- An estimated 1.79 million women went through mistreatment during labour in Gauteng and KwaZulu-Natal over 10 years.
- Only one in three women realised the mistreatment was wrong, and just 7 percent reported what happened to them.
- The survey recorded cases of physical, verbal and emotional abuse, as well as medical procedures done without proper consent.
Childbirth is meant to be a time of care, dignity and support as a woman brings new life into the world. Yet new research shows that millions of women giving birth in South Africa’s public health system have faced mistreatment during labour.
Research highlighted by Bhekisisa estimates that 1.79 million women who gave birth in Gauteng and KwaZulu-Natal over a decade experienced mistreatment during labour. This is around 60 percent of women who gave birth in these provinces at that time, which means about 490 women faced mistreatment every day.
The survey, done by Social Surveys Africa and commissioned by the DG Murray Trust and Embrace, found that mistreatment ranged from physical and verbal abuse to emotional abuse and medical procedures done without proper consent.
According to the research, only one in three women who went through mistreatment realised it was wrong, and just 7 percent reported it. That means about 11 out of every 12 cases were never reported.
Mistreatment during labour
Women who took part in the survey described being slapped, shouted at, mocked, roughly examined, and ignored while in labour. The survey also found that these forms of mistreatment often happened together, with affected women experiencing an average of four incidents during labour.
The research also looked at the issue of informed consent. More than a third of women surveyed said they went through procedures against their wishes because no one asked for permission beforehand, they felt pressured to agree, or they were coerced.
Episiotomies, which involve making an incision during childbirth, made up a large number of these interventions.
A problem documented over decades
Bhekisisa reported that research by the South African Medical Research Council nearly 30 years ago found similar stories of women being slapped, shamed, and shouted at during labour.
The recent survey uncovered many of the same experiences, showing that mistreatment during childbirth has gone on for decades.
This research took place as the public health care system struggles with overcrowding and limited resources, while documenting women’s experiences of disrespect and abuse in maternity care.
Why so few women report abuse
The survey found that few women recognised abuse, and even fewer reported it. Researchers say that mistreatment has become so normalised that it leads to underreporting.
Women might see being shouted at during labour as routine, may not know their rights, might not know where to complain, or feel that reporting won’t change anything. Because so few women report what happened, many instances of mistreatment are never officially recorded.
Lasting effects beyond childbirth
Bhekisisa reported that mistreatment during childbirth can damage women’s trust in the health care system.
The research also found that traumatic birth experiences can affect whether mothers return for their own medical care or take their babies for vaccinations and routine check-ups.
Measures aimed at respectful maternity care
According to Bhekisisa, the Department of Health launched an online training course on respectful maternity care. The course includes three lessons and takes about three and a half hours to complete.
The department has said it wants to make the training mandatory for everyone working in maternity settings, including midwives, doctors, assistant nurses, cleaners, and security staff.
The survey also found that 75 percent of women said they were not allowed to have someone with them during birth, and four out of 10 women said no curtains were separating them from other patients.
Bhekisisa reported that national maternity guidelines already allow for birth companions, who can give emotional support and help women speak up if they are not treated well.
The research recommends better enforcement of current maternity policies, more awareness about patients’ rights, and stronger complaints procedures to improve accountability in maternity services.
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