GC: n

S: WHO – http://www.who.int/features/factfiles/obstetric_fistula/en/ (last access: 7 August 2015); UNFPA – http://www.unfpa.org/public/home/mothers/pid/4386 (last access: 7 November 2013); https://www.fistulafoundation.org/what-is-fistula/ (last access: 7 August 2015).

N: 1. obstetric fistula, abnormal duct or passageway that forms between the vagina and a nearby organ. This type of fistula most often forms either between the bladder and the vagina (vesicovaginal fistula) or between the rectum and the vagina (rectovaginal fistula). Obstetric fistulas frequently occur as a result of complications that arise during childbirth and that cause a prolonged decrease in blood supply to the vagina and bladder or rectum. This typically occurs when an obstruction causes the fetus’s head to remain pressed against the pelvis for a long period of time. Deprived of blood, the affected tissues eventually die and an opening forms between them, giving rise to a fistula and allowing urine or feces to pass uncontrollably. Other causes of obstetric fistula include Crohn disease, infections, tumours, radiation therapy, and physical trauma sustained during sexual violence.
2. One of the most serious injuries of childbearing is obstetric fistula, a hole in the vagina or rectum caused by labour that is prolonged – often for days – without treatment. Usually the baby dies. Because the fistula leaves women leaking urine or faeces, or both, it typically results in social isolation, depression and deepening poverty. Left untreated, fistula can lead to chronic medical problems. Like maternal mortality, fistula is almost entirely preventable. Yet at least 2 million women in sub-Saharan Africa, South Asia and the Arab region are living with fistula, and some 50,000 to 100,000 new cases develop each year. The persistence of fistula is a signal that health systems are failing to meet the needs of women.

S: 1. EncBrit – http://global.britannica.com/science/obstetric-fistula (last access: 7 August 2015). 2. UNFPA – http://www.unfpa.org/public/home/mothers/pid/4386 (last access: 7 November 2013).

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CR: childbirth, midwife.