Beyond Surgical Repair: Psychosocial Recovery and Social Reintegration for Obstetric Fistula Survivors in Somalia.

Obstetric fistula is a preventable childbirth injury with profound physical, psychological, social, and economic consequences for women. In Somalia, fistula reflects delayed access to skilled childbirth care and emergency obstetric services, but its effects continue long after the clinical injury. Drawing on Somalia-specific evidence and relevant global literature, this commentary argues that fistula care should move beyond a procedure-centered model toward a survivor-centered continuum of psychosocial recovery and social reintegration. Surgical repair remains essential, yet recovery is incomplete when survivors return to stigma, shame, marital strain, social isolation, economic dependence, grief, or fear of future childbirth. A more complete approach should link respectful identification and referral with surgical repair, counseling, family engagement, stigma reduction, livelihood support, peer support, follow-up, and safe future pregnancy planning. For the International Journal of Women's Health readership, this commentary highlights obstetric fistula as an obstetric, reproductive health, psychosocial wellbeing, and healthcare leadership priority. Strengthening postrepair recovery can help restore dignity, community participation, and emotional wellbeing while reinforcing Somalia's wider maternal health agenda.