Childbirth: a remarkable feat of life or a deeply traumatic experience? That can depend on your access to healthcare.

In Angola, only around half of all women give birth with the help of a skilled health worker. A main barrier to care is transportation. Many women simply live too far to walk to the nearest hospital and can’t afford a ride. This can result in tragedy.

Amelia, 28, has given birth to five children at home, but only two have survived. In a difficult delivery, she developed obstetric fistula, a serious childbirth injury resulting most often from prolonged or obstructed labour unassisted by a skilled health worker. “I never want to give birth at home again,” she told UNFPA, the United Nations sexual and reproductive health agency.

Amelia is now recovering from surgery to repair the fistula at Vangulula House, a unit of the Azancot de Menezes Hospital in the city of Luanda. Run in partnership with the Fistula Foundation, Vangulula House, which means “restore for life” in the local language, is the only facility in Angola that performs advanced fistula surgeries. Women come here from across the country for care; when they’re ready to return home, the foundation covers their transportation costs.

UNFPA is supporting Vangulula House in developing strategies to build financial sustainability, while also providing literacy and skills training to fistula survivors. In addition, starting in 2026, UNFPA will support Angola’s Ministry of Health to train health providers on emergency obstetric and neonatal care.

Across Angola, UNFPA-supported health workers, including skilled midwives, are making childbirth safer, preventing fistula, caring for newborns who need intensive support and providing objective, accurate information about family planning – giving women more choice and autonomy. Investing in midwives is a crucial, cost-effective way to reduce preventable maternal deaths and tragic childbirth injuries.

“Fistulas are now treatable through surgery. But the next step must be prevention,” says surgeon Dr. Paolo Parimbelli. Providing access to skilled healthcare and equipped facilities and reducing teen and early pregnancy can help prevent the condition.

Globally, more than 500,000 women are living with fistula. UNFPA is working with partners around the world to end this crisis.

In Angola, UNFPA supports health facilities across the country, including Maternidade Augusto Ngangula Hospital in Luanda, pictured here.

Teresa, Conceicao and Goreth have received prenatal support from Maternidade Augusto Ngangula Hospital and plan to give birth at the facility.