Having a baby is supposed to be one of the happiest moments in life. But for hundreds of thousands of women, especially in parts of Africa, childbirth can lead to lifelong injury, shame, and isolation. Obstetric fistula is one of the clearest signs of how uneven global healthcare really is. It’s preventable. It can usually be treated. Yet it’s still destroying lives every single day.
Obstetric fistula is a serious childbirth injury that happens when a hole forms between the birth canal and nearby organs, usually the bladder or rectum, causing constant leakage of urine, stool, or both. It most often develops during long, obstructed labor when a baby can’t pass through the birth canal and emergency medical care isn’t available in time. During this prolonged labor, pressure cuts off blood flow to the pelvic tissue, causing the tissue to die and leaving a hole between organs. Obstetric fistula doesn’t just affect a woman’s health — it can completely upend her life, affecting her relationships, her place in the community, and her sense of dignity.
Unfortunately, Beatriz’s story is not unique. According to the United Nations, more than two million women around the world are living with untreated fistula, and as many as 100,000 new cases happen every year. A huge share of those cases are in Nigeria, which accounts for about 40 percent of the global total, with roughly 13,000 new cases each year.
Obstetric fistula is common in many low-income parts of the world where women don’t have reliable access to emergency childbirth care. When labour becomes obstructed and there’s no quick access to surgery or skilled medical help, the risk of fistula increases dramatically. Globally, fistula is closely linked to poverty and inequality. Many women in rural areas must travel long distances to reach healthcare, and some give birth without trained medical support. Social factors like child marriage, early pregnancy, poor nutrition, and limited education also increase the risk. In simple terms, fistula is most common in places where healthcare systems are weak and women have fewer resources and fewer protections.
Around the world, efforts are increasing to treat and prevent obstetric fistula. The United Nations Population Fund Campaign to End Fistula works in more than 30 countries to prevent new cases, treat women already affected, and help them reintegrate into society by expanding maternal health services. It also trains skilled birth attendants, improves access to emergency C-sections, and raises awareness about safe childbirth. Still, much more support is needed to reach all those at risk.
While treatment can give women hope and help them regain dignity, societal factors play a huge role in whether fistula occurs in the first place. Issues like child marriage, limited education for girls, poverty, and cultural barriers that prevent access to skilled birth care all increase the risk. Addressing these social challenges — keeping girls in school, delaying early pregnancies, and ensuring communities support safe childbirth — is just as important as medical treatment when it comes to preventing new cases and breaking the cycle of suffering.
