International Day to End Obstetric Fistula: Understanding a Preventable Childbirth Injury
- Sunil Khattri
- 15 hours ago
- 4 min read
Every year on May 23, the world observes the International Day to End Obstetric Fistula to raise awareness about one of the most devastating yet preventable childbirth injuries affecting women and girls globally.
The day was established by the United Nations to mobilise governments, healthcare systems, and communities to end obstetric fistula through better maternal healthcare, timely treatment, and stronger protection of women’s reproductive rights.
Despite medical advances, obstetric fistula continues to affect hundreds of thousands of women, particularly in low-resource settings where access to emergency obstetric care remains limited.
The United Nations estimates that around half a million women and girls across regions including Asia and Africa are currently living with fistula, with new cases developing every year.
What Is Obstetric Fistula?
Obstetric fistula is a serious childbirth injury that usually develops after prolonged or obstructed labour without timely medical intervention, particularly emergency Caesarean section.
The condition creates an abnormal opening between the birth canal and the bladder or rectum, leading to:
continuous leakage of urine or stool
severe infections
chronic pain
infertility in some cases
social isolation and stigma
In many communities, women living with fistula are abandoned, excluded, or forced to live in extreme emotional distress because of the constant incontinence and smell associated with the condition.
What makes this tragedy even more heartbreaking is that obstetric fistula is considered almost entirely preventable and treatable with proper maternal healthcare.
Why Obstetric Fistula Still Happens
The persistence of fistula is closely linked to inequality and failures in maternal healthcare systems.
According to the United Nations Population Fund (UNFPA), fistula is often a consequence of lack of access to skilled birth attendants, delayed emergency obstetric care, poverty, child marriage and teenage pregnancy, malnutrition and weak healthcare infrastructure.
Women in remote or economically vulnerable communities are especially at risk because they may not have access to hospitals capable of handling obstetric emergencies.
In India and other developing countries, delayed referrals, shortage of trained staff, poor monitoring during labour, and inadequate emergency response systems continue to contribute to maternal injuries during childbirth.
When Medical Negligence Can Become Part of the Story
While obstetric fistula is often associated with poor healthcare access, certain cases may also raise serious questions about medical negligence.
In some situations, women experience:
prolonged labour without timely intervention
delayed decision-making for Caesarean section
failure to monitor fetal distress
lack of specialist availability
improper post-delivery care
When labour complications are not managed appropriately despite the availability of medical facilities, the resulting injury may potentially become a medico-legal issue.
Courts in India have increasingly recognised that delays or failures in providing timely obstetric care can amount to negligence if they result in preventable harm to the mother or child. Maternal healthcare litigation in India has included cases involving delayed surgeries, childbirth injuries, newborn complications, and failure to provide emergency treatment.
Obstetric fistula therefore represents not only a public health issue, but in some cases also a reminder of the importance of accountability and quality maternal care.
The Emotional and Social Impact on Women
The consequences of obstetric fistula extend far beyond physical injury.
Many women affected by fistula experience depression and emotional trauma, social isolation, abandonment by spouses or families and severe financial hardship.
In some communities, women are wrongly blamed for their condition despite it resulting from lack of medical care.
The stigma associated with fistula often prevents women from seeking help, allowing the condition to persist untreated for years.
Global Efforts to End Obstetric Fistula
The UNFPA launched the global Campaign to End Fistula in 2003, working with governments and healthcare organisations to:
improve maternal healthcare access
train healthcare workers
support fistula surgeries and rehabilitation
strengthen emergency obstetric services
raise awareness about prevention
The 2025–26 observance continues focusing on the theme of women’s health, dignity, and reproductive rights, while calling for stronger investments in maternal healthcare systems. (United Nations Population Fund)
Experts repeatedly stress that ending fistula is not only a medical challenge, but also a matter of human rights and healthcare equity.
What Needs to Change
Preventing obstetric fistula requires strengthening healthcare systems at multiple levels.
This includes:
access to quality prenatal care
skilled birth attendants during delivery
timely emergency Caesarean sections
better rural maternal healthcare infrastructure
awareness around high-risk pregnancies
reducing child marriage and adolescent pregnancies
Healthcare systems must also ensure that women experiencing complications during labour receive immediate attention without delays caused by overcrowding, staff shortages, or administrative barriers.
Why Awareness Still Matters
Many people have never heard of obstetric fistula until a devastating case emerges.
Awareness matters because fistula is both preventable through proper maternal care and treatable through surgery and rehabilitation.
The International Day to End Obstetric Fistula serves as an important reminder that no woman should suffer lifelong injury simply because she lacked access to timely healthcare during childbirth.
Final Words
Obstetric fistula is often described as one of the clearest signs of inequality in maternal healthcare. It reflects not only medical gaps, but also failures in protecting the dignity, health, and rights of women and girls.
As the world marks the International Day to End Obstetric Fistula, the message remains urgent and simple:
No woman should suffer a preventable childbirth injury because timely medical care was unavailable, delayed, or inadequate.
Ending obstetric fistula requires not just awareness, but stronger healthcare systems, accountability, and the recognition that safe childbirth is a fundamental human right.
The Author :
Dr. Sunil Khattri
+91 9811618704
Dr Sunil Khattri MBBS, MS(General Surgery), LLB, is a Medical doctor and is a practicing Advocate in the Supreme Court of India and National Consumer Disputes Redressal Commission, New Delhi.
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