Childbearing is supposed to be a joyful process from conception to the birth of a healthy, full-term baby without trauma to the mother. The sight of the baby in the puerperal period should be a source of joy and pride and not a reminder of painful experiences. Yet it is common knowledge that many women experience abuse at the hands of health care providers. As the world prepares to celebrate yet another International Day for Women in March 2012, it is an opportune time to reflect on respectful maternity care. Many organizations and individuals recognize the fact that women have a right to receive care that they require and deserve at any level of the health care system. The White Ribbon Alliance for Safe Motherhood (WRA) has developed a Respectful Care Charter that specifically addresses the rights of childbearing women and their families. This is a great step in the right direction towards the realization of safe motherhood.Some countries have developed charters that spell out the rights and responsibilities of both patients and health service providers. For example, in Malawi, the charter which stipulates the rights and responsibilities is written in English as well as two local languages spoken or understood by the majority of Malawians. Some of the rights cited are:
- Right to access health care provided by a competent health worker according to his/her health needs
- Right to choice of health facility and second opinion when required
- Right to adequate information and health education
- Right to respect and dignity without regard to age, gender, ethnicity, religion and economic status
- Right to privacy and confidentiality
Assumptions have been made that some health workers abuse women because they are overwhelmed by the workload resulting from staff shortages; and some abuse women because they have misunderstood the meaning of democracy, e.g. taking time for break when a woman in labor calls out that her baby is coming and actually ends up delivering the baby without skilled help in a hospital setting. There is also anecdotal information that suggests that many health workers including midwives have misinterpreted certain sections of labor laws and have refused to assist women in environments deemed to be "unsafe" for themselves without considering whose responsibility it is to make that environment safe for women and health workers alike. In a multicultural environment within which women give birth, there is a tendency to expect women from one culture to cope with the process of childbirth in the same way as a woman from another cultural background and yet each woman is unique.
The White Ribbon Alliance for Safe Motherhood-Malawi is working with communities in Mangochi district, especially in Njereza, and surrounding villages to encourage women to have hospital births. It would be a tragedy if women who have been motivated to have their babies in a health facility encountered disrespect in such facilities. They would be discouraged and seek unskilled assistance during birth.
As we strive for a future where a woman's right to respectful maternity care is realized, we indeed need a specific Charter that facilitates the achievement of this goal. At the same time, we need to have data that establishes the root causes of the abuse so that meaningful strategies can be developed and implemented in order to eliminate disrespect experienced by childbearing women and their families all around the world. This requires concerted efforts and a multidimensional approach. Together, we can make it happen.
WRA is working in countries across the globe to achieve every women's right to respectful maternity care. You can donate here. By giving to the Alliance, you can make a difference in the lives of thousands of women and newborns.
Visit the White Ribbon Alliance website to learn more about how you can help.
Lennie Kamwendo is a registered nurse and midwifein Malawi and a member of the WRA Global Board of Directors. She holds a Bachelor's degree from the University of Ulster at Coleraine, Northern Ireland and a Master's degree from the University of Pennsylvania, United States. As a perinatal nurse specialist, Ms. Kamwendo has vast experience in midwifery education, practice, and research. Currently, Ms. Kamwendo heads a monitoring and evaluation team, which oversees nursing and midwifery education and practice in the southern region of Malawi.