A 27-year-old woman says she was told to stop being dramatic when she was forced to give birth to her baby boy with her pants on because a nurse refused to help her.
When Tasniem Ally was ordered to walk across the room to another bed, her placenta fell to the floor in full view of other patients at a Johannesburg hospital on November 15 last year.
Ally has joined Embrace, a movement of mothers, to expose obstetric violence as a form of gender-based violence (GBV) during 16 Days of Activism for no Violence against Women and Children.
Embrace leader Julie Mentor said obstetric violence included abuse and neglect, “such as denying access to family planning services or turning pregnant and birthing people away from facilities; verbal assault; and discrimination and stigma based on age, gender, sexual orientation, race, class or HIV status”.
“Physical forms include assault such as slapping, dragging, applying pressure to the abdomen during labour and isolating women in active labour as a form of punishment. Invasive medical procedures such as vaginal and cervical examinations, C-sections, episiotomies and hysterectomies when performed without informed consent or knowledge are also considered obstetric violence,” she said.
Ally regrets not complaining to hospital management..
“I felt like I was in a horror movie that just wouldn’t end. I suffered for months after giving birth, haunted by this trauma, and I wanted absolutely nothing to do with the hospital.”
Bongekile Msibi, 33, suffered a different form of obstetric violence. She says her uterus was removed without her knowledge when she gave birth at the age of 17.
After trying for a long time with no luck, I decided to visit a doctor, who informed me I could not conceive as I do not have a uterus.
— Bongekile Msibi, Gauteng mother
“After I gave birth, I started using contraceptives. A few years later I got engaged to be married. I stopped using the pills in hopes that I would conceive again. After trying for a long time with no luck, I decided to visit a doctor, who informed me I could not conceive as I do not have a uterus.
“In addition to this, he also informed me that my uterus was surgically removed. The only time I had had an operation that would have involved anything to do with my fertility is when I was 17, when I had a C-section, which led to the birth of my daughter, Amanda. This means this operation was performed when I was a minor, without my consent.”
Msibi is engaged in legal action against the Gauteng department of health.
“What is most disturbing and traumatising for me is that the doctor in charge decided to make a life-altering decision on my behalf, without my mother’s or my consent. I do not think anyone has the right to make such a decision.
“I visited the hospital where this incident took place on several occasions to try to get answers. As far as I know, neither my life nor my child’s life was in danger for them to make such a drastic decision on my fertility,” she said.
Dr Jess Rucell, a feminist researcher who has investigated the causes and drivers of obstetric violence in SA by analysing the public sector’s governance and management of women’s health, found verbal assaults on women, including attacking their dignity by judging their economic status, nationality and ethnicity, are common.
“For instance, assaults that accuse women of having little morals and blaming women for damage to their newborns. The normalisation of this demeaning treatment contributes to intimidation and coercion, and enables physical assaults on women during childbirth. There are many cases of obstetric violence.
“A prominent example I looked into in my research happened when a maternity unit repeatedly turned away women in active labour. Three had stillbirths in one week,” she said.
Gender justice attorney at the Centre for Applied Legal Studies at Johannesburg’s Wits University Basetsana Koitsioe said SA required proper legislation and policy to acknowledge obstetric violence.
“Once this is acknowledged, the law can then reflect obstetric violence as an act of gender-based violence, rather than what we currently have, which is that obstetric violence is seen as medical malpractice. The issue with medical malpractice is that it fails to deal adequately with very serious violations of women’s rights that occur during acts of obstetric violence. Medical malpractice cannot, at this point in time, properly respond to some of the consequences of obstetric violence that victims have expressed feeling.”
The South African Society of Obstetricians and Gynaecologists (Sasog) condemned all violence, particularly GBV.
“Where there are allegations against members of Sasog or the wider OBGYN profession of violence against patients, we believe these matters should be reported to the healthcare facility or the Health Professions Council of South Africa (HPCSA) ... the statutory body tasked with investigating and dealing with issues of malpractice by healthcare professionals.”
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