During prolonged or obstructed labor, undue, extended pressure in the birth canal can lead to tissue damage. If untreated, this tissue damage results in a fistula — an abnormal opening between a woman’s vagina and bladder or rectum (or both).
An obstetric fistula permits the uncontrollable passage of urine and feces into the vagina, producing a foul odor and often leading to social isolation. Women with fistula usually feel shamed or disgraced. They are sometimes deserted by their husbands and cut off from family, friends, and daily activities. The physical and emotional stress of those suffering from an obstetric fistula is often compounded by the loss of the baby.Because its the USAID site, it is referring mainly to women in developing countries who cannot receive emergency obstetrical care to fix the tissue damage.
Data from the United States and the United Kingdom indicate that fistula is rare in developed countries and almost never results from obstructed or prolonged labor.
Obstructed labor occurs:
In cultures where child marriage is common and pregnancy occurs soon after menarche, obstructed labor can be common because young adolescent girls may not have achieved their maximal growth potential and thus start childbearing with an inadequate pelvis. Obstructed labor can also occur in subsequent pregnancies in which maternal nutrient deprivation may result in a distorted pelvis, or in women prone to pelvic fractures and other acquired pelvic deformities. Nutrient deficiencies such as calcium, vitamin D, folic acid, iron, and zinc deficiencies interact in combination with various biological and biosocial factors to determine the prevalence of obstructed labor. (American Journal of Clinical Nutrition)