| Course | NUR 495 Public and Global Health in Nursing |
|---|---|
| Module | Module 6 |
| Paper type | Maternal and infant health reflection paper |
| Length | About 841 words, 6 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NUR 495 Module 6
The Walk Home and the Walk to Help: Obstetric Fistula, Emergency Obstetric Care and What Arizona Data Show
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
NUR 495: Public and Global Health in Nursing
Instructor Name
Month Day, Year
The Walk Home and the Walk to Help: Obstetric Fistula, Emergency Obstetric Care and What Arizona Data Show
Introduction
Obstetric fistula is an injury most nurses in the United States have never seen. It happens when obstructed labor goes on for days without a cesarean birth, and the pressure of the baby's head destroys tissue between the birth canal and the bladder or rectum. The woman usually loses the baby and is left leaking urine or stool. This assignment asked me to reflect on fistula and on maternal and infant health in developing countries through the documentary Walk to Beautiful, my own experience in labor and delivery, and health data from Arizona.
Reflection on Walk to Beautiful
The film follows women in Ethiopia who developed fistula after prolonged labor, often as young teenagers in rural areas far from any hospital. What stayed with me was less the injury than the isolation. Women described being sent away by husbands, sleeping apart from their families, and hiding for years because of the smell. Many walked or were carried for days to reach a hospital that could repair the injury. The women were young, poor and often married early, and many had labored at home without a skilled attendant. Every factor named in this assignment, poverty, poor nutrition, early childbearing and lack of emergency obstetric care, appeared in their stories.
The film also showed hope. Surgical repair at a specialized hospital restored continence for many women, and the walk home became a walk back into family and community life. Yet repair treats the result, not the cause. The cause is the absence of timely emergency obstetric care when labor is obstructed.
What the Data Show Globally
Fistula is rare in high-income countries and concentrated where emergency obstetric care is scarce. A recent meta-analysis of 62 datasets from 38 countries, covering more than 2.5 million women, estimated an overall pooled prevalence of 0.76%, with the highest regional prevalence in the African Region and the lowest in North America (Shu et al., 2026). The authors called for stronger emergency obstetric and surgical services to guide prevention. The broader picture is similar for other complications: in a large trial in four African countries, a simple early detection and treatment bundle reduced severe outcomes from postpartum hemorrhage, showing how much depends on timely recognition and response (Gallos et al., 2023).
What the Data Show in Arizona
Arizona's numbers describe a very different setting, but not one without gaps. The state's 2023 advance report counts 430 babies who died before their first birthday, a rate of 5.5 for every thousand born alive, and about 8 low-birthweight infants in every hundred births; Maricopa County's infant mortality rate was 5.6 (Arizona Department of Health Services, 2024). Rates were higher in some rural counties, where small numbers make estimates less stable but where distances to hospitals with obstetric services can be long. Arizona has no obstetric fistula problem of the kind shown in the film, because a woman in obstructed labor almost always reaches a cesarean in time. That difference is the point of the assignment: access to emergency obstetric care is the single factor that turns the same obstetric event into a routine operation in one place and a lifelong injury in another.
Reflection on My Own Practice
In my unit, I have cared for women in prolonged labor who went to cesarean within hours of the decision, and I have taken it for granted. I have also cared for women who arrived late in labor after driving from small towns, some with no prenatal care. One young mother from a rural area had labored for many hours before her family drove her to us. Her baby was fine, but I now see that her story sat on a continuum with the women in the film: the further a woman is from emergency care, the more an ordinary complication becomes dangerous. Early childbearing also appears in my practice; teenage mothers often come with less prenatal care and more social risk.
Implications for Nursing
Three implications follow. First, nurses in high-resource settings should support efforts to keep obstetric services available in rural areas, since closures lengthen the distance to emergency care. Second, nurses can contribute to global maternal health through organizations that train midwives, supply equipment and support fistula repair and prevention. Third, nurses everywhere can advocate for education and delayed marriage for girls, which reduce early childbearing. Public health nursing treats these as population problems with population solutions (Stanhope & Lancaster, 2024).
Conclusion
Walk to Beautiful made fistula real to me, and the data made it clear that it is a disease of distance and poverty more than of biology. Arizona's mothers are far safer, but the same principle, timely access to skilled emergency care, explains both our successes and our remaining gaps.
The assignment also changed how I see my own unit's resources. The operating room down the hall, the anesthesia team on call and the blood bank are not ordinary; they are the reason obstructed labor ends safely here.
