Maternal Health Task Force

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Free Women From Disrespect and Abuse: Promote Respectful Maternity Care

By: Christina Rawdon, National Coordinator, White Ribbon Alliance Zimbabwe

How great it would be if all women the world over were free from any form of disrespect and abuse (D&A) in their life time; not because I am a woman but because I am an advocate for human rights with love for other human beings.

Health care professionals are the pillar of respectful maternity care (RMC). Who disrespects and abuses women in health facilities? It is often but not always the health professionals. Employees such as auxiliaries, cleaners and hospital guards may also be the perpetrators. Sometimes these employees act as gatekeepers and they may cause untold suffering before the women come into contact with health care providers.

RMC affects every nerve of the health care system and permeates reproductive health policies, and yet RMC is not enforced anywhere in the system. RMC campaigns must include everyone involved in providing maternal health services to ensure that everyone is well-informed and understands how to translate RMC theory into action. This will ensure that all forms of D&A are addressed and eliminated at every level of the health care system.

Interest generated at the global level should trickle down to the national level and support the development of policies that protect women from D&A and the means to apply them. Reproductive health policies and systems should offer women an environment where they can access maternity care with dignity, and enjoy pregnancy and childbirth without fear of D&A. Low resource countries face particular challenges due to severe shortages of staff, tools, equipment and training—all of which are implicated as underlying causes of D&A—and campaigning for RMC in such environments is particularly challenging. RMC is synonymous with quality, woman-centered care, but how can such care be provided when there is just one midwife available to assist over 100 mothers?
The issue of D&A is complex and in order to successfully address it at the country-level, multiple advocacy strategies and campaigns need to target all aspects of health care. This includes raising awareness among policy makers, health care providers and those who provide auxiliary services in maternity departments; community mobilization and empowerment regarding human rights; improving the health system infrastructure; provision of adequate resources and commodities; enforcement of reproductive health policies (for example, through free maternity and family planning services).

As White Ribbon Alliance campaigns for RMC, a simultaneous assessment of the barriers to RMC should be taking place to better inform the demands for improved working environments. Campaigning for RMC is a long-term commitment, and one that will need to be replicated and scaled up to realize effect. Every woman deserves to be treated with dignity and respect, to be well informed and involved in making the decisions about her healthcare and preferences, and to be provided with the quality health care that she needs. Considering the vast discrepancies between the standards of midwifery trainings internationally and even regionally within one single county, it cannot be assumed that every health professional is knowledgeable about their responsibility to deliver RMC. RMC must be considered a core input in pre-service and in-service training as well as in maternal and perinatal audits so that the issue of D&A receives the attention it deserves.

Though RMC campaigns will vary in quality and coordination, the successes will be reflected in positive outcomes; some outcomes will be realized immediately and others only after some time, but recognizing the long-term benefits is key to ensuring that RMC is available to every mother and child.

This post was originally posted by the White Ribbon Alliance.

To promote the WHO’s consensus statement,”Prevention and elimination of disrespect and abuse during childbirth”, follow #EndDisrespect and contact Natalie Ramm at nramm@hsph.harvard.edu for a copy of our social media toolkit.

Categories: Cross-post Maternal Health Respectful Maternity Care Series

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