Obstetric Fistula: A Devastating But Fixable Health Issue

Fistula Repair Tools Gynocare Fistula Center, Eldoret, Kenya

 

Chances are you haven’t heard of obstetric fistula. That’s because Americans haven’t suffered from fistula since the 19th century, when a fistula hospital stood on the site of today’s Waldorf Astoria Hotel in Manhattan. Unfortunately, in developing countries where access to safe childbirth services is still limited, an estimated two million women continue to suffer from this devastating condition.

Obstetric fistula is primarily caused by prolonged and obstructed labor, when a woman goes for days without receiving essential obstetrical care such as a cesarean section.  The result of this difficult labor is the development of a hole, or fistula, in the birth canal.  If untreated, a woman with obstetric fistula will experience constant and uncontrollable leakage of urine and/or feces.  And in most cases of obstructed labor in which a fistula develops, the baby is stillborn.

In addition to the loss of her child and the physical injuries, the social trauma suffered by women with obstetric fistula is severe. The humiliation, isolation, and stigma as a result of the smell and constant leakage is devastating. Many women with fistula are abandoned by their husbands, taunted by community members, and ostracized from society.

An estimated 50,000 to 100,000 new cases develop each year, far surpassing the global capacity for treatment. Slowly, treatment services are expanding as more doctors are becoming trained to provide fistula repair surgery and more women with fistula are being identified and referred to treatment. At the same time, efforts to improve coverage of skilled providers at birth and increase access to emergency obstetric care to manage complications are helping to prevent new cases of fistula from occurring.

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Editor’s note: The Global Fistula Map was migrated to the Global Fistula Hub in 2020 to better understand the landscape, known need, and availability of fistula repair services around the world.

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