Cursed by God?

Americans generally think of pregnancy and birth in terms of natural processes that call for a healthy diet, doctor’s appointments, ultrasounds, and pain management during labor. But as New York Times columnist Nicholas D. Kristof reported February 25, giving birth can prove nothing short of disastrous for many women in Africa.

That’s because a large number of African women are stricken with obstetric fistula, a complication in childbirth that can leave the woman incontinent and socially isolated. With little recourse to corrective surgery, many of these women come to see themselves as cursed by God.

Obstetric fistula is the development of an abnormal body cavity that can allow uncontrolled leaking of urine and feces. For afflicted women, this can mean social ostracism and eventual abandonment. Their appearance, odor, and likely inability to bear more children can lead to their being shunned and to early death. While worldwide figures for postlabor fistula are hard to come by, partly because of the shame often associated with the condition, the United Nations Population Fund estimates that 2 million women live with the condition. There are a hundred thousand new cases each year.

In 2005, the World Health Organization (WHO) showcased a program called Great Expectations. Its aim was to draw attention to maternal-and-child health worldwide. It traced the lives of six women, from pregnancy through...

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About the Author


Agnes R. Howard is assistant professor of history at Gordon College in Wenham, Massachusetts.