What is obstetric fistula?

One of the worst things that can happen to a woman or girl is an obstetric fistula, an internal injury caused by an obstructed labour when adequate health care has not been available, that leaves her incontinent, humiliated and often cut off from her community.  

An obstetric fistula is a hole between the birth canal and the bladder or rectum. It leaves survivors leaking urine or faeces – and sometimes both – through their vagina. Some patients suffer from paralysis caused by nerve damage. 

Tragically, 93% of obstetric fistula survivors give birth to a stillborn baby, often after an agonising obstructed birth lasting days. 

Sufferers of obstetric fistula are often subject to severe social stigma due to their smell and perceptions of uncleanliness. Many patients report psychological issues, and many marriages do not survive, unable to cope with the ongoing physical and emotional health issues.

Survivors often voiceless and marginalised, tend to live in impoverished countries, with the common thread of being poor, rural and female. 

These women have suffered more than any woman should be called upon to endure.

Dr. Catherine Hamlin

The challenge in Ethiopia

Whilst Ethiopia is one of the fastest growing economies in Africa, it carries an enormous population living in poverty, struggling with a lack of health services and infrastructure. 

For a population of over 112 million, Ethiopia has fewer than 626 obstetricians / gynaecologists, and whilst huge progress has been made in recent years, there are still less than 17,000 trained midwives working in Ethiopia.  

Fewer than 30% of Ethiopian women receive any form of care from a skilled childbirth attendant (1). Imagine suffering for days through an excruciating obstructed labour, losing your baby and then suffering the most horrendous internal injury. Just because you are a woman without access to effective maternal healthcare.

This lack of health professionals and services has a devastating impact – with approximately 11,000 women and girls (2) dying during childbirth or as a result of complications of childbirth, and another 948 (3) surviving but with an obstetric fistula each year. It is estimated there are up to 5,000 women (4) in Ethiopia living with obstetric fistula in need of vital treatment.

How is obstetric fistula prevented?

In Western countries, obstetric fistulas are virtually a thing of the past because there is access to effective maternal healthcare. With the right access to maternal healthcare, this horrific childbirth injury is entirely preventable. 

Having access to a well-trained midwife and an emergency caesarean section can prevent obstetric fistula in the first place. Pregnant women also need support from trained health care professionals throughout pregnancy and access to family planning. 

Our hospitals across Ethiopia are helping tackle fistula and provide vital maternal health care.  

The women who receive this life-changing treatment are often too poor to pay. Their treatment is offered free, thanks to generous donors from the UK and around the world. 

Find out more about how we are working to eradicate fistula in Ethiopia: 


  1. Ethiopia Demographic and Health Survey 2016
  2. UNICEF Ethiopian Profile
  3. Ministry of Health Ethiopia, National Strategic Plan for Elimination of Obstetric Fistula 2021-2025
  4. Prevalence of obstetric fistula and symptomatic pelvic organ prolapse in rural Ethiopia, International Urogynecology Journal, Dec 2015