Obstetric fistula is one of the most serious and tragic injuries that can occur during childbirth. It is a hole between the birth canal and the bladder or rectum caused by prolonged, obstructed labour without treatment.
The condition typically leaves women incontinent, and as a result they are often shunned by their communities. Sufferers often endure depression, social isolation and deepening poverty. Many women live with the condition for years – or even decades – because they cannot afford to obtain treatment.
An estimated 2 million women in sub-Saharan Africa, Asia, the Arab region, and Latin America and the Caribbean are living with this injury, and some 50,000 to 100,000 new cases develop each year. Yet fistula is almost entirely preventable. Its persistence is a sign that health systems are failing to meet women’s essential needs.
Obstetric fistula can be avoided by:
• postponing the age of first pregnancy;
• ending traditional harmful practices; and
• enabling women to have timely access to obstetric care.
The fact that obstetric fistula has not disappeared testifies to the deficiencies of health systems in meeting the essential needs of women. This condition is one of the most revealing examples of their unequal access to sexual, maternal and reproductive health care.
The United Nations Population Fund (UNFPA) distributes medical supplies, provides training and funds for the prevention and treatment of fistula, and offers reintegration programs. It also strengthens maternal health services and emergency obstetric services to prevent the occurrence of this injury.
On March 5, 2013, in its resolution A/RES/67/147, the UN General Assembly called on the international community to use the International Day to significantly raise awareness and intensify actions towards ending obstetric fistula.
Photograph: Fistula patient lies on a hospital bed in Juba, South Sudan UN Photo/Tim McKulka