Obstetric fistula and why health systems must meet women’s essential needs

It’s estimated that two million women and girls live with untreated obstetric fistula and the rate is especially high in Sub-Saharan Africa and Asia. With timely obstetric care, birth injuries like this are almost entirely preventable. But for marginalised women and girls living in poverty or with disabilities, safe childbirth often remains out of reach.

Living with pain and stigma

Nigeria is one of the most dangerous countries in the world to give birth. Here, more than 150,000 women and girls live with fistula.

It’s difficult to fully comprehend the pain and stigma they experience. The leaking of urine and faeces stains a woman’s clothes, and the wetness and smell is extremely uncomfortable. On top of this, many face rejection by their families and friends, and sometimes their whole communities.

Fistula requires surgery to be corrected – but many people living in marginalised communities either cannot afford treatment or are not aware of the treatment options. Healthcare workers may not have received the training to identify and treat fistula, so women can spend years of their lives housebound and isolated.

Safiya’s story

When 30-year-old Safiya from Nigeria went into labour, she knew that something didn’t feel right. She couldn’t push. After 24 frightening and painful hours in labour, her baby was born by caesarean section. Initially, Safiya was relieved to have delivered her baby, but she soon realised something was wrong. She was leaking urine constantly and was told she had an obstetric fistula.

Poverty and disability increase barriers to healthcare

For women and girls like Safiya – living in poverty or with a disability – gender inequality is intensified. It means they face even greater barriers to healthcare and education. And this increases the risk of preventable and debilitating health problems – like obstetric fistula.

It’s why CBM works alongside local partners in Nigeria to run comprehensive and inclusive women’s health projects. These are providing life-changing surgery, rehabilitation, and mental health support for women and girls affected. As well as this, the projects support the training of healthcare staff, provision of equipment and safer maternity practices to prevent fistula in the first place. 

International Day to End Obstetric Fistula

International Day to End Obstetric Fistula on 23 May is a vital reminder of the work to be done. This year’s theme – ‘Her health, her right: Shaping a future without fistula’ – emphasises the fundamental right of every woman and girl to health, particularly sexual and reproductive health. The continued existence of obstetric fistula is a clear violation of that right.

For the estimated two million women and girls living with obstetric fistula, the need for gender-responsive health systems that are inclusive and accessible is clear. Essential healthcare services should not be dependent on geography, income, or status.