1. What is obstetric fistula?

Fistula is a medical condition caused by prolonged or obstructed labor. The most common childbirth injuries that occur after obstructed labor are vesicovaginal fistula (VVF) and rectovaginal fistula (RVF). The word “fistula” is a medical term for an abnormal connection between two body organs or cavities. In VVF, the pressure of the fetal head in the pelvis during obstructed labor interrupts the blood flow to the tissues that are being compressed and causes those tissues to die. When the tissues between the bladder and vagina die, a hole opens up between them which allows urine to leak out as soon as it reaches the bladder. In RVF, the same process occurs, but in this case the tissues between the vagina and rectum are destroyed and feces pour out through the vagina.

2. Who suffers from obstetric fistula?

While it is impossible to know exactly how many women suffer from fistulas caused by obstructed labor, it is estimated that between two million to 3.5 million women in the developing world currently suffer from the condition and between 50,000 to 130,000 new cases develop each year. Fistula was common in western countries more than a century ago, but advances in medical care and universal access to emergency obstetric services have all but eliminated this condition in the industrialized world. Most of the women who have fistula today live in developing countries, where access to obstetric care is limited or nonexistent.

3. What happens to women who have this condition?

Once a woman sustains a childbirth injury of this kind, there are really very few places where she can go for help. In many parts of the world, women who do find help have waited five years between injury and treatment. By opening up a fistula hospital in Danja, Niger, the Worldwide Fistula Fund is committed to increasing access to care for women with childbirth injuries of this kind.

4. What happens to babies in cases of obstructed labor?

Among women who survive obstructed labor and developed an obstetric fistula, fewer than 7-percent have a live baby at the end of their ordeal. Since childbirth injury typically occurs during the mother’s first pregnancy, almost 70-percent of fistula victims end up with no living children. In the developing world, where family is usually one’s only source of security, the lack of children is devastating.

5. How does the Worldwide Fistula Fund help?

The Worldwide Fistula Fund helps by performing fistula surgeries on women in southern Niger. Although fistula surgery is very challenging, it can still be performed with a high degree of success in low-technology settings throughout Africa.

6. How successful are obstetric fistula surgeries?

The surgery to close a VVF is successful in the vast majority of cases but “closure” of the fistula does not necessarily mean that the woman is “cured.” About 15-percent of women whose fistula is closed continue to lose urine due to other problems with the bladder and urethra. Many women who have been through obstructed labor also have other injuries (including nerve damage, partial paralysis and/or traumatic pelvic conditions) that cause tremendous suffering and require ongoing physical therapy to address.