23 May 2019

International day to end obstetric fistula

Many people do not know about the existence of this serious complication as a result of pregnancy or what it means for a woman. For millions of pregnant women in Africa, however, obstetric fistula is a real possibility due to very long labor and poorly assisted childbirth.

If the woman survives a difficult birth, she can develop a necrosis of the soft tissues, which are crushed between the bones of the skull of the fetus and the pelvis of the mother and which remain without blood supply. As a result of this necrosis, a laceration is created between the bladder and the vagina, the rectum and the vagina or the urethra and the vagina. This laceration is called obstetrical fistula.

These lesions leave an indelible mark: severe urinary and/or faecal incontinence, which often causes these women serious social traumas. They are teased, treated as infected and isolated from families and communities.

In Europe and America obstetric fistulae were a common occurrence until the second half of the nineteenth century, but thanks to the wide coverage provided by the health system and the assistance before and after birth, have almost disappeared. In developing countries, however, they are still seen today.

According to data collected by the World Health Organization (WHO), more than two million women are affected by obstetric fistula. In general, it is estimated that there are about 50,000-100,000 new cases in the world every year.

These data have pushed the international community to introduce as a goal of the “Millennium Development Goals” the end of obstetric fistulae through prevention, surgical repair and reintegration of healed women into social life.

The International Day for the Elimination of Obstetric Fistula is therefore intended to be an event to stimulate reflection to increase the collective awareness of this phenomenon, which is completely preventable and in many cases treatable.