How Obstetric Fistula Happens

An obstetric fistula most often follows days of obstructed labor. In these cases, a woman may not only lose her baby, but also suffer severe internal damage. Prolonged pressure from the baby’s head cuts off blood flow to the birth canal, causing tissue loss and creating a hole between the vagina and the bladder or rectum.

Without surgical repair, she is left incontinent, leaking urine and sometimes stool uncontrollably. Many fistula survivors are divorced, abandoned by their families, and left with no reliable way to support themselves.

In high resource countries like the United States, access to quality maternal healthcare means obstetric fistula is virtually unheard of. In Uganda, where there is only one doctor for every 25,000 people, many women give birth without proper medical assistance. In rural areas, the situation is even more severe. If labor becomes obstructed, a woman may go for days without help, often resulting in this life altering injury.

Obstetric fistulas can also result from poorly performed cesarean sections. In Uganda, approximately 52 percent of obstetric fistulas are iatrogenic, meaning they are caused by surgical injury during cesarean delivery. These cases reflect gaps in surgical training, supervision, and access to safe operating conditions, underscoring the need for stronger systems of care, not just more surgeries.

A Life Altered by Injury and Isolation

Obstetric fistula is one of the most devastating childbirth injuries, not only because of its physical effects, but because of the profound social consequences women endure.

Women living with fistula experience constant leakage of urine or stool. Many suffer chronic infections, pain, and exhaustion. Just as damaging is the stigma. Women are often isolated due to odor and misunderstanding. Some are abandoned by partners or excluded from their communities. Many live in silence for years, believing their condition is permanent or untreatable.

What makes this suffering especially tragic is that obstetric fistula is almost entirely preventable and, in most cases, surgically repairable.

With skilled surgery and appropriate follow-up care, women can heal, regain continence, and return to daily life with dignity. When treatment is paired with strong health systems, future injuries can be prevented altogether.

This is why The Musa Project focuses not only on repairing fistula, but on building the surgical capacity and hospital infrastructure needed to ensure women receive timely care before injury occurs.

Finding Women Who Have Been Left Behind

Even when treatment is available, many women living with obstetric fistula never reach care.

Shame, stigma, poverty, distance, and lack of awareness keep women hidden. Some have lived with fistula for ten, twenty, or even thirty years without knowing treatment exists. Others are physically unable to travel or fear rejection if they are seen seeking help.

Find Her is The Musa Project’s outreach initiative designed to identify and reach these women.

Through community mobilization, partnerships with local leaders, and coordination with regional hospitals, Find Her works to locate women living in isolation and connect them with life changing surgical care. Once identified, women are supported through referral, transport, treatment, and recovery.

Finding women is just as critical as treating them. Surgery cannot restore dignity if women never make it through the hospital doors.

By combining outreach with treatment and prevention, The Musa Project ensures that women who have been invisible for years are finally seen, treated, and restored.