkable maternal health issue.  According to the World Health Organization [WHO] (2019), in Africa alone an estimated 2-3 million women and girls are living with Obstetric Fistulas. Also between 50 000 to 100 000 women diagnosed yearly with the highest prevalence of 300, 000 solely in the sub-Saharan African countries with approximately 700 new cases reported annually in Ghana. Male partners in their quest to support their spouses and partners have varied experiences and stories to share. However, there is a lack of ample evidence on male partners and spousal involvements in the are and treatment of women and girls with the devastating but preventable Obstetric fistula condition. The identified gap in the  literature has to do with the stories on male partners involvement in the treatment and care of women suffering form Obstetric Fistula. 

Study Aim:
The study sought to help understand the in-depth experiences and stories of Male partners who are living with  women with Obstetric fistula.
Study design, materials and methods
Using the qualitative approach, the narrative inquiry design was used as a framework to understand the participants’ experiences and their reflections in living with women with Obstetric Fistula in Africa. This qualitative study was conducted with purposeful and criteria-based sampling selection from August to October, 2019. Face to face conversational interviews with unstructured interview guide was used to enhance the conversation from three male participants between the ages of 32-60 who voluntarily consented and agreed to go through the research. Agreed pseudonyms  of participant numbers were used for anonymity and confidentiality sake to comply with ethics rules.. Verbatim transcriptions of the narrations were turned into text and narrative content analysis (Rantakari & Vaara, 2017:271) was used to analyse the collected data.
Results
Findings/ Results 
Three overarching themes that emerged from their stories include “Psychosocial ad emotional torture and reality”, “deprivation and changes with sexual life”, “divorce is an option if resilience to support fails”. The results of this study showed the depths of the burden that sis placed on the Obstetric Fistula sufferer and how the male partner share the burden. Finally, this study created an avenue  for male partners to voice out their candid experiences and involvement in the care of women with Obstetric Fistula.
Interpretation of results
Theme 1: “Psychosocial ad emotional torture and reality”, 

“[...] Hmmm, I must say that with all the years of experience in living a woman with leakage of urine , its never been easy at all, its been a real hustle because it looks like mystery yet a reality on the grounds.The experience is more than a mental torture and its full of household responsibilities , taking care of the sick wife, the children and struggle to get some monies for the house, ensuring all matters surrounding the experience is kept in private. I tell you its never an easy task at all,  sometime I have  to lie about what is happening  when I am questioned as to why I am always doing the house chores " 
                                                                                                                                             
                                                                                                                                         Participant 2, 42 years old 

Participant 3 lamented that: 

" The reality is that I am talking about a woman who was very beautiful and whenever she undress in my presence I felt satisfied with her but honestly as it stands now, I am dying within because I feel  bothered about every about her but I wouldn't  like her  to also  know what I am going through.i thought I will be enjoying my marriage with my pension baby and my beautiful wife but its rather unfortunate it did not turn out the way I anticipated and planned it. Tell me ! what you will go on with your mind if you were in such a situation. wouldn't it have been stressful for you ? I am actually stressed I  must say but we are in the hardship together. I need to continually support her after all what will gain leaving her for another woman at my age.  There is no need although my I am still sexually active. I could only pray for some positive change and miracle to happen when see goes for the operation (surgery) as discussed."                                                                                                                             

                                                                                                                                               Participant 3,  60 years


 Theme 2 : “Deprivation and changes with sexual life”, 
”In fact  living in the same roof with a woman you are married to and had sexual intercourse with for years and reflecting that before the disease condition, her looks sometimes initiate sexual activities. Now I am unable to have sex intercourse with her because of the condition and she doesn't also look attractive any longer in current state. I no longer have access to her as it used to be. For me I can only give myself a year..."  
      
                                                                                                                                           Participant 1, 39  years old

" [CRYING] I am absolutely tired of this punishment in marriage. 
... madam its getting too difficult now because  ever since my wife delivered and had the fistula condition I have been without sex intercourse for 2 solid years and its getting difficult. If I tried going close, she complains of lower abdominal pain and cries. I smell alone few minutes after bathing puts me off from sex. Sometime she ask me whether I feel for other women or feel for sex but I could only answer her with another question: how do you see the situation? and just leave it there."
                                                                                                                                            Participant 2, 42 years old 
Theme 3 : “divorce is an option if resilience to support fails”. 

[...] I think I have done my best supporting my wife in this journey but I am a man who need a woman who will satisfy me. I know she could testify that I have supported her so much, going extra mile of doing the thing any man will do for a wife but if the condition persist I have no option than to leave the marriage for another woman because I have no child " Participant 1, 39 years
Concluding message
Conclusion
Our study concluded that male partners are equally challenged  and are overwhelmed with varied psychosocial and emotional struggles as their spouses live with the Obstetric Fistula disease.  Although they try their best to support their partners, policy makers  could help empower the male partners identifying strategies to support their spouses and also help as key agents to prevent , treat and help reintegration in their communities again as strong point to help eradicate Obstetric fistulas in Sub-Saharan Africa.
References
  1. Ghana News Agency Wed 22nd May, (2019) 21:31 Ghana joins the world to mark International Day to End Obstetric Fistula. http://78.47.45.183/agency/ghana- news-agency/20190522/122199622/ghana-joins-the-world-to-mark-international-day-to-end-obstetric-fistula
  2. World Health Organization [WHO].(2019) Sexual and reproductive health: End fistula. Restore Women's Dignity. 2019. Accessed from: https://www.who.int/reproductivehealth/topics/maternal_perinatal/fistula/en/. Accessed on: 11 April 2019.
  3. Rantakari, A., & Vaara, E. (2017). Narratives and processuality. Sage Handbook of Process Organization Studies, Sage, London, 271-285.
Disclosures
Funding self-funded Clinical Trial No Subjects Human Ethics Committee Committee for Human Research Publication and Ethics Helsinki Yes Informed Consent Yes
27/03/2024 19:07:26