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Urgent action required to address Obstetric Violence in South Africa

Joint Statement:

Pregnant women, girls, and gender non-conforming birthing people continue to experience disrespect, neglect and abuse including physical and psychological forms of violence by our reproductive health services. For more than two decades of our democracy, verbal and physical assaults and unnecessary medical procedures have been documented in our country’s maternal health clinics, Maternity Obstetric Units (MOU) and hospital obstetric departments. This normalised state of violence against women and birthing people seeking healthcare has an enduring, negative impact on maternal health outcomes and early childhood development. The abusive treatment of women and girls in maternity services is a form of gender violence that reflects the broader societal devaluation of women and girls in South Africa and the normalisation of violence against them, particularly marginalised and impoverished women and girls.

Black and low-income women and birthing people are especially vulnerable to this form of gender-based violence, known as obstetric violence. Women and birthing people are targeted further by multiple and intersecting forms of discrimination based on immigration and refugee status, sexual orientation, gender identity, religion, ethnicity, age, and disability.

The challenges faced by the healthcare system including inadequate human and financial resources, equipment, medicines and other necessary support for those working in maternal care contribute to obstetric violence, and must be transformed. Lack of resources cannot be an excuse to not provide humane quality of healthcare. Poor working environments or perceived unsafe practices by pregnant women and persons cannot justify gender-based violence.

South Africa’s national clinical guidelines for maternity care outline and mandate humane healthcare. The signatories of this statement jointly call upon the Health Ombudsman, the Ministers of Health, and Women, Youth, and Persons with Disabilities, the Heads of Maternal & Child Health, Provincial MECs and District Health Managers to use their authority to urgently take the following steps that will systematically intervene in the pandemic of gender-based violence, by addressing obstetric violence.

We call for:

  1. The recognition of every pregnant person’s autonomy and right to accurate and accessible information delivered and in their language of choice so as to enable them to make decisions about their care. Furthermore, the right of every pregnant or birthing person to dignified, respectful health care throughout pregnancy, and for the recognition of their right to be free from violence and discrimination during childbirth.
  2. The Department of Health to prioritise the prevention of violence and ensuring of humane treatment of pregnant women and birthing persons in the Department’s implementation plan and applications for delivery of the National Strategic Plan Against Gender-Based Violence.
  3. The Minister of Health, and Minister of Women Youth and Persons with Disabilities to develop and cost a measurable and time-bound plan to transform the resourcing of maternal health with the aim to prevent neglect and abuse due to understaffing and under resourcing by December 2022.The Department of Health, and the health system contribute to the power and empowerment of girls, women and birthing persons by strengthening comprehensive sexual and reproductive health and human rights education; and by improving existing reporting structures (e.g. the health ombudsman, professional bodies such as South African Nursing Council and the Health Professions Council of South Africa).
  4. Political and administrative managers throughout the health systems to apply a zero-tolerance response to obstetric violence. Including through education and ongoing training for healthcare workers on the rights-based approach to sexual and reproductive healthcare, and obstetric violence. Applying binding punitive employment sanctions to perpetrators of violence, including directors and managers who fail to investigate and prevent this particular form of violence against women.

We recognise that everyone has the right to live free from violence and call for an end to obstetric violence in all its forms.

Rumbi Goredema Gorgens, Embrace
Nonkululeko Mbuli, Embrace
Julie Mentor, Embrace
Kayla-Tess Pattenden, The Connect Group
Roeline Van Eck, Embrace / Mamandla
A/Prof Simone Honikman, Perinatal Mental Health Project, University of Cape Town
Dr Rachelle Chadwick, Gestational Justice Research Hub, University of Pretoria
Thanya April, Perinatal Mental Health Project, University of Cape Town
Dr Jessica Rucell, The Just Agency
Amanda Busson CPM, The South African Registry of Community Midwives
Amanda Mokoena, Glow Movement NPO
Dr Nicole Daniels
Maggie Marx, Embrace Mamandla Fellow
Portia Mahlobo, The IThemba Project, Embrace Mamandla Fellow
Nicola Lopez-Rabkin, Natural Fertility & Thriving Health Community
Lara Govender, Roam Parenting Guidance & Support
Christy-Joy Ras
Ashlene Philander
Ashleigh du Plessis
Gabriela Mckenzie
Marion Stevens, PhD Candidate, Gender and Politics, Stellenbosch University, Registered Midwife, Founding and outgoing director, SRJC
Jean Ridler, IBCLC
Distinguished Professor Catriona Ida Macleod, Critical Studies in Sexualities and Reproduction, Rhodes University
Dr Rahmat Bagus GP, IBCLC, La Leche Laegue Leader
Sabrina King, Gender Studies student, University of Pretoria
Irene Bourquin, Wombs birth and Post partumdoula trainer Reg nurse and midwife
Noloyiso Williams, Postpartum care specialists and Flourish
Debby Bonnin
Dr Veronica Mitchell, Research Associate, Dept Women’s and Gender Studies, UWC
Ruth Lundie, Sikunye
Anna-Marie Müller, DG Murray Trust
Dr Camilla Pickles
Faith Abrahams, TLC Children’s Home (Trauma Informed CYCC)
Phillimon Twala, Treatment Action Campaign
Bryony Dobson, Sikunye
Associate Professor Amrita Pande, University of Cape Town

We need your support. Comment below and we will add your name to the list of signatories.

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