Sabitri Kohar: A profile of uterine prolapse in Nepal

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Sabitri Kohar
Rupandahi District, Nepal

Just a month or two after giving birth to her first child at the age of 19, Sabitri Kohar became pregnant with a second child. She describes the second delivery as being much like the first one: both were relatively uncomplicated labors played out on the packed dirt floor of her thatch house. At the end of both deliveries, the mid-wife attending her birth pushed and prodded Sabitri’s stomach in an effort to release the placenta. When describing her first two deliveries, Sabitra almost forgets to mention one crucial difference in her experiences. “That second time, I had not eaten for eight days before I gave birth. We had no food in the home, so I did not eat.”

Although Sabitri does not consider her second birth to be remarkable in any particular way, her body undoubtedly suffered from extensive stress during her second labor. Undernourished and still in the recovery stage from her first delivery, her reproductive system would have struggled to manage the second labor. The cumulative effects of the mid-wife’s prodding after both deliveries also likely damaged the already sensitive and stressed muscles in her pelvic region. A year after Sabitri gave birth to her second child, the consequences of her dangerous delivery caught up with her.

Bending over to pick up a load of grass in the fields, Sabitri felt a sudden and sharp pain in her back and lower abdomen. That same day she noticed that something was protruding from her vaginal canal, but she told no one about it and did not think to go to the doctor’s. A month later, Sabita returned to her birth home and mentioned her persistent symptoms to an elder female relative, who told her that she was probably experiencing pateghar khasne samasya (“fallen womb problem”). Too shy to share the details of her personal health with anyone else, Sabitri kept her problem to herself for the next fourteen years. Even Sabitri’s husband has been ignorant of her condition for fourteen years, during which time she gave birth to two more children and suffered silently through the pain and discomfort of a prolapsed uterus.

It wasn’t until a community health volunteer arrived at Sabitri’s door and began to talk to her about pateghar khasne samasya that Sabitri shared the details of her experience with anyone else. Since then she has gathered the courage to tell her husband, who agrees that she should seek treatment. Sitting in a circle of other women who are suffering from uterine prolapse, Sabitri says she is happy that she has met the community volunteer and finally told her husband. After fourteen years of not being able to talk to anyone about her condition, she now knows that she has support and there is hope yet for her suffering.

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Photos

Sabitri Kohar
Sabitri Kohar has lived with uterine prolapse for almost fifteen years. Her condition was likely caused by malnutrition and poor birthing practices employed by an untrained mid-wife during delivery.