Abstract:
Background: Obstetric fistula is a debilitating childbirth injury. Patients live in despair and self-stigmatize. Studies
highlight beliefs and perceptions about the cause of the disease and how it can be cured. Experiences among both
treated and untreated patients are also discussed vastly but there is limited information on negative perceptions and
beliefs among obstetric fistula patients towards their spouses, families, and communities and how these affect social
reintegration. This study determined the relationship between self-fulfilling prophecies and social reintegration
among obstetric fistula patients in different repair categories.
Methods: A cross-sectional mixed-methods survey was done among the obstetric fistula patients (n=398) at St. Joseph
Kitovu Hospital in Uganda. Also, 12 key informants participated. A semi-structured questionnaire and an in-depth
interview were used to get data from the patients. The interviews covered patients ’ expectations and beliefs on
reacceptance, interaction, self-satisfaction and comfort with others. The hypothesis: “ there was a significant
relationship between self-fulfilling prophecies and social reintegration among obstetric fistula patients in different
repair categories” was tested by Pearson chi-square at a 95% confidence interval.
Results: Accordingly, 51.5%, 14.4% and 9.0% of the 398 participants felt that their spouses, communities, and
parents respectively would not reaccept them. Again, 33.6% were not satisfied with their lives and 47.7% felt
uncomfortable around others. A major difference was observed in the relationship between their self-perceived
stigma, sense of loss, self-worth, achievement, the expectation of reacceptance, perception of others’ attitudes towards
them, labeling, moods, self-satisfaction, comfort with others and social reintegration. A relationship with the patients’
repair category was noted across all variables: P-values less than 0.001 at a 95% confidence interval.
Conclusion: A relationship was found between the patient’s negative beliefs, perceptions, and social reintegration.
Negative beliefs and expectations could be transformed into positive ones through the promotion of personal hygiene
and comprehensive counseling.
