Earlier this month, the UN released its final report on the Millennium Development Goals. Progress in MDG 5, improving maternal health, ultimately lagged behind the others. Far too many women in the 21st century are still dying during childbirth, and not enough are delivering in the presence of a skilled birth attendant. For every woman who dies during childbirth, at least 20 more suffer from devastating injuries like obstetric fistula, a condition that results from prolonged obstructed labor and renders a woman incontinent.
So why are so many women delivering on their own, without skilled assistance or emergency obstetric care? Why are women still developing obstetric fistulas, when we know it’s a condition that can be prevented and should no longer exist? Some of the main hurdles are due to poverty – women may live far away from the nearest hospital, particularly in rural areas, and transportation can be too expensive. Still other hurdles have to do with healthcare infrastructure, or, perhaps more appropriately, a lack thereof: for women who do make it to a hospital or health center, the facility might not have the necessary supplies or expertise to help her deliver safely.
Women may also face specific challenges depending on which region they are from. In Nigeria, for example, particularly in the rural northern region, there are a number of barriers that prevent women from accessing treatment. Understanding these barriers is important, as Nigeria has the world’s largest burden of obstetric fistula (estimates start at 10,000 new cases every year) and one of the world’s highest rates of maternal mortality.