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Obstetric
Fistula: A Tragic Failure to Deliver Maternal Care
Every minute a woman dies from complications of
pregnancy. For every woman who dies, 20 or more are injured
or disabled.
One of the most serious injuries of childbearing
is obstetric fistula, a hole in the vagina or rectum caused by labour
that is prolonged – often for days – without treatment. Usually
the baby dies. Because the fistula leaves women leaking urine or faeces, or both, it typically
results in social isolation, depression and deepening poverty. Left
untreated, fistula can lead to chronic medical problems.
Like maternal mortality, fistula is almost entirely
preventable. Yet at least 2 million women in sub-Saharan Africa,
South Asia and the Arab region are living with fistula, and some
50,000 to 100,000 new cases develop each year. The persistence of
fistula is a signal that health systems are failing to meet the
needs of women.
Obstetric fistula occurs disproportionately among
impoverished girls and women, especially those living far from medical
services. Affecting the most powerless members of society, it touches
on nearly every aspect of UNFPA's mandate, including reproductive
health and rights, gender equality, poverty, harmful traditional
practices and adolescent reproductive health.
In 2003, UNFPA spearheaded the global Campaign
to End Fistula, which is working in more than 35 countries to
prevent and treat fistula, and to help rehabilitate and empower
women after treatment.
Prevention is the key to ending fistula. Making
family planning available to all who want to use it would reduce
maternal disability and death by at least 20 per cent. Complementing
that with skilled attendance at all births and emergency obstetric
care for all women who develop complications during delivery would
make fistula as rare in resource-poor countries as it is in the industrialized world today. These interventions
are part of UNFPA's overall strategy to make motherhood safer. Addressing
social issues that contribute to the problem - such as early pregnancy,
girls' education, poverty and women's empowerment - are important
areas of intervention as well.
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