An estimated 1.79 million women in Gauteng and KwaZulu-Natal experienced mistreatment during childbirth over the past decade, according to research commissioned by the DG Murray Trust and Embrace.

The survey, conducted by Social Surveys Africa, found that an estimated 60% of women who gave birth in the two provinces experienced physical, verbal or emotional mistreatment during labour.

The Mail & Guardian, in a report produced by the Bhekisisa Centre for Health Journalism, said the abuse included women being slapped, shouted at, roughly examined or ignored during childbirth.

Most childbirth abuse goes unreported

According to the survey, only one in three women who experienced mistreatment recognised that the behaviour of healthcare workers was wrong.

The Mail & Guardian reported that only 7% of women who experienced obstetric violence formally reported what happened.

Its analysis of the survey data also estimated that affected women experienced about four incidents of mistreatment during labour.

Julie Mentor, who leads Embrace, told the publication that some women continue to carry the emotional pain of their experiences years after giving birth.

The Mail & Guardian reported that more than a third of women surveyed said a medical procedure was performed against their will, either without permission or after they were pressured to agree.

About four in 10 of these procedures were episiotomies.

The World Health Organisation and South Africa’s Department of Health guidelines say episiotomies should not routinely be performed during childbirth.

The survey also found that 75% of women were not allowed to have someone with them during the birth, while four in 10 said no curtains were separating them from another patient.

Health Department plans maternity training

The Department of Health told the Mail & Guardian that an online respectful maternity care course is set to launch on its Knowledge Hub platform on 22 September.

Fikile Ndlovu, the department’s deputy director-general for maternal health, said the course consists of three lessons and takes about three-and-a-half hours to complete.

Ndlovu said the department wants the programme to eventually become mandatory for all workers in maternity settings, from security and cleaning staff to nurses, midwives and doctors.

South African Medical Research Council specialist Rachel Jewkes told the publication that stronger leadership was needed to tackle violence during childbirth.