This piece is featured on Bhekisisa and appears in the 3 May edition of the Mail & Guardian.
Women – many of them mothers – constitute more than half of the population. What should moms think of before casting their vote?
Unlike Mother’s Day, elections don’t come around each year. This year, these two events happen four days apart from each other in May. Political leaders ought to consider moms’ needs when campaigning for votes. In short: motherhood should be treated as the serious and life-altering process that it is.
But what should mothers be on the lookout for when deciding on who to vote for? Here are five issues Embrace, a maternal health and motherhood organisation, has come up with:
1. Will the mistreatment of women in labour become a punishable crime?
Fewer mothers — about a third less — who give birth in public hospitals, died in 2016 than in 2009, according to a 2018 study in the South African Medical Journal. But, the quality of care received by women who give birth in public hospitals remains a concern.
Ever heard of “obstetric violence”? That’s a term used to describe health workers’ mistreatment — often through verbal or physical violence and bullying — of birthing women. A 2017 study published in the journal, Feminism & Psychology, for which 35 black women who gave birth in South African public health facilities were interviewed, found that many experienced abuse and violence from health workers, such as being shouted at to “lay straight” during labour or being told to “shut your mouth” and that they were deserving of labour pain because “you want to do such things [have sex]”.
In countries such as Venezuela, Argentina and Mexico, obstetric violence is a punishable crime.
As maternal health activists, we want the South African government to commission a full audit of obstetric violence cases reported in the country between 2015 and 2018. We want them to use these findings to award reparations to survivors of such violence and to introduce an amendment to the Health Professionals Act 56 of 1974 that clearly defines obstetric violence and lays out penalties for professionals and institutions guilty of such violence.
2. Will you give moms access to breastfeeding-friendly workplaces?
The World Health Organisation (WHO) recommends that babies are exclusively breastfed — giving them nothing other than breast milk, in other words, no other liquids or water — for the first six months of their lives. Studies have shown that breastfed babies are less susceptible to diseases such as diarrhoea and pneumonia and less likely to become obese later in life — even more so, if they’re breastfed exclusively, according to 2016 research published in The Lancet.
South Africa follows the WHO’s guidelines: our breastfeeding policy says all moms should breastfeed their infants exclusively for six months — including HIV-positive mothers.
But for most South African women, breastfeeding is a tremendous challenge — only one out of three breastfeeding women does so exclusively for six months, Statistics South Africa’s 2016’s health and demographic survey shows.
And the country’s labour laws aren’t helping.
The law also only provides for four months of maternity leave, taking working mothers away from their babies, and making it close to impossible to breastfeed their children exclusively for an entire six months, unless they’re able to express milk and appoint someone to feed it to their infants.
The Code of Good Practice on the Protection of Employees during Pregnancy and after the Birth of a Child stipulates that breastfeeding parents should get two feeding or expressing breaks of 30 minutes each, in addition to their lunch break. But the implementation of these guidelines isn’t monitored. A 2018 review of Wits and the National Research Foundation which examined the implementation of and compliance with breastfeeding policies in 11 workplaces in South Africa, found that almost half of the employers surveyed deducted pay for those breaks, putting further pressure on breastfeeding mothers.
And, few workplaces in South Africa provide spaces where working mothers can safely express and store their breast milk.
When we vote, we will be looking for leaders who are prepared to propose that the Code of Good Practice is made a law that can be enforced and monitored.
3. Does your party have plans to address gender-based violence?
Violence against women is one of South Africa’s most worrying crimes.
Gender-based violence in all its forms “denies women and girls the opportunity to achieve equality and freedoms enshrined in the Constitution”, Statistics SA states in its 2018 analysis of crime survey data. The analysis found we’ve got a long way to go. For instance, 7.7% of men surveyed reported it acceptable for a husband to hit his wife if she argued with him and only 4.4% of women felt safe to walk alone to fetch wood or water.
The international organisation ActionAid’s 2017 evaluation of urban safety for women ranked South African cities as amongst the least safe for women, with access to safe public transport as a key concern.
We want your party to introduce changes that will make South Africa safer for women and children. We also want to know which of our prospective leaders are willing to acknowledge that obstetric violence, by its very nature, is gender-based violence and should be treated with gravity?
4. Will you give teenagers non-discriminatory access to contraception, HIV and family planning services?
Over the past five years, the number of teenagers giving birth in hospitals in South Africa has decreased by 12%, data from the latest District Health Barometer shows. But the overall figure remains high: in 2016, almost 7% of all such births were among teenagers under the age of 18.
On paper, South Africa’s sexual and reproductive policies are leading the way on the African continent. But, in practice, such policies are often not implemented well enough to translate into easy access to such services for adolescent girls.
Several studies have shown that nurses are judgmental and rude to young women seeking birth control and HIV testing. As a result, “unacceptably large numbers of pregnant women — especially adolescent girls and young women — are still only finding out their HIV status once they fall pregnant”, Yogan Pillay, the health department’s deputy director-general for HIV and maternal health, wrote earlier this year in an op-ed for Bhekisisa.
In 2017, South Africa’s department of basic education released its first new HIV policy in 20 years. In the document, the department commits to facilitating access to condoms for all learners 12 years or older as well as school staff. It also says that roving health department teams or other qualified health workers will provide sexual and reproductive health services to pupils, including youth-friendly health services such as screening for sexually transmitted infection – preferably in their home languages.
Will these commitments be implemented with urgency?
And, what plans have your political party got in place to curb unconstitutional suspensions and expulsions of teenage mothers from school?
5. Will all working moms get paid maternity leave?
Women accounted for 43,8% of total employment in the second quarter of 2018, according to Statistics South Africa.
When women fall pregnant, the law requires employers to provide them with four months of maternity leave, but employers are not legally obligated to pay mothers during this time. Instead, the law states that moms can claim from the Unemployment Insurance Fund — a procedure which has proven time-consuming and often ineffective with claims being paid out way too late to adequately cover gaps in the salaries of parents who take leave.
This means that mothers may take as little time off as possible and a significant proportion of the productive workforce is returning to work before they — or their babies — are physically or otherwise ready.
Would your political party be willing to commission research on the impact of unpaid parental leave on national economic productivity and on early childhood outcomes? And, would your party be willing to explore the merits of the development of an official code on flexible working arrangements?