A London woman, Zara Ishfaq, was left with a significant disability after a severe vaginal tear during childbirth went untreated for more than two years. The injury ultimately developed into a 3cm fistula, a hole between the bowel and the vagina, requiring major surgery and the temporary fitting of a stoma bag.
Ms. Ishfaq, now 31, gave birth to her first child on December 21, 2021. She notes that despite her son being on the 97th percentile for size, a Cesarean section was not discussed. During the delivery, midwives used forceps due to the baby's shoulders becoming stuck, and an episiotomy was performed. Shortly after delivery, Ms. Ishfaq experienced a severe post-delivery bleed, losing two liters of blood.
She was discharged two days later and, by her postnatal appointment on Boxing Day, reported pain, swelling, and a fever. Despite concerns that the tear was not healing properly, she was reassured her recovery was normal. In the months following the birth, she began experiencing severe bowel issues, including frequent bowel movements and leakage, leading her to wear incontinence pads. These concerns were dismissed, and she was advised to perform pelvic floor exercises, unaware of the underlying, undetected injury.
It wasn't until December 2022 that she was referred for a specialist assessment, which occurred in July 2023. Following extensive testing, in May 2025, doctors confirmed the severity of the birth injury, which had been significantly underestimated. The necessary surgery to repair the fistula required the temporary use of a stoma.
Ms. Ishfaq's health issues continued into her second pregnancy, where she experienced hyperemesis gravidarum, diarrhea, recurrent infections, and sepsis, all linked to complications from her previous injuries. She is now advocating for greater awareness of birth injuries and improvements in maternity care, emphasizing the need to listen to women and address these issues promptly.
According to The MASIC Foundation, approximately one in 20 first-time mothers suffer an obstetric anal sphincter injury. In the 2024-25 fiscal year, over 60 percent of the NHS's clinical negligence budget, totaling £60.3 billion, was allocated to maternity and neonatal liabilities. The NHS is reportedly considering changes to manager contracts to improve accountability for failings in maternity care, a move that follows a major report on maternity scandals at Nottingham University Hospitals NHS Trust.