,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #higa  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,decemb] #ae1         
#bjbj,mrs4 ,c>olyn ,b4 ,maloney ( ,new  
,york introduc$ ! foll[+ bill2 :i* 0    
ref]r$ to ! ,committee on ,=eign        
,affairs  ,a ,,bill  ,to au?orize       
assi/ance to aid 9 ! prev5tion &        
treatm5t ( ob/etric fi/ula 9 =eign      
c\ntries1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,ob/etric ,fi/ula ,prev5tion1 ,treatm5t1
 ,hope1 & ,dignity ,re/oration ,act (   
#bjbj4  #b4 ,f9d+s ,congress f9ds !     
foll[+3 7#a7 ,e two m9utes1 "o woman    
dies f pregnancy-relat$ complications4  
,?is means approximately #hcj wom5 die f
 pregnancy- or *ildbir?-relat$          
complications ar\nd ! _w e day4 ,( ^!   
dea?s1 #ii p]c5t occur 9 develop+       
c\ntries4 ,ov] half ( ^! dea?s are 9    
sub-,sah>an ,africa & "o-?ird are 9 ,s\?
 ,asia4  7#b7 ,ob/etric fi/ula is "o ( !
 mo/ sev]e & tragic pregnancy-relat$    
injuries1 :i* occurs :5 a woman         

exp]i5ces prolong$1 ob/ruct$ labor 9 !  
abs5ce ( tra9$ m$ical assi/ance1 :i* is 
mo/ commonly a ,caes>ean section1       
necess>y = a safe deliv]y4  7#c7        
,ob/etric fi/ula is a hole t is =m$     
betwe5 ! bladd] & ! vag9a1 or ! rectum &
 ! vag9a 7or bo?74 ,9 ! /ruggle to pass 
?r\gh ! bir? canal1 ! fetus puts con/ant
 pressure1 sometimes = sev]al days1 on !
 bladd] & vag9al or rectal walls1       
de/roy+ ! tissue t !n dies & sl\ghs (f1 
result+ 9 ! abnormal op5+ or hole4  7#d7
 ,9 approximately #ij p]c5t ( ob/etric  
fi/ula cases1 ! baby w be /illborn4 ,a  
"m w exp]i5ce physical pa9 & multiple   
physical disabilities1 z well z social &
 emotional trauma f liv+ ) incont95ce & 
f ! loss ( h] *ild4  7#e7 ,9 addition to
 con/ant uncontrollable leak+ ( ur9e1   
feces1 or bo?1 ! physical consequ5ces ( 
ob/etric fi/ula may include frequ5t     
bladd] infections1 pa9ful sores1 kidney 
failure1 inf]tility1 f\l odor1 or?op$ic 
injury1 n]ve damage t makes normal walk+
 impossible & int]nal g5ital sc>r+ t    

de/roys normal sexual function4  7#f7   
,wom5 & girls ) ob/etric fi/ula are     
commonly o/raciz$ by _! families &      
communities1 lead+ to depression1       
anxiety1 po/-traumatic /ress disord]1   
social isolation & discrim9ation1       
suicidal ?\ghts or actions1 & lack (    
adequate economic opportunities1 result+
 9 deep5+ pov]ty1 isolation1 &          
vuln]ability4  7#g7 ,al?\gh data on     
ob/etric fi/ula are sc>ce1 ! ,_w ,heal? 
,organization 7,,:o7 e/imates !re are m 
?an #b1jjj1jjj wom5 & girls liv+ )      
fi/ula1 & #ej1jjj to #ajj1jjj new cases 
ea* ye>4  7#h7 ,ob/etric fi/ula 0 once  
common ?r\gh\t ! _w1 b ov] ! la/ c5tury 
has be5 virtually elim9at$ 9 ,europe1   
,nor? ,am]ica1 & o!r develop$ regions   
?r\gh improv$ access to high-quality1   
timely m$ical int]v5tions1 p>ticul>ly   
em]g5cy ob/etric c>e includ+ ,caes>ean  
section4  7#i7 ,ob/etric fi/ula is      
prev5table ?r\gh timely m$ical          
int]v5tions & provid+ access to family  
plann+ = all wom5 :o ne$ x4 ,social     

