Pakistan faces renewed calls to end obstetric fistula

Experts cite rural healthcare gaps, stillbirth risks, and delayed treatment

IV Report

KARACHI: Health experts, surgeons, and women’s rights advocates have called for urgent investment in maternal healthcare and stronger rural obstetric services to eliminate obstetric fistula in Pakistan, warning that thousands of women continue to suffer from one of the world’s most devastating — yet preventable — childbirth injuries.

The call was made during separate events held in Karachi on May 23 to mark the International Day to End Obstetric Fistula 2026 under the theme, “Her Health Is a Right: Invest to End Fistula and Childbirth Injuries.” Speakers stressed that timely maternity care, skilled birth attendants, emergency obstetric services, and community awareness were essential to preventing avoidable childbirth injuries and maternal deaths.

The Sindh Institute of Urology and Transplantation (SIUT) observed World Obstetric Fistula Day with an awareness session, where experts highlighted the urgent need for better emergency obstetric services, stronger rural maternity care, skilled birth attendants, and free ambulance networks.

Experts including Prof Murli Dhar of SIUT, Dr Mohammed Soheb Nizam from the United States, Prof Pushpa Sirichand Sachdev of Isra University Hospital Hyderabad, and Prof Riffat Jaleel of Dow University of Health Sciences discussed the causes, prevention, treatment, and long-term consequences of obstetric fistula.

They explained that obstetric fistula usually occurs after prolonged obstructed labour when women fail to receive timely emergency treatment, particularly Caesarean section. The condition can cause severe damage between the birth canal and the bladder or rectum, leading to continuous leakage of urine or stool.

Speakers noted that beyond physical suffering, women living with fistula often face stigma, social isolation, emotional trauma, and loss of dignity despite the condition being largely preventable and treatable. According to experts, nearly 4,000 to 5,000 women in Pakistan develop obstetric fistulas annually, particularly in underserved rural areas where access to hospitals, transport, and skilled birth attendants remains limited.

SIUT said it is among the few institutions in Pakistan providing free fistula treatment. The institute has carried out more than 1,000 fistula surgeries so far, including 39 successful procedures in 2025 — among them nine robotic vesicovaginal fistula repairs.”

Speaking at a separate press conference, participants noted that an estimated two million women worldwide are living with fistula, while thousands more continue to suffer in silence without access to treatment. They said nearly 90 per cent of obstructed labour cases linked to fistula result in stillbirth.

The speakers stressed the importance of community participation, women’s empowerment, and prevention of gender-based violence in addressing maternal health challenges. They called for expanding access to safe and holistic fistula treatment, including surgical repair, rehabilitation, and social reintegration.

Participants also urged the government to strengthen rural healthcare services by activating basic health units and tehsil headquarters hospitals, training skilled midwives, ensuring free emergency obstetric care, and improving the career structure of midwives. They further called for training young doctors in safe pelvic surgeries to prevent iatrogenic fistula and warned against the growing trend of unnecessary Caesarean sections in Pakistan.

The press conference featured speakers including Dr Sajjad Ahmed Siddiqui, Dr Abdul Ghafoor Shoro of the Pakistan Medical Association, Dr Muhammad Ismail Memon, Dr Sana Ashfaq, Sheema Kermani, Dr Sonia Naqvi, and Renuka Swami of the United Nations Population Fund.

Photos courtesy SIUT & PMA