In developing countries, obstetric fistula is the result of prolonged or obstructed (blocked) labour, often lasting several days, when the unborn baby cannot pass through the pelvis. The baby may be too big for the pelvis or lying in the wrong position, or the pelvis may be misformed or not fully developed. In developed parts of the world, a woman with this kind of obstructed labour would be given a caesarean section, but in developing countries this may not be available. Consequently, the pressure of the baby’s head for an abnormally long time on the blood vessels supplying the tissue of the vagina, bladder, urethra and rectum cuts off the supply of oxygen (ischaemia) and leads to the death of the affected tissue (necrosis). The dead tissue then sloughs away, leaving a hole between adjacent organs.
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WHO Reproductive Health:
Campaign to End Fistula UNFPA
Campaign to End Fistula
Worldwide Fistula Fund
Worldwide Fistula Fund UK
The Fistula Foundation