Rectovaginal fistulas are often the result of trauma during childbirth (in which case it is known as obstetric fistula), with increased risk associated with significant lacerations or interventions are used such as episiotomy or operative (forceps/vacuum extraction) deliveries[2] or in situations where there is inadequate health care, such as in some developing countries.

[3] Risk factors include prolonged labour, difficult instrumental delivery and paramedian episiotomy.

Fistulas can also develop as a result of physical trauma to either the vagina or anus, including from rape.

[citation needed] After diagnosing rectovaginal fistula, it is best to wait for around three months to allow the inflammation to subside.

Medications such as antibiotics and Infliximab may be prescribed to help close the rectovaginal fistula or prepare for surgery.