By Memory Mudzani
Early pregnancy, poverty and limited access to timely maternity care are among the factors increasing the risk of obstetric fistula, a debilitating childbirth injury that remains a public health challenge in Zimbabwe.
Obstetric fistula occurs when prolonged, obstructed labour damages tissue between the birth canal and the bladder or rectum, leaving a woman with abnormal and often uncontrollable leakage of urine or faeces. The condition is largely preventable when women have timely access to quality emergency obstetric care.
Ministry of Health and Child Care fistula repair programmes coordinator Dr Chipo Dembedza said prolonged obstructed labour without timely medical intervention could cut off blood supply to tissues in the pelvis, eventually creating a hole.
She was speaking in a video published on the ministry’s Facebook page.
Dembedza said adolescent pregnancy could increase the risk because younger girls may not have a fully developed pelvis, potentially making childbirth more difficult.
The World Health Organisation similarly identifies prolonged or obstructed labour as the main cause of obstetric fistula and notes that adolescent mothers, particularly in poor and rural communities, can face barriers to obtaining emergency obstetric care.
In Midlands, concerns over early pregnancies are particularly relevant in communities where poverty and limited access to services can expose young girls to greater reproductive health risks.
However, claims linking artisanal miners directly to increased cases of obstetric fistula in the province require further local evidence. Poverty, early marriage and pregnancy, inadequate maternity services and barriers to emergency care are recognised risk factors.
Amnesty International reported in 2021 that some women and girls in Zimbabwe faced barriers to accessing maternal healthcare, including the cost of hospital care, inadequate health infrastructure and other social and economic factors.
The organisation said these barriers contributed to some women opting for home births, increasing the risk of complications.
The organisation also reported that access to prevention and treatment for obstetric fistula remained limited for many women and girls in Zimbabwe.
According to the WHO, preventing obstetric fistula requires measures including preventing early and unintended pregnancies, ending child marriage, ensuring skilled attendance at childbirth and providing timely emergency obstetric care when complications arise.
The condition is also treatable. WHO guidance states that appropriate treatment can repair fistula in many cases, while Amnesty International has cited surgical success rates of up to 92 percent when quality treatment is available.
Deputy Minister of Health and Child Care Sleiman Kwidini, speaking during the May 2025 commemoration of the International Day to End Obstetric Fistula, said government was working with local and international partners to address the condition.
“We must continue to advocate for the rights of women and girls throughout Zimbabwe,” Kwidini said.
The persistence of obstetric fistula highlights the importance of preventing early pregnancies while ensuring that women and girls, particularly those in underserved communities, can access antenatal care, skilled birth attendance and emergency treatment when complications arise.
