A Tragic Failure to Deliver Maternal Care
Every day more than 1000 women die 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 45 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.