Transforming Obstetric Fistula through Concealment in Niger Available to Purchase

Obstetric fistula, a birthing injury caused by obstructed labor and that results in chronic incontinence, is frequently described by donor and media narratives as an eminently visible condition resulting in social stigma. However, through ethnographic research in four fistula centers in rural and urban Niger, this research revealed that the majority of the 100 women interviewed hid their conditions from their communities, kin, and even husbands. Women invested their time, energy, and finances into these strategic acts of concealment. Yet, concealment came at a high price to women's psychosocial health as the women who were most successful in “passing” as whole and healthy were often seen by their kin and communities to have rejected vital tenets of relational reciprocity. Additionally, it was often fistula centers that unintentionally undermined women's concealment efforts, outing them within their communities. This research demonstrates the importance of ethnographic insight in reshaping fistula interventions to better serve women.