The Problem Obstetric Fistula. Lack of medical assistance during childbirth, particularly in the developing world, frequently results in obstructed labor which lasts for many days. As a result, over a million women worldwide suffer from obstetric fistula, a tear between the birth canal and the rectum or bladder. Fistula can cause ongoing pain, repeated vaginal and urinary tract infections, leaking feces, and reduced ability to bear children. It also leads to severe incontinence, with stark social consequences: women living with fistula are often shunned by their family and community due to the foul smell.