Motherhood is often described as a time of immense joy, love, and transformation. But what happens when this life-changing journey also brings unexpected health challenges? While a mother does everything she can to ensure a smooth pregnancy, some complications arise beyond her control. One such unfortunate and serious childbirth injury is Obstetric fistula. Often called the “most neglected health crisis for women,” obstetric fistula is a condition that affects thousands of women, particularly in regions with inadequate maternal healthcare.
So, what causes this condition, and why does it still affect so many women despite advances in modern medicine? Let us understand the reasons from Dr Amita Jain who is a leading laparoscopic surgeon and one of the best doctors and surgeons for fistula treatment and surgery in Delhi.
What is an Obstetric Fistula?
The term obstetric relates to pregnancy, childbirth, and maternal health, while fistula refers to an abnormal connection between two organs that are not normally connected. Obstetric fistula is a medical condition that occurs when an abnormal opening forms between a woman’s birth canal and her urinary tract or rectum. As a result, women with obstetric fistula experience continuous leakage of urine or feces, which can lead to infections, and anaemia.
, and nerve damage in the lower limbs. Obstetric fistulas are classified based on the organs involved:
- Rectovaginal fistula – an opening between the rectum and the vagina, leading to the leakage of stool.
- Vesicovaginal fistula – an opening between the urinary bladder and the vagina, causing continuous urinary leakage.
- Vesicouterine fistula – an abnormal connection between the urinary bladder and the uterus, which may lead to urinary incontinence or menstrual irregularities.
- Urethrovaginal fistula – an opening between the urethra and the vagina, leading to difficulty in controlling urination.
Reasons for Obstetric Fistula?
· Obstructed labour is a major cause of obstetric fistula. During prolonged labour, the baby’s head presses against the mother’s pelvic bone, cutting off blood flow to nearby tissues. Without oxygen and nutrients, these tissues die, creating abnormal openings (fistulae) between the birth canal and the bladder or rectum. This leads to uncontrollable urine or stool leakage. If untreated, it can cause lifelong suffering and social isolation. The baby also faces oxygen deprivation, which can be fatal without urgent medical care.
· Lack of Treatment: Unfortunately, in many developing countries, pregnant women lack access to skilled birth attendants, hospitals, or emergency medical care during labor, leading to severe complications like obstructed labour going unmanaged. This increases the risk of obstetric fistula, a devastating condition that primarily affects young women who give birth at home in poor, remote areas with little to no maternal healthcare.
Women in rural regions, where hospitals are miles away, are at the highest risk. When a woman endures a difficult childbirth and suffers a fistula, she is often abandoned by her family and shunned by her community. Due to this, medical treatment is delayed, thereby aggravating the problem further.
· Early Childbirth
We are living in an era where medical advancements have significantly improved maternal care, yet early childbirth remains a major risk factor for obstetric fistula in pregnant women. Young girls who conceive before their bodies are fully developed often face complications due to an underdeveloped pelvis, making normal childbirth difficult.
Young mothers, especially those who are malnourished, often have underdeveloped pelvises, leading to obstructed labor. Prolonged labor causes severe tissue damage, creating abnormal openings between the birth canal and nearby organs. Poor nutrition further weakens pelvic structures, increasing the risk of childbirth-related injuries and lifelong complications.
How Obstetric Fistula Can be prevented?
You will be glad to know that Fistulas can be prevented.
· Access to prenatal care for early detection and management.
· Skilled birth attendants to ensure safe deliveries.
· Timely medical interventions like cesarean sections when necessary.
· Education and awareness about pregnancy risks and maternal health.
· Improved nutrition for young girls and expectant mothers.
It is important to recognize that obstetric fistula, though distressing, is preventable with proper maternal care, timely medical intervention, and education. By ensuring skilled childbirth assistance, early treatment, and better healthcare access, we can offer women a ray of hope, restoring their dignity and enabling them to embrace motherhood without suffering.
Dr Amita Jain is a surgeon with the highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi and Sr. General and Laparoscopic Surgeon at Rainbow Children Hospitals, Malviya Nagar, Delhi.