On 22 June 2025, the Newsday published a story of a woman who lived for 37 years with obstetric fistula. All because she did not know that it was treatable.
And this is not an isolated incident. It’s also the story of Aneni, Maria and Sandra.
Despite the International Day to End Obstetric Fistula being commemorated every year to promote action to prevent and treat this devastating maternal injury; awareness remains low.
On a post on X commemorating the day to end obstetric fistula, an account asked, ‘Tearing of tissues😲you can’t possible (sic) treat that. Can you?’
The answer is yes, you can possibly treat that. Despite its devastating impact, it is not a condition that people simply have to endure. Modern surgical techniques offer highly effective repair, restoring health and dignity to those affected.
In this fact sheet, we look at what obstetric fistula is, what causes it and how it can be reversed.
What is Obstetric Fistula?
An obstetric fistula is a hole that forms between the birth canal and the bladder (vesicovaginal fistula) or rectum (rectovaginal fistula), or both. This tear is typically caused by prolonged, obstructed labour when timely medical care, such as a caesarean section, is not available.
The sustained pressure of the baby’s head against the mother’s pelvic bone cuts off blood supply to the soft tissues, leading to tissue death and the formation of a hole.
Symptoms and Impact
The most immediate and distressing symptom of an obstetric fistula is continuous leakage of urine or faeces, or both. This leads to:
- Incontinence: Uncontrollable leakage of bodily waste.
- Chronic infections: The constant wetness and irritation can lead to recurrent urinary tract infections, skin infections, and other health issues.
- Social isolation: The odour and stigma associated with incontinence often lead to women being abandoned by their husbands and ostracised by their communities.
- Psychological trauma: The physical and social consequences can result in severe depression, anxiety, and a profound loss of self-esteem.
Treatment: Yes, It Is Possible!
The good news is that obstetric fistula is treatable, primarily through surgery. The goal of surgery is to close the hole and restore the integrity of the affected organs.
- Surgical Repair: A skilled surgeon can repair the fistula by carefully closing the opening, often by rejoining the healthy tissues. The success rate of these surgeries is very high, especially when performed by experienced specialists.
- Post-operative Care: After surgery, patients typically require a period of recovery, which may include a catheter to allow the bladder to heal and antibiotics to prevent infection.
- Rehabilitation: Beyond the physical repair, many women also need psychosocial support to help them reintegrate into their communities and overcome the trauma they’ve experienced
Prevention is Key
While treatment is effective, the ultimate goal is prevention. Obstetric fistulas are largely preventable with access to:
- Skilled birth attendants: Having trained healthcare professionals present during childbirth can identify and manage complications early.
- Emergency obstetric care: Access to C-sections and other emergency interventions is crucial in cases of obstructed labor.
- Family planning: Empowering women to make informed decisions about their reproductive health can reduce the risk of complicated pregnancies.
- Poverty reduction and education: Addressing underlying socioeconomic factors can improve access to healthcare and reduce the incidence of fistula.
Where to find help in Zimbabwe
Visit any health facility if you observe any of the signs and symptoms of obstetric fistula or call toll-free number 08080231 for booking.
Conclusion
In summary, while the idea of an obstetric fistula might sound insurmountable, it is a condition that can and should be treated. With increased awareness, improved access to quality healthcare, and continued support for affected women, Zimbabwe is working towards a world free of obstetric fistula.