10 facts about obstetric fistulas

Modern medicine allows for much safer childbirth, but in developing nations where there is often no help available from properly trained midwives, or gynaecologists who can perform a caesarean section when needed, childbirth continues to be high risk.


In an obstructed labour the baby is usually the first casualty. If the mother survives the ordeal she may be left with a devastating condition known as an obstetric fistula (or VVF). The resulting incontinence often leads to the woman being kicked out of her own home and even her village, losing her job (if she had one) and having to live in the jungle foraging for food as best she can. Most of these women don’t even know that there is a cure available!

Here are 10 facts about obstetric fistulas:

1. Obstetric fistulas which are rare outside of developing nations and usually consist of a hole in the bladder or rectum that allows urine or faeces to leak into the vagina producing incontinence and other health problems for the sufferer.

2. They are most often caused by obstructed labour during childbirth that can last several days, and can usually be prevented if the mother receives adequate medical attention. The prolonged obstructed labour results in constant pressure from the baby’s body on the bladder or rectum cutting off vital blood flow, and producing a fistula (or hole) between the vagina and the bladder or the rectum.

3. Not only does the mother have to grieve the loss of her baby but often becomes a social outcast because of the smell produced by her incontinence. These women usually don’t have access to sanitary products to absorb the leaking urine.

women waiting

4. In developing nations the woman is often kicked out of the home by her husband and sometimes even expelled from her village. She usually loses her job if she had one, and may have to find shelter in the jungle and forage for food for herself and even for other small children she may already have.

5. A factor that greatly increases the risk of obstructed labour is the cultural acceptance in many developing nations of girls being married off and becoming pregnant in pre or early teens, before their bodies have developed sufficiently to facilitate childbirth.

6. The incidence in developing nations could be greatly reduced if cultural attitudes to early marriage and pregnancy can be changed via education programs and also by training more midwives in proper techniques for assisting obstructed labour.

7. Obstructed labour is one of the 4 most common causes of maternal mortality affecting 5% of live births and 8% of all maternal deaths (WHO figures).

8. Each year more than 50,000 women develop an obstetric fistula.


9. In 1974 the world’s first specialized facility, the Addis Ababa Fistula Hospital, was established in Ethiopia by an Australian husband and wife team of surgeons Dr’s Reginald & Catherine Hamlin.

10. In 2001 Mercy Ships volunteers who had trained at the Ethiopian hospital began repairing obstetric fistulas on board the hospital ship Anastasis. Mercy Ships built West Africa’s first fistula clinic in Sierra Leone which began operations on April 26th, 2005 with a grant of 180,000 Euros from Spain’s CaixaBank (La Caixa). Mercy Ships is also working with the Madagascan government and other partners on the establishment of a permanent fistula clinic in Toamasina, Madagascar.