In the U.S., for instance, 305,420 babies were born to girls and young women 15 to 19 years old in 2012iii but there have been very few fistulas for a long time.iv Early pregnancy is a cause for concern everywhere around the world, but fistulas occur in developing countries because of the lack of access to emergency obstetric care. Even where fistula repair surgery is available, there needs to be more fistula prevention, which is to say more access to emergency care, to skilled birth attendants, and to properly outfitted medical facilities.