Hypothesis / aims of study
Obstetric fistula continues to pose a significant yet preventable maternal health challenge among women and adolescent girls in low-resource settings, including Ghana. Although extensive research has documented the physical suffering, stigma, and social exclusion associated with the condition, far less attention has been directed toward the lived realities of recovery and life beyond surgical repair.
Emerging global health priorities now advocate for holistic, survivor-centred approaches that emphasize dignity, resilience, and meaningful reintegration into society (2,3).
These priorities resonate with the Sustainable Development Goals, particularly SDGs 3 (Good Health and Well-being), 5 (Gender Equality), and 10 (Reduced Inequalities), which underscore the importance of inclusive and equitable health outcomes (3). Against this backdrop, this study explores the recovery journeys, reintegration experiences, and lived aftermath of women and adolescent girls following obstetric fistula repair in Ghana.
Study design, materials and methods
A qualitative narrative inquiry design was used. Eleven participants (3 adolescents aged 15–19; 8 women aged 20–45) were purposively and snowball sampled. Data were collected through in-depth interviews guided by Appreciative Inquiry and analysed using Braun and Clarke’s (1) thematic analysis. Rigour followed Guba and Lincoln (4) for credibility, confirmability, conformability, transferability and authenticity.
Interpretation of results
Theme 1: Early Vulnerability
Participants described profound suffering shaped by child marriage, poverty, prolonged labour, and delayed access to care, leading to stigma and social isolation.
Asana, a 48-year-old woman, narrated from her reflections that “[…] I was married at age 15. I have suffered, yet I endured. With the last pregnancy, labour lasted almost two days at home. My baby died…, and I started leaking. I stayed indoors because of shame, but today, I smile because I am healed, feel liberated, and can walk freely again.”
Another participant, Precious, 33 years: “People avoided me because of the smell. I felt rejected and alone, but now I sit with others, laugh, and feel accepted again.” These narratives reveal how structural inequities produce deep emotional trauma and social exclusion.
Theme 2: Restored Identity
Recovery enabled reconstruction of identity, confidence, and belonging.
Munia (18 years): “Before, I hid from people because I was ashamed. Now I go to the market, laugh with friends, and feel proud of myself again.”
Maggi (33 years) concurred that: “My family accepts me now. I dress well, attend gatherings, and feel like a respected woman again.” These accounts signify restored dignity and social reintegration.
Theme 3: New Beginnings
Participants described empowerment, independence, and renewed purpose. Zeinab (28 years): “I have started trading again. I can now provide for my children, and I am happy seeing my life improve.”
Ekuwa (40 years): “I now speak to other women about treatment and encourage them. Helping others gives me joy, and my life has meaning again.” This demonstrates resilience and forward-looking transformation.
Theme 4: Emotional Burden and Psychological Recovery
Participants revealed deep psychological distress followed by emotional healing and inner peace. Adiza (17 years): “I stayed indoors because of shame and cried often, thinking my life was over, but now I feel free and happy again.” Yasmin (32 years): “I used to fear meeting people, but now I wake up happy, without fear, and feel confident in myself again.” This highlights holistic recovery beyond physical repair.