Childbirth shouldn't be a death sentence

Childbirth should be a moment of joy … but for thousands of women like Awawu, it is the beginning of a nightmare.

Instead of celebrating a healthy delivery with a newborn baby in their arms, they are left with a stillborn infant and a life-altering injury: obstetric fistula.

I met Awawu in her small, rural village in Ethiopia. She believed God had cursed her — that her injury was proof she had done something unforgivable. People told her to her face, “You are less worthy now.”

Awawu said she wanted to die.

For thousands of women, they are married off too young, just as Awawu was. Shortly thereafter, they become pregnant, but their bodies are not ready. Years of malnutrition, hard labor, and stunted growth mean their body cannot safely deliver a baby. An obstetric fistula happens when a baby becomes stuck during prolonged labor, cutting off blood flow and causing devastating internal injury. The result is chronic incontinence, often leading to a woman being exiled from society. Without surgery, she can live this way for the rest of her life.

In Awawu’s case, she was in labor for four days before losing her baby. To add to the heartache, an obstetric fistula is entirely preventable. It is not a rare tragedy. It is simply the outcome of being born female in places where maternal health care is out of reach.

As the world celebrates International Women’s Day on March 8, conversations turn to equality and opportunity. But women’s health — particularly maternal health — too often remains an afterthought.

Obstetric fistula is a stark reminder of what happens when it is.

When I traveled to Ethiopia this past year, Awawu wasn’t the only woman I met who had suffered from fistula. Some had endured it for years or even decades — not because they did anything wrong, but because they had no choice but to give birth at home, hours from the nearest facility equipped to handle labor complications.

What struck me most was not just the physical pain Awawu and so many others endured, but how they had been failed by a lack of access to basic maternal health care and education long before their labor ever began.

Because they had never been told otherwise, these women, including Awawu, believed they were being punished. Cursed. Unclean. Rejected by God. A burden.

Thankfully, Awawu’s story doesn’t end there.

After finally receiving fistula repair surgery, Awawu received medical treatment, post-surgery care, counseling, spiritual support, and the tools to rebuild her life. She was trained to raise livestock and run a small business and was given a cow to help regain her independence.

But the most powerful transformation wasn’t physical — it was spiritual and social. She began to understand she was deeply loved by God. The same community that once kept its distance began to see her strength. She was trained to become a Safe Motherhood Ambassador, educating other women about prenatal care, safe delivery, and how to prevent fistula in the first place.

Before I left, I watched Awawu stand before a group of expectant mothers in her village as a trusted guide. She was poised, and hope radiated from her. She educated them on the importance of prenatal care and how to prevent obstetric fistula in the first place. The woman who once hid in isolation, wanting to die, is now honored as a protector of mothers and babies. A life completely transformed. Yet there are so many other women like Awawu just waiting to receive that hope.

The growing attention to fistula in global conversations about women’s health signals progress. But awareness alone is not enough. If International Women’s Day is truly about advancing women, then maternal health must be a key component of that. No woman should suffer a life-altering injury simply because she gave birth where health care was inaccessible.

And fistula is only one example of what happens when women are overlooked. Around the world, millions of women face preventable suffering due to a lack of access to health care, clean water, education, opportunity, and the consequences ripple for generations.

This International Women’s Day, the call to action is clear: we must invest in women. When women are healthy and supported, children survive, economies grow, and futures change.

Awawu’s journey from being labeled as “cursed” to becoming a source of hope for mothers is a reminder of what is possible when women are given access to care and empowered. Her story is an illustration of what can happen anywhere when women are no longer forgotten.