• University of Pretoria master's graduate Zilungile Silinda achieved 83% for research examining obstetric violence against black women in South Africa.
  • The study found that black women are disproportionately exposed to mistreatment, neglect and abuse during facility-based childbirth.
  • Silinda hopes her research will contribute to policy reform, public awareness and efforts to eradicate obstetric violence.

The experiences of black women during childbirth in South Africa are being shaped by deep-rooted inequalities that continue to influence maternal healthcare, according to research by University of Pretoria master's graduate Zilungile Silinda.

Silinda recently completed a master's degree in Political Science at the University of Pretoria, earning 83% for her dissertation, Gratuitous Violence Radical Black Theory and Obstetric Violence Against Black Women in South Africa.

The research was inspired by her mother, a midwife, lecturer of midwifery and founding member of the Society of Midwives of South Africa, whose career focused on promoting sexual and reproductive health rights and respectful care during childbirth.

"I chose this topic because my mother, who was a midwife, lecturer of midwifery and a founding member of the Society of Midwives of South Africa, made it her life's mission to advocate for sexual and reproductive health rights, and for compassionate, respectful care during childbirth," said Silinda.

Stories of childbirth trauma

Obstetric violence refers to mistreatment, coercion, neglect or abuse experienced by pregnant or birthing women within healthcare facilities. It is recognised as a form of gender based violence and a violation of human rights.

Silinda said the subject became personal as she engaged with stories from archives, reports, documentaries, news coverage and women within her own community. According to her research, many women carry the effects of these experiences long after childbirth.

"The women were subjected to violations that not only traumatise them at the moment of giving birth, but leave physiological, psychological and metaphysical scars that will take a lifetime to repair," she said.

Reflecting on the significance of the research, Silinda said, "It wasn't merely a research topic, but a reckoning with how power structures shape life, unevenly distributing morbidity and mortality according to race, class and gender."

Her study points to evidence that many women in Gauteng and KwaZulu-Natal have experienced some form of obstetric violence. Women who were accompanied by partners or family members often reported more dignified treatment, while those without support frequently described feeling ignored, dismissed and dehumanised during childbirth.

Silinda said many incidents go unreported because women do not believe they will be taken seriously or feel uncomfortable speaking publicly about their experiences.

Call for maternal healthcare reform

A key finding of the dissertation is that South Africa's historical and structural inequalities continue to shape childbirth experiences for black women.

Silinda said one of the most important conclusions of her research was that "the unjust settler colonial and apartheid foundations of South Africa produce conditions that disproportionately expose black women to obstetric violence during facility-based childbirth."

She argued that the government must address both the diversion of resources from the public maternal healthcare system and the broader conditions that contribute to the devaluation of black women's lives and reproductive experiences.

"The state fails women upon their entry into the hospital, where they are provided with the minimal care required during childbirth," said Silinda.

"What we need is an overhaul of the maternal healthcare system in South Africa to provide care and support, not only to birthing women, but to midwives working in the biomedical system."

Continuing a family legacy

Silinda described her achievement as both humbling and validating, particularly because it came during her mother's battle with cancer. She credited her mother's resilience, faith and determination for helping her remain focused throughout her studies.

"My mom is driven by a commitment to the educational development of midwifery, institutional autonomy of midwives within the public healthcare system and integrating indigenous values in her practice as a midwife to respect women's autonomy during childbirth," she said.

Silinda also acknowledged the support of her supervisors, Professor Nolwazi Mkhwanazi and Safiyya Goga, and shared the approach that guided her research journey.

"What worked well for me was prioritising progress over perfection. My personal motto is, 'A good research project is a finished research project,'" she said.

She has now been given the opportunity to continue researching obstetric violence and anti-Black racism through PhD studies. Her goal is to contribute to activism, create greater public awareness and help drive policies that reflect the realities faced by women during pregnancy and childbirth.

"I hope my mother feels proud when she sees me cross that stage," said Silinda. "I also hope that she knows that I am who I am today because of who she is."

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PR practitioner, media liaison officer, education activist, and founder and director of Skills Information Base, a non-profit organisation committed to providing access to resources and information on career development and guidance.

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