Hypothesis / aims of study
Introduction:
Obstetric fistula remains a preventable yet devastating maternal health condition affecting women and adolescent girls in low-resource settings, including Ghana. Existing literature has largely focused on women’s suffering, stigma, and social exclusion, with limited attention to relational healing and couples’ experiences following successful repair. Increasingly, global health priorities emphasized survivor-centred and family-inclusive approaches that promote dignity, resilience, and reintegration (1).
This aligns with the Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities), which advocate for improved maternal health outcomes, elimination of harmful practices such as child marriage, and strengthening of family systems (2).
This study, though a subset of a larger obstetric fistula research project, is the first study in Ghana that has explored the shared recovery experiences, relational healing, and post-repair transformation among African couples following obstetric fistula repair.
Study design, materials and methods
A qualitative narrative inquiry design was employed to capture couples’ experiences and relational journeys over time. The study was conducted in a tertiary hospital and selected districts in Ghana. Using purposive and convenience sampling, 10 couples (20 participants) were recruited for the study. An inclusion criterion required women to have undergone successful fistula repair, and both partners consented and voluntarily participated. Data were collected through in-depth interviews conducted individually and jointly. Interviews were guided by Appreciative Inquiry principles, the 4-D cycle: Discovery, Dream, Design, and Destiny. Interviews were audio-recorded, transcribed verbatim, and supported by field notes. Data collection continued until data saturation was achieved. Data were analysed using Braun and Clarke’s (1) thematic analysis.
Interpretation of results
Theme 1: Broken Beginnings:
Couples’ narratives reveal the quiet heartbreak that obstetric fistula introduces into relationships, where love becomes strained, intimacy is lost, and connection fades into silence. These experiences reflect profound emotional wounds, loneliness, and relational disruption that reshape once-loving unions.
Aku, 27 years, shared that “I avoided my husband and felt I had lost him… but now we laugh together again.”
Ambos 30 years old husband affirmed that: “We became distant, but today we are closer and happier because our sexual life has changed for the better.” These accounts highlight both the depth of disconnection and the lingering hope embedded within strained relationships.
Theme 2: Healing Together:
Surgical repair marked a critical turning point, restoring affection, trust, and emotional closeness.
Adjoa, 32 years old, expressed that “Hmm, after the surgery, my husband held me… as if it was our first love encounter, now our home is full of joy.”
Christian, 35-years, concurred that: “Peace has returned to our marriage.”
Theme 3: Restored Partnership and shared new future
Healing fostered renewed intimacy, companionship, and mutual respect.
Halima, a 21-year-old woman, happily expressed that: “We go out together and enjoy each other’s company again.”
Iddrisu, 28 years concurred that: “Our relationship is stronger now.”
Also, from the couple of narrations, a powerful shift from survival to shared hope, where love is no longer defined by pain but by renewed dreams and emotional bonds anchored in resilience and gratitude. Amina (28 years): “We are planning our future again. I wake up happy.” Kalu (40 years): “There is joy in our home now.”
Concluding message
In conclusion, obstetric fistula repair restores not only physical health but also love, dignity, and shared life purpose. Couples’ narratives reveal resilience, reconciliation, and profound relational transformation. The findings highlight the need for partner-inclusive and integration of couple-based psychosocial support, strengthening stigma reduction to enhance recovery and reintegration.