Obstetric violence is a very critical issue affecting many pregnant women in hospitals. Defined as any humiliation, mistreatment, neglect, physical, verbal, and emotional abuse during childbirth or towards pregnant women, it also includes any unwanted medical procedure and even denying the woman pain medication.
According to research done by Harvard University, adolescents, women in low-income settings, and those with low social standing are especially vulnerable.
South Africa is no exception. Young mothers often speak about being treated unfairly due to the stigma of being young and pregnant.
A painful experience
Imagine being a confused and scared 17-year-old experiencing painful contractions and being scolded. This is the experience of Zinhle Kunene from Pietermaritzburg who says she received hurtful treatment from nurses during childbirth.
“I always feel like I was judged by nurses because of the stigma around teenage pregnancy. I was called names and spoken harshly to by nurses because I was young. But I was shocked when even someone who was older than me in the ward was treated the same way. Because of this, I was told instead of being asked to have input in most decisions, they just told me they’d insert a depo and they did not explain the procedure.
“I also remember being cut underneath, and I felt like I was at risk because they asked if they didn’t leave anything in me, so as a patient, I got the sense of not knowing what they were doing,” she recalls.
A tragic outcome
Although her clinic visits went exceptionally well and were informative, Kelebogile Mothibe from Johannesburg states that the mistreatment and negligence she experienced started on the morning of her delivery.
Mothibe explains how she was transferred but had to wait for a long time for the ambulance.
“When I eventually got to the hospital, I informed the nurse that I’m not feeling well and my baby’s heart is very low, but she just said, ‘There’s nothing I can help you with, you can see the beds are full.’. I was only taken seriously when they saw my baby’s head crowning, but they came and shouted for only a stillborn to come out,” Mothibe says.
Still, in incredible pain, Mothibe explains that she laid a complaint with the heads of the labour department at the hospital, and her cries were listened to with sympathy. However, she says she is still waiting for a letter of apology taking responsibility for what happened.
No sympathy
After being referred to the hospital by her gynaecologist, Victoria Lukhele from Pretoria says the care she received from the nurses was not good, but bearable as she considered the fact that they were short-staffed. Things, however, took a turn when she was admitted at 30 weeks pregnant. She describes everything from the condition inside the hospital to the service, the food, and the environment as bad.
“The mistreatment started with the cooking ladies, who would tell us that they did not owe us fresh food and that we could either decide to eat or not. Secondly, the nurses were disrespectful; they couldn’t tell me I had a UTI (urinary tract infection), instead, they spoke about it freely for everyone to hear instead of respecting my privacy and letting me know through the right channels.
“The discrimination I received was also the nurses denying me the right to freedom of choice, information, and privacy. They withheld the information that I had pre-eclampsia because they were ‘protecting’ the baby since I always complained that I wanted to go home, so instead they would lie to me every time,” Lukhele explains.
“The C-section procedure was explained briefly because the baby was in distress. I was induced without any explanation as to what would happen after the induction.
“I also nicely requested for my husband to be part of the theatre experience but he was refused the opportunity, and I was told that I am not special,” Lukhele says.
Lukhele says she tried to file a complaint with the maternity sister in charge, and she was considerate up until all the nurses ganged up on her because they believed she was giving me special treatment.
Scars that never heal
Crystal Esau from Cape Town, who is now an independent midwife after working as a midwife for over 20 years, highlights that she too has experienced harsh treatment during her pregnancy and even in her journey as a midwife in the workplace.
“I believe that no one, especially young mothers, should be ill-treated by nurses, midwives, or any health workers while undergoing a vulnerable stage in their lives. Young mothers need a lot of help, advice, and support, as most do not receive such from their partners, community, or families. We are understaffed, overworked at times, and underpaid, but that is still not a reason to mistreat someone because it will not help the circumstances or pressure.
“My daughter is now 22, but I still remember how that nurse made me feel when I was pregnant because she was extremely rude. The day you give birth is a day you never forget, so it’s best not to leave scars and have a negative effect on the rest of someone else’s life,” she says.
Follow procedures and report mistreatment
The acting registrar and CEO of the South African Nursing Council (SANC), Jeanneth Nxumalo, says there are allegations of poor management of women in labour and negative attitudes about the mistreatment by healthcare workers the SANC has heard of.
“Nurses should practice their profession within the parameters of their scopes of practice, legislation, and code of ethics. To increase awareness, the list includes but is not limited to workshops, continuing professional development, seminars, and webinars. The public should also be informed about the procedure to be followed if they are mistreated by health workers,” Nxumalo says.
National department of health spokesperson Foster Mohale highlights that they are not aware of specific incidents of mistreatment directed to pregnant mothers, hence they call upon anyone with complaints to lodge complaints.
Patients urged to lodge complaints
“Most health facilities have complaint boxes where aggrieved customers can register their complaints, and these are handled with confidentiality. The department urges any patients who feel treated badly by the health workers to lodge complaints with the complaints/quality assurance manager or anyone who is in charge at the health facility, so the matter can be investigated without delays and an update will be provided to the complainant on a regular basis.
“We also have a patients rights charter which promotes a healthy and safe environment, choices of health services, access to healthcare, confidentiality and privacy, informed consent, a complaint about the quality of health services, etc,” he says.Â
South Africa now also has a simpler way to report mistreatment with the Office of Health Standards Compliance (OHSC), set up under the National Health Amendment Act of 2013, to ensure that both public and private health establishments in South Africa comply with the required health standards.
Mohale further states that everyone deserves to be treated with dignity and respect, both patients and health workers and thus encourages people to know their constitutional rights and exercise them responsibly.
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