int]v5tions su* z alleviat+ pov]ty1     
delay+ e>ly m>riage & e>ly *ildbe>+1    
educat+ & emp[]+ "y wom51 rem$y+ g5d] & 
socioeconomic inequalities1 & address+  
malnutrition c also help prev5t ?is     
complication4  7#aj7 ,! majority (      
ob/etric fi/ula c be surgically treat$4 
,:5 p]=m$ by a skill$1 compet5t surgeon1
 ! proc$ure is relatively inexp5sive )  
high rates ( success4  7#aa7 ,9 #bjjc1 !
 ,unit$ ,nations ,population ,fund      
7,,unfpa71 ,engender,health1 & o!r      
p>tn]s laun*$ a global ,campaign to ,end
 ,fi/ula 7! ,campaign7 to id5tify &     
address ob/etric fi/ula 9 an ef=t to    
develop a means to treat & support ^?   
wom5 :o are suff]+ & provide ! necess>y 
heal? s]vices to prev5t fur!r cases4    
,op]at+ 9 m ?an #ej c\ntries across     
,africa1 ,asia1 & ! ,arab region1 !     
,campaign has f\r ma9 goals3 ! prev5tion
 ( fi/ula cases1 treatm5t ( exi/+ fi/ula
 cases1 social re9tegration & foll[ up =
 fi/ula survivors1 & advocacy = end+    
fi/ula4  7#ab7 ,9 ord] to meet ^! goals1

 ,! ,campaign supports & p>ticipates 9 !
 em]g+ safe surg]y community ( practice 
t /r5g!ns surgical ecosy/ems 9 l[- &    
middle-income c\ntries 7,,lmic7 t[>ds   
bett] access to ess5tial & life-sav+    
surg]ies1 :i* includes improv$ tra9+1   
equipm5t1 supplies1 infra/ructure &     
heal? work] d5sity = timely access to   
,caes>ean section & = environm5ts t     
optimize outcomes ( fi/ula surg]y4      
7#ac7 ,s9ce #bjjc1 ,,unfpa has directly 
support$ m ?an #he1jjj fi/ula repairs1 )
 additional repairs support$ by         
,campaign p>tn]s4  7#ad7 ,,usaid1 9     
accordance ) ! ,unit$ ,/ates ,gov]nm5t's
 commitm5t to end+ prev5table mat]nal & 
newborn dea?s & disabilities1 curr5tly  
supports fi/ula treatm5t s]vices 9 #acg 
sites 9 six c\ntries4 ,,usaid addresses 
prev5tion 9 ^? sites & ?irty-six m4     
,s9ce #bjjd1 m ?an #ci1jjj wom5 h       
receiv$ fi/ula repairs ) ,,usaid        
support4  7#ae7 ,! ,unit$ ,/ates has    
committ$ to jo9+ multilat]al ef=ts      
involv+ ! ,unit$ ,nations & o!rs to make

 progress t[>d a*iev+ ! ,su/a9able      
,developm5t ,goals 7,s,d,gs71 includ+   
?r\gh ! ,global ,/rategy = ,wom5's1     
,*ildr5's & ,adolesc5ts' ,heal?         
7#bjaf-bjcj74 ,elim9at+ ob/etric fi/ula 
is key to a*iev+ ! ,s,d,gs' vision (    
leav+ no "o beh9d44  7#af7 ,9 8 #bjaf   
/atem5t on ! ,int]national ,day to ,end 
,ob/etric ,fi/ula1 ,unit$ ,nations      
,secret>y ,g5]al ,ban ,ki-,moon boldly  
laid =? a new global vision & goal (    
end+ ob/etric fi/ula )9 a g5]ation1 say+
 t1 ,! p]si/5ce ( fi/ula 9 "s c\ntries &
 regions is an indicator ( v poor access
 to quality mat]nal heal? s]vices4 ,to  
end x1 we mu/ /r5g!n heal? sy/ems &     
address broad] developm5t & human rights
 issues affect+ wom5 & girls3 pov]ty1   
g5d] inequality1 e>ly m>riage1 e>ly     
*ildbe>+1 & lack ( education4 ,let u use
 ! mom5tum ( ! ,su/a9able ,developm5t   
,goals toge!r ) /rong political         
lead]%ip1 accel]at$ inve/m5t & action1 &
 passionate & committ$ *ampions1 to     
a*ieve ?is hi/oric & trans=mative goal44

  #c4 ,prev5tion & treatm5t ( ob/etric  
fi/ula  7a7 ,au?orization ,! ,presid5t  
is au?oriz$1 9 accordance ) ?is section 
& section #d1 to provide assi/ance1     
includ+ ?r\gh int]national              
organizations1 national gov]nm5ts1 &    
int]national & local nongov]nm5tal      
organizations1 to-- 7#a7 address !      
social1 /ructural1 heal?1 & human rights
 issues t lead to ob/etric fi/ula2  7#b7
 support treatm5t ( ob/etric fi/ula t   
includes /r5g!n+ ! safe surg]y & safe   
ane/hesia environm5t 9 e c\ntry :]e     
fi/ula p]si/s & :]e ob/etric s]vices d n
 meet an acceptable /&>d ( c>e2 &  7#c7 
address & ackn[l$ge ! urg5cy ( ensur+ t 
all wom5 :o ne$ a ,caes>ean section are 
able to h access to su* life-sav+ surg]y
 9 a timely1 safe1 & high-quality c>e   
environm5t1 & address ! gr[+ ?reat (    
iatrog5ic fi/ula t mo/ (t5 results f    
,caes>ean deliv]y done poorly & "u      
conditions ) inadequate /aff1 supplies1 
or equipm5t4  7b7 ,activities ,assi/ance
 provid$ pursuant to ?is section &      

