“Obstetric violence”, or mistreatment of pregnant women and neglect during child birth is prevalent in health facilities across all provinces, demonstrating a pattern of “gender discrimination and harm in the health systems”.
This “obstetric violence” is “a form of gender-based violence (GBV) … when pregnant women seek care from health systems”, says Dr Jessica Rucell, an adviser to the Wits University Centre for Applied Legal Studies.
World Health Organisation (WHO) research shows that more than one-third of women experience mistreatment during childbirth in health facilities across four countries.
In 2014, the WHO confirmed that women giving birth in hospitals in low- and high-income countries commonly experience obstetric violence. Suffering the most are women “whose power is constrained and limited socially, politically and economically”.
Rucell told City Press that in South Africa, evidence has documented verbal and physical assault of women during childbirth in most provinces.
Neglect could also bring about distress during childbirth, and harm both the newborn baby and the mother.
Obstetric violence is also driven socially, she said. Verbal or physical assault, bullying, humiliation or coercion by clinicians and healthcare workers results from discrimination.
“Verbal assaults and humiliation, which are routine, are often related to a woman’s linguistic background, and economic and disease status,” said the scholar.
For some pregnant women, seeking healthcare exposes them to ridicule, fear and assault. These often preventable acts of obstetric violence may result in trauma and post-partum depression.
Prevention of this form of violence required accountability and co-ordinated consequence management, and the lack of intervention by duty bearers put pressure on the leadership of others, she said.
The government, professional associations and the Office of the Health Ombudsman had particular responsibilities, for instance an investigation by the ombud would provide the government with direction for systematic remedial action, Rucell added.
A failure of the health system is that patients report complaints to numerous authorities, each of which offers different potential outcomes.
This can be overcome by streamlining the complaints structure to increase efficacy, consequence and management, and lessen the reporting burden on patients.
“For example, the Health Ombud national helpline could be expanded to provide instant reporting to all relevant duty bearers, the tracking of cases and follow-up to patients.”
See more from MedicalBrief archives:
Abuse of women by healthcare professions demands urgent intervention
16 Days of Activism: SASOG calls health care professionals to action
SASOG introduces guidelines for routine screening for GBV
UN report on the abuses against women in reproductive healthcare