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Watch | Unpacking obstetric violence in South Africa’s public health facilities

Yuri Ramkissoon, Dr Tlaleng Mofokeng and Dr Jessica Rucell. Photo: Center for Applied Legal Studies/Twitter


Pregnant women continue to face abuse and neglect in South Africa’s public health facilities.

Obstetric violence, which is the violence faced by women who are pregnant or giving birth, includes psychological and emotional abuse by health professionals. This violence, neglect and erosion of the dignity of these women can continue from the moment they enter the hospital until the doctors and nurses harass them in the delivery room.

LILY: Obstetric violence is a growing concern as pregnant women continue to suffer

So said the UN Special Rapporteur on the right to health, Dr. Tlaleng Mofokeng. She was speaking at a seminar on obstetrical violence and women’s right to health. It was organized by the SA Human Rights Commission in partnership with the Center for Applied Legal Studies and Wits University Law School.

Center for Applied Legal Studies expert advisor Dr. Jessica Rucell said obstetrical violence robs patients of agency and autonomy. The violence that manifests in obstetrics is exercised both directly and structurally.

“Directly when health workers physically or verbally abuse pregnant women and people and this is structural through its organization’s laws, policies and practices that normalize neglect and violation of sexual and reproductive health rights,” explained Rucell.

Obstetrical violence endangers not only the pregnant patient but also the fetus or newborn.

The phenomenon is widespread on a global scale.

In 2019, the World Health Organization said millions of patients are injured each year due to unsafe and harmful healthcare worldwide, leading to 2.6 million deaths annually in low-income countries alone. and intermediate. Most of these deaths are preventable.

Behaviour change

Patients have adapted their behavior towards healthcare professionals amid rising levels of neglect towards pregnant women in the public healthcare system, Mofokeng noted.

LILY: We have normalized the abnormality of teenage pregnancies

She said poor patient co-operation and lack of resources should not be factors fostering violence.

Patients are just easy targets to blame. We are simply blaming patients for systematic failure and because doctors and nurses are the faces of the health care system, but they do not have the power to have a particular budget approved by the minister.

In South Africa, women seeking abortions are routinely ostracized for their choice. “There was a clinic we visited that did a study on adolescent health and what we found was that the person reading and managing the complaints and comments box was the one chatting the anymore, so they stopped writing in that box.”


Young doctors regularly witness malpractice in the public health system. But, because of their rank, speaking out is not easy, Mofokeng acknowledged. Young doctors rooted themselves in a dehumanizing system that was hard to get rid of.

“It’s very difficult as a student, when you see something wrong, to speak up, because you could be in danger of not passing medical school. There are limits to what a young doctor can do. do in this patriarchal system.

Mandate of UN Special Rapporteur

The UN Special Rapporteur focuses on patient feedback and complaints. They are expected to take action by writing to the state about patient allegations, the type of action expected, and how to prevent violations.

“We await an investigation into this allegation and justice for those responsible and remedies for victims and their families.”

Mofokeng is convinced that any violation of human rights allows other possible violations, so she analyzes each allegation for any other violations that may arise from the first allegation.

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