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An obstetric fistula is a condition in which a hole develops between a woman's rectum and vagina or her bladder and vagina. This is caused most often by complications during childbirth due to insufficient medical care. The hole forms when pressure is applied to the woman's pelvic bone, usually by the baby's skull. This pressure deprives the pelvic area of blood flow, deadening the surrounding tissue. The dead tissue then falls away and creates a hole either between the rectum and vagina or the bladder and vagina. Although the condition does occur in developed countries, obstetric fistula most commonly occurs in poor countries that lack adequate medical treatment for pregnant women. More than two million women have sustained this type of injury throughout Africa, Asia, Latin America, and some Arab countries. Concern about the prevalence of this condition in developing countries led the United Nations to declare May 23 the International Day to End Obstetric Fistula in 2013.