What You Need To Know About Fistulas
How rare are fistulas in the U.S.?
Fistulas are usually consequences of fourth-degree lacerations during delivery; fourth degree is when the rectum has been reached with a laceration. About 1% of deliveries are complicated with fourth-degree lacerations; however, among Asians, this number is around 5%. It’s also much higher among women who have a very short perineum. About 1-5% of fourth-degree tears do not heal well and lead to fistula formation. So overall, women in the United States aren't likely to develop a fistula.
What should a woman do if she suspects that she has a fistula?
She should be checked by a gynecologist.
Is there any way to prevent a fistula from occurring when a woman gives birth?
Yes. There are actually quite a few things that can occur in order to avoid a fistula. These are:
- Controlling delivery of the baby's head so it comes out very slowly
- Supporting the perineum during delivery
- Avoiding episiotomy or cutting very little
- Pushing slowly and gently when the fetal head is crowning
- Stretching the perineum with oil during the last four weeks of the pregnancy
- Decreasing weight gain during pregnancy so the baby does not become too big
It's less likely to get big tear during delivery if your baby is an average size. Daily exercise and a proper diet are important during pregnancy. Ultimately, good and skillful prenatal care with an OB/GYN will make a difference. In cases of fourth-degree lacerations, patients should soak their bottom twice daily with warm water, keep clean and dry, take stool softener, and avoid strenuous activity until well-healed.
Do you know of anyone who developed a fistula after giving birth?