23 May International Day to End Obstetric Fistula


Obstetric fistula is a serious childbirth injury that affects millions of women, particularly in low-resource countries with limited access to quality maternal healthcare. It is a debilitating condition that can have profound physical, emotional, and social consequences for those who suffer from it. In this response, I will provide a comprehensive overview of obstetric fistula, including its causes, symptoms, prevention, and treatment options.

It refers to an abnormal opening between the birth canal and either the rectum or the bladder, or both. It usually occurs as a result of prolonged and obstructed labor without timely medical intervention, causing tissue damage due to prolonged pressure of the fetal head against the mother's pelvis. The lack of blood flow to the affected tissues leads to necrosis (tissue death), resulting in the formation of a hole or fistula.


The primary cause of obstetric fistula is inadequate medical care during childbirth, particularly in settings where access to skilled birth attendants, emergency obstetric care, and cesarean sections is limited. Risk factors for obstetric fistula include:

Early marriage and childbirth: Girls, who give birth at a young age, before their bodies are fully developed, are at a higher risk.

Lack of access to healthcare: Limited access to prenatal care, skilled birth attendants, and emergency obstetric services increases the risk of developing obstetric fistula.

Poverty: Women living in impoverished communities often lack resources for proper healthcare during pregnancy and childbirth.

Malnutrition: Poor nutrition can weaken a woman's body, making her more susceptible to complications during labor.

Female genital mutilation: In some cultures, female genital mutilation can lead to obstetric complications and an increased risk of fistula formation.


The symptoms of obstetric fistula can vary depending on the location and size of the fistula. Common symptoms include:

  1. Continuous and uncontrollable leakage of urine (urinary fistula) or feces (rectovaginal fistula).
  2. Foul-smelling vaginal discharge.
  3. Chronic pelvic pain.
  4. Irritation or infection of the affected area.
  5. Social isolation, depression, and stigma due to the constant leakage and foul odor.


Preventing obstetric fistula requires a comprehensive approach that addresses the underlying causes.

Access to quality healthcare: Ensuring that all women have access to skilled birth attendants, emergency obstetric care, and timely interventions during prolonged or obstructed labor.

Education and empowerment: Providing comprehensive sexual and reproductive health education, including family planning, to empower women to make informed decisions about their reproductive health.

Ending child marriage: Efforts should be made to end child marriage and promote the education of girls, as early childbirth increases the risk of obstetric complications.

Access to family planning: Promoting access to and use of contraception helps to prevent unintended pregnancies and allows women to space their pregnancies appropriately.


The primary treatment for obstetric fistula is surgical repair. Fistula repair surgery aims to close the abnormal opening and restore the normal anatomy. The specific surgical technique depends on the location, size, and complexity of the fistula. In some cases, multiple surgeries may be required to achieve a successful repair. Additionally, pre- and post-operative care, including nutritional support and counselling, are crucial for successful outcomes.

Rehabilitation and Support

Women who have undergone fistula repair surgery may require rehabilitation and support to regain their physical and emotional well-being. This includes:

Post-operative care: Close monitoring of the surgical site, prevention of infection, and provision of appropriate pain management.

Psychosocial support: Counselling and support groups can help women cope with the emotional and psychological effects of obstetric fistula, as well as the stigma associated with the condition.

Reintegration: Efforts should be made to reintegrate women who have undergone successful repairs back into their communities. This may involve vocational training, education, and economic empowerment programs.

Global Initiatives

Several organizations and initiatives are working to address obstetric fistula and improve maternal health worldwide. The United Nations, through its Sustainable Development Goals, has set a target to end obstetric fistula by 2030. Organizations such as the Campaign to End Fistula, Fistula Foundation, and various national governments and NGOs are involved in prevention, treatment, and rehabilitation efforts.

Obstetric fistula is a devastating condition that affects women, primarily in resource-poor settings, due to inadequate obstetric care. Prevention through improved access to healthcare, education, and empowerment is crucial. Timely surgical repair, along with post-operative care and rehabilitation, can help affected women regain their quality of life and reintegrate into their communities. Efforts by the global community are ongoing to raise awareness, improve care, and ultimately eliminate obstetric fistula.





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