section #d %all focus on ! foll[+3 7#a7 
,increas+ prev5tion ( ob/etric fi/ula   
?r\gh access to sexual & reproductive   
heal? s]vices1 includ+ skill$ att5dance 
at bir?1 compreh5sive em]g5cy ob/etric &
 newborn c>e1 timely1 safe1 high-quality
 ,caes>ean section :5 necess>y1 pr5atal 
& ant5atal c>e1 contraception & family  
plann+1 & compreh5sive reproductive     
heal? education4  7#b7 ,build+ local    
capacity & improv+ national heal? sy/ems
 to ensure t all wom5 9 ne$ h access to 
safe surg]y1 includ+ timely1 &          
high-quality life-sav+ ob/etric &       
newborn c>e s]vices to prev5t & treat   
ob/etric fi/ula4  7#c7 ,support+ tools  
to enable c\ntries to address ob/etric  
fi/ula1 includ+ ! foll[+3 7,a7 ,support+
 rese>* to bett] id5tify ! key factors  
caus+ p]si/5ce ( ob/etric fi/ula 9 c]ta9
 regions4  7,b7 ,quantitative data      
collection on ! incid5ce & preval5ce (  
ob/etric fi/ula1 & developm5t (         
su/a9able univ]sal heal? c>e f9anc+     
me*anisms to enable all wom5 to h access

 to skill$ & life-sav+ heal? c>e dur+   
pregnancy1 deliv]y1 & ! po/p>tum p]iod4 
7,c7 ,provid+ fi/ula survivors access to
 free or af=dable treatm5t4  7,d7 ,tra9+
 ( midwives & skill$ bir? att5dants4    
7,e7 ,provision ( basic ob/etric c>e at 
! community level4  7#d7 ,ensur+ t      
c\ntries address surg]y1 ane/hesia1 &   
ob/etrics ecosy/em deficits 9 /and>diz$ 
heal?c>e work] education1 cred5tial+1 & 
ret5tion1 ,,wa% & p[] 9 facilities1     
equipm5t & mat]ials1 transport1 &       
heal?c>e f9anc+4  7#e7 ,address+ social 
& economic inequities t are correlat$ ) 
high] incid5ce ( ob/etric fi/ula by     
emp[]+ wom5 & girls1 alleviat+ pov]ty1  
r$uc+ incid5ce ( *ild m>riage1 promot+  
delay & spac+ ( *ildbir?1 & increas+    
access to =mal & non=mal education4     
7#f7 ,support+ re9tegration & education 
to help wom5 :o h und]gone treatm5t or  
are await+ treatm5t to obta9 m$ical &   
m5tal heal? s]vices1 legal c\nsel+1     
basic education1 & income g5]at+ skills 
z ne$$1 to return to full & productive  

lives4  7#g7 ,promot+ public aw>5ess 9  
communities to increase und]/&+ (       
ob/etric fi/ula1 & !reby improve        
prev5tion & treatm5t ef=ts1 & to help   
r$uce /igma1 exclusion1 & viol5ce aga9/ 
wom5 & girls ) ob/etric fi/ula4  #d4    
,coord9ation1 report+1 rese>*1 monitor+1
 & evaluation ,assi/ance au?oriz$ "u ?is
 ,act %all-- 7#a7 promote ! ,,unfpa-l$  
global ,campaign to ,end ,fi/ula & !    
,int]national ,ob/etric ,fi/ula ,work+  
,gr\p2 &  7#b7 be us$ = ! developm5t &  
implem5tation ( evid5ce-bas$ programs1  
includ+ monitor+1 evaluation1 & rese>*  
to measure ! effectiv5ess & effici5cy ( 
su* programs ?r\gh\t _! plann+ &        
implem5tation phases4  #e4 ,report+ ,n  
lat] ?an "o ye> aft] ! date ( ! enactm5t
 ( ?is ,act & annually !reaft]1 !       
,presid5t %all transmit to ,congress a  
report on activities und]tak5 pursuant  
to ?is ,act dur+ ! prec$+ fiscal ye> to 
r$uce ! incid5ce ( & increase treatm5t =
 ob/etric fi/ula1 & h[ su* activities   
fit into exi/+ national action plans to 

prev5t & treat ob/etric fi/ula4