References
Arizona Department of Health Services. (2024). Advance vital statistics by county of residence, Arizona, 2023. https://pub.azdhs.gov/health-stats/report/avs/avs23/pdf/avs2023.pdf
Gallos, I., Devall, A., Martin, J., Middleton, L., Beeson, L., Galadanci, H., Alwy Al-Beity, F., Qureshi, Z., Hofmeyr, G. J., Moran, N., Fawcus, S., Sheikh, L., Gwako, G., Osoti, A., Aswat, A., Mammoliti, K.-M., Sindhu, K. N., Podesek, M., Horn, I., ... Coomarasamy, A. (2023). Randomized trial of early detection and treatment of postpartum hemorrhage. New England Journal of Medicine, 389(1), 11-21. https://doi.org/10.1056/NEJMoa2303966
Shu, Y., Xu, M., Li, B., & Cao, H. (2026). Prevalence of obstetric fistula: A systematic review and meta-analysis of available evidence from 38 countries. Irish Journal of Medical Science. Advance online publication. https://doi.org/10.1007/s11845-026-04572-z
Stanhope, M., & Lancaster, J. (2024). Public health nursing: Population-centered health care in the community (11th ed.). Elsevier.
NUR 495 Module 6 instructions, in plain terms
The posted syllabus lists the Maternal Health and Fistula assignment among the Module 6 clinical practice experience activities, alongside two child abuse activities and a reflection and integration activity. Its description calls for a practical application activity that increases awareness of how poverty, poor nutrition, early childbearing and lack of access to emergency obstetric care in developing countries affect maternal and infant outcomes. You reflect on your own experiences in emergency departments and hospitals, use state and local health department data on maternal and infant health, and reflect on the film Walk to Beautiful. Check Canvas for the required questions, length and whether the film must be cited.
How this NUR 495 Module 6 example is built
The paper explains obstetric fistula in plain terms for readers who have never seen it, then reflects on the film's portrayal of the women, connecting their stories to each factor named in the prompt. A global data section uses a recent meta-analysis and a large trial. An Arizona section uses 2023 state vital statistics and compares access to emergency obstetric care across the two settings. A reflection on the writer's own practice places a rural patient on the same continuum, and three nursing implications and a short conclusion follow. Sources are cited where their figures appear. Each sheet carries a margin comment tying it to one element of the prompt.
Where the marks sit in the NUR 495 Module 6 rubric
This assignment is usually graded on depth of reflection on the film and on personal practice, accurate use of state or local data, understanding of the social and health system factors behind maternal and infant outcomes, and connection to public health nursing, with APA writing. Graders look for reflection that goes beyond emotional reaction to analysis of causes. Data should be cited with the source and year. Linking global and local conditions, rather than treating them as unrelated, shows the integration the module is aiming for. Reflections that compare the systems in the film with those in your own state, rather than treating them as unrelated worlds, tend to earn the highest marks. Cite the film if your instructor asks.
NUR 495 Module 6 help: mistakes that cost marks
Students often summarize the film scene by scene instead of reflecting on what it shows about causes. Focus on the factors the prompt names. Another weakness is using national data when state or local data are requested; check your state health department's vital statistics. Report numbers exactly. Keep personal patient stories general enough to protect privacy. Avoid writing about women in developing countries as helpless; describe the systems that fail them. If you would like help connecting the film to your own practice and data, send the prompt to the desk. Respect the dignity of the women in the film when you write about them, and keep your own patients unidentifiable. Finally, check your state's report for the most recent year available.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 495 and RN to BSN sample papers
- NUR 495 Module 1: Introductory Presentation on Public Health Values
- NUR 495 Module 3: Global Health Project on Postpartum Hemorrhage
- NUR 495 Module 4: Health Policy Paper on a Vulnerable Population
- NUR 445 Module 5: Capstone Project Proposal
- NUR 464 Module 1: Capstone Proposal Resubmission
- NUR 318 Module 2: Practice Problem and PICOT Discussion
- NUR 391 Module 4: Cultural Advocacy Discussion
NUR 495 Module 6 questions, answered
Where can I find a free NUR 495 Module 6 sample paper?
The maternal health and fistula paper is on this page in full: reflection on Walk to Beautiful, global fistula data, Arizona 2023 birth data, personal practice reflection and nursing implications, with references.
What is obstetric fistula for NUR 495?
An injury caused by prolonged obstructed labor without timely cesarean, leaving an opening between the birth canal and the bladder or rectum and causing incontinence.
What data should I use for the NUR 495 maternal health paper?
The syllabus asks for state and local health department data on maternal and infant health, such as your state's vital statistics report.
Do I need to reflect on my own practice in NUR 495 Module 6?
Yes. The assignment asks you to reflect on your experiences in emergency departments and hospitals alongside the film and data.
Why does access to emergency obstetric care matter in NUR 495?
Timely cesarean and emergency care turn complications such as obstructed labor into routine events; without them, the same events can cause fistula or death.