Obstetric fistulas are holes between the vagina and the bladder or rectum, through which urine or stool leaks continuously. They usually arise from prolonged, complicated, and unattended labour. Women and girls with untreated fistulas may be stigmatised and excluded from family and community life, which adds enormously to their suffering. Our health care projects for pregnant women help prevent the occurrence of fistulas, and provide treatment and psychological support for those affected.
Almost all obstetric fistulas are caused by prolonged, obstructed labour where the infant’s head is too big for the mother’s pelvis. Delivery stops when the uterus is not contracting properly. As the baby’s head continues to press against the birth canal, the surrounding tissue eventually dies and creates a hole or fistula.
Fistulas do not heal naturally. Often the baby will be stillborn, adding even more suffering for the mother.
While rare, our surgeons have also seen a small number of fistula cases resulting from extreme sexual violence.
We also perform fistula repair through either permanent programmes or “fistula camps”, focusing on some of the world’s poorest regions with little access to obstetrical care. Because of the stigma attached to fistulas, our teams also provide psychological and psychosocial care to help fistula sufferers re-integrate into their communities.
We also conduct training for both midwives and local surgeons. Training local midwives is vital because they can identify when a mother is having difficulty giving birth and can arrange help before it is too late. For surgeons, although the operation does not require sophisticated equipment, it is technically difficult to carry out and takes some time to master.
Fistula sufferers often face severe stigma and even exclusion from work and/or community life. Our teams, therefore, provide psychological and psychosocial care aimed at helping patients see they are not alone, encouraging them to bond with one another and find the courage to heal, and then to re-enter the society that had shunned them.
By donating to MSF, you form part of, and enable, a network of individuals worldwide who are helping to better the lives of millions of women through our obstetric fistula programmes.
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