Lead Writer: Bernard Otu Assim-ita

Obstetric fistula is a devastating childbirth injury caused by prolonged, obstructed labour, resulting in a hole between the birth canal and bladder or rectum which leaves women leaking urine, faeces, or both and often leads to chronic medical problems, social ostracisation, and severe psychological trauma. Obstetric fistula has been practically eliminated in developed nations, but in the developing world, it is estimated that approximately 500,000 women and girls live with the condition. In Nigeria, where child marriages are prevalent, obstetric fistula is a significant health concern. Beyond child marriage, the global landscape of maternal health has seen significant strides in recent years. Yet, the spectre of obstetric fistula persists, particularly in lower- and middle-income countries especially, Nigeria. While pregnancy and childbirth are generally safer than ever before, thousands of women still endure the devastating consequences of obstetric fistula annually highlighting that beyond being a medical issue it has also become a reflection of systemic inequalities ingrained within societies.

Girls and women in civilised societies, especially in a democracy, deserve the care and protection of the state. The Child Rights Act of 2003 and even the Violence Against Persons Prohibition (VAPP) Act, enacted in 2015, expressly prohibit child marriage, recognising the inherent vulnerabilities of minors and the imperative to protect them from harm. However, enforcement remains challenging, and cultural practices continue to undermine legal protections this negligence, raises significant concerns about girls’ futures, particularly regarding serious health risks, including obstetric fistula, which disproportionately affects young brides.

Empowering girls with education and protecting their rights can help break the cycle of poverty and prevent the health complications associated with early marriages, safeguard their rights, and provide them with the opportunity to pursue a brighter future. For mature women who have consented and desire to carry a child, prioritising maternal health care in Nigeria is crucial to prevent conditions like obstetric fistula and to reduce maternal mortality rates. This includes comprehensive pre and post-natal care, skilled birth attendants, and emergency obstetric services.

Addressing the root causes and improving maternal health care ensures that women don’t die #WhileGivingBirth, and prioritising the health and well-being of women and girls builds a healthier, more equitable future for all Nigerians. 

As we commemorate the 2024 International Day to End Obstetric Fistula, themed “Breaking the Cycle; Preventing Fistula Worldwide,” we must renew our commitment to ending child marriage and improving health systems. This day serves as a reminder of the urgent need to address the factors contributing to obstetric fistula and to advocate for policies and programs that support maternal health and protect the rights of girls and women.