Each year some 50,000-100,000 women sustain an obstetric fistula in the act of trying to bring forth new life. Fistula is a preventable and treatable condition, one that no woman should have to endure. Yet more than two million women remain untreated in developing countries. That is why UNFPA has launched a global Campaign to End Fistula.

Key Facts
    Every minute, a woman dies from pregnancy-related complications. For every woman who dies, 15 to 30 live but suffer chronic disabilities, the worst of which is obstetric fistula.

    An estimated 15 per cent of all pregnancies result in complications. Most cannot be predicted, but they can be treated.

                                      Fistula surgical repair has up to 90 per cent success rates and costs between $100-$400.

What is Fistula?

An obstetric fistula is more than a hole. For those afflicted, it is a comprehensive social and psychological disaster, resulting from a dramatic failure in obstetric care.
– Dr. Andrew Arkutu

Obstetric fistula is the most devastating of all pregnancy-related disabilities and affects an estimated 50,000-100,000 women each year. It usually occurs when a young, poor woman has an obstructed labour and cannot get a Caesarean section when needed. The obstruction can occur because the woman’s pelvis is too small, the baby’s head is too big, or the baby is badly positioned. The woman can be in labour for five days or more without medical help. The baby usually dies. If the mother survives, she is left with extensive tissue damage to her birth canal that renders her incontinent.

The results are life shattering. The woman is unable to stay dry and the smell of urine or faeces is constant and humiliating. Nerve damage to her legs can also make it difficult to walk. Rather than being comforted for the loss of her child, she is often rejected by her husband, shunned by her community and blamed for her condition. Women who remain untreated not only face a life of shame and isolation, but may also face a slow, premature death from infection and kidney failure. While some women receive support from their families, others are forced to beg or turn to sex work for a living.

How fistula occurs

During obstructed labour, the prolonged pressure of the baby’s head against the mother’s pelvis cuts off the blood supply to the soft tissues surrounding her bladder, rectum and vagina. The injured tissue soon rots away, leaving a hole, or fistula. If the hole is between the woman’s vagina and bladder, she loses control over her urination, and if it is between her vagina and rectum, she loses control of her bowels. Reconstructive surgery can mend this injury, but most women are either unaware that treatment is available or cannot access or afford it.

The tragedy of an obstetric fistula is that it touches a young girl at the very essence of her being - her childbearing capabilities. It touches her when she is too young to understand what has happened. . . If not operated on or helped, recurrent urinary tract infections can lead to kidney problems and eventual renal failure and death. So though the girl with obstetric fistula is a survivor of maternal mortality statistics in the first light, is she really, if she dies later, unwanted and lonely in some remote village hut?

- Dr. Ruth Kennedy, Addis Ababa Fistula Hospital

About UNFPA

UNFPA is the world's largest multilateral source of population assistance. Since it became operational in 1969, it has provided more than $6 billion in assistance to developing countries. UNFPA is working with partners on a global campaign to prevent and treat fistula in 2002. The goal is to eventually make fistula as rare in Africa and Asia as it is in the developed world. Findings from the report will be used to shape country programmes. 
For more information, visit www.unfpa.org

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