The final plenary of the Global Maternal Health Conference 2013 (GMHC2013) in Arusha, Tanzania struck a nerve. The expert panel presented evidence of disrespect and abuse in maternity wards from all over the world. The audience was captivated and moved but not shocked. From Rwanda to the Netherlands, everyone had a story.
Many had witnessed signs of undignified maternity care, yet it had not been named. It had been pushed aside as a cultural norm, or considered as an outcome of a constrained health system. Disrespect and abuse is practiced when laboring mothers are admonished or beaten in a moment of acute vulnerability for having too many children, for having children too soon, for having HIV, or for simply crying out in pain. It manifests itself structurally when an overburdened midwife tries desperately to accommodate an overflowing delivery room, when a mother is abandoned by skilled personnel to deliver on a bare labor ward floor, and when she is handcuffed to a bed when she cannot afford to pay hospital fees.
Disrespect and abuse during childbirth is not a new phenomenon. Evidence of poor patient-provider interactions have been documented for decades in North America, Europe, Sub-Saharan Africa, South Asia, and Latin America. Maltreatment discourages women from delivering in health institutions, where life-saving treatment for complications in pregnancy and childbirth is available. Often referred to as the ‘moment of truth,’ the quality of the interaction between the healthcare provider and the patient is closely linked with women’s utilization of skilled birth attendance and, ultimately, maternal and newborn health outcomes. However, due to the already overstretched global health agenda, it is easy to overlook the importance of this critical relationship in maternal health programs and policies.
The GMHC2013 afforded an opportunity for researchers, practitioners, and policymakers not only to share evidence, interventions, and advocacy for respectful maternity care, but also to challenge all those present to acknowledge this global problem that is hiding in plain sight. If advocates champion that maternal health is women’s health and share the imperative that women’s rights are human rights, then it is vital to support systems, infrastructure, and policies that ensure women’s rights extend to the delivery room.
Over the next few weeks, the MHTF will host a series of guest blogs on respectful maternity care that will continue where we left off in Arusha. Posts will explore questions such as: What are programs and policies that are advocating for women’s dignity during childbirth? Should respectful maternity care be considered a component of quality care? What are the economic and human rights implications? How can communities become involved? How is disrespect and abuse present in rural and urban settings? In the private and public sectors? In rich countries and poor countries?
We invite you to share your story. Please submit your blog post to Sarah Blake firstname.lastname@example.org