What is so bad about child brides?

“You are a 14 year old girl. You’ve never been to school. You were married to a man in a neighboring village at age 13—before your first menstrual period and six months later, you became pregnant. Now you are in labor with your first child.

Labor has already lasted for three days, but still the baby has not come. You are exhausted. You have lost a lot of blood and are running a fever. You haven’t passed urine in over two days, and your genitals are horribly swollen and bruised from the constant pushing.  Why won’t the baby come out? You wonder. You dread the long bony fingers of the old woman who is attending your birth.  Nothing she does brings relief.

Soon the sun is rising on the morning of your fourth day of labor. At midday, with agony, you manage to pass the child from your body.  The baby is stillborn.  It has been dead for nearly three days and has started to decay. The softening of its tissues finally allowed it to pass through your vagina.

Thank God, you sigh, It’s finally over, but it is not.

On the morning of the fifth day, you pass more dead tissue.  And then it starts. Urine is running out of your vagina, unto your thighs, onto the floor.  What is going on? The urine does not stop.  You find some rags and stuff them between your thighs.

There, that ought to take care of it, you think, but it doesn’t.

In an hour or two, the rags are soaked. In six hours you have run out of rags. In 12 hours you notice—to your horror—that feces are also coming out. No matter how much you try, no matter how much you wash, you cannot get rid of it.

The odor and wetness are constant. Your husband is disgusted.  He cannot stand to have you around. Your presence is unendurable. 

“What has happened to you?  What did you do?”  He demands.  You were supposed to become a woman, the mother of his first-born son, but instead you have turned into a human cesspit.  This all must be punishment for something you did.   He turns you out of the house. Your family takes you back but you are not fit to live in their dwelling, so they put you in a shack on the edge of the family compound, where you sit day after day—alone, wretched, and stinking—until your family has had enough and cast you out.

You are 14.  You are illiterate and have no money. You have no skills with which to learn a livelihood.  You reek of urine and feces.  And you want to die.

You don’t know that your condition has a name, all you know is that you are cursed for reasons you don’t understand.  As far as you can tell, you are the only woman who has ever been afflicted in this way.  You don’t know that 3 to 4 million other women currently share your fate of have a fistula.  Neither do you know that tens of thousands more join this sisterhood of suffering every year.  As the lonely months roll by, you understand that this condition will not go away,  that your injury will not heal on its own, and that nothing you can do will change your condition.

Most importantly, perhaps, you do not know that fistulas are both curable and preventable.

Labor is an involuntary process. Once started, it continues until delivery is achieved or it ends in one of several catastrophic ways.  The pregnant woman whose pelvis is too small for childbirth may be in hard labor for days, suffering severe, unrelenting uterine contractions without achieving delivery until—exhausted, weak from blood loss, and probably infected because of the long labor—she dies without ever delivering her child. Sometimes the uterus will rupture, killing both the woman and her baby in a sudden cataclysm in which the fetus and the afterbirth are thrown into her abdomen through the burst wall of her womb.

Women who do not succumb eventually pass a stillborn infant who is asphyxiated during the long birth process.  After death, the entrapped baby starts to decay, eventually macerating and sliding out of the mother’s body.  

And if this were not terrible enough, the worst is yet to come.  A few days later, the base of the woman’s bladder sloughs away due to her injuries, and a torrent of urine floods through her vagina.  In obstructed labor, the woman’s bladder is trapped between the fetal skull and her pelvic bones. The skull is forced relentlessly downward by the contractions, but the unyielding bones of her pelvis refuse to let it pass.  As her pelvis’s soft tissues are crushed, they die and slough away, forming a fistula.  Once this happens, the fistula will not heal without a surgical operation.”

(The good news is that surgery is almost like a miracle and may cost only a few hundred dollars. A fistula is a break in the wall of an organ allowing fluid to flow from one place to another.)

Because surgery is so scare in this part of the world—Africa—most of these women never receive help.”