By Neelam Rahim
There are few moments in a woman’s life when she is as vulnerable as she is during childbirth. Her body is exposed, her pain is visible and, for hours, she places an extraordinary degree of trust in those around her to keep both her and her baby safe. In those moments, kindness can be remembered for a lifetime. So can cruelty.
For many women in South Africa, memories of childbirth are not only of contractions, first cries and holding their babies for the first time. They are also memories of being shouted at, ignored, humiliated or subjected to procedures they did not fully understand or consent to. The evidence suggests these experiences are far from isolated.
The 2025 Embrace Birthing Survey, conducted by Social Surveys Africa among 845 women in Gauteng and KwaZulu-Natal, found that 60% of respondents had experienced some form of obstetric violence. The report estimated that this could represent approximately 1.79 million people across the two provinces, with the figure rising to 63% in KwaZulu-Natal and standing at 58% in Gauteng.
Some 57% of respondents said they had experienced disrespect or belittling, while 41% reported being insulted, sworn at or shouted at. Nearly a quarter said healthcare workers had joked about their pain, while one in three reported undergoing procedures without being properly informed about what was being done or without giving consent. Fourteen percent said they had been slapped, pinched or humiliated.
Perhaps most troublingly, two-thirds of those who experienced abuse did not initially recognise what had happened to them as abuse, while nine in 10 did not report their experiences. Fear of retaliation, trauma, shame, uncertainty about complaints procedures and the normalisation of mistreatment were among the reasons cited.
This is not a new problem. A 2017 survey involving 653 new mothers at midwife-led obstetric units in Tshwane found that only 48% believed they had been treated with “a lot of respect”, while just 47% said they had been asked for consent before a physical examination.
These findings sit uneasily alongside the rights South African patients are supposed to enjoy. The Patients’ Rights Charter recognises the rights to dignity, privacy, informed consent and information in a language patients understand, while the World Health Organisation similarly defines respectful maternity care as including dignity, freedom from mistreatment, informed choice and appropriate support during childbirth.
Yet between those rights on paper and what some women experience in labour wards lies a painful gap.
I know something of that gap because I have lived it.
When my waters broke at 5:30pm, I made my way to hospital and arrived at around 6:30pm. My waters continued breaking in stages, yet there was little guidance about where I was supposed to register or book in. I sat unattended for nearly two hours before I was eventually assisted.
What followed was not simply an inconvenient hospital experience. It was a succession of moments in which, while heavily pregnant and in active labour, I felt that my dignity had become secondary.
I was sent to another ward to have my blood pressure checked and, when I asked a nurse for directions, she responded in an African language I did not understand. When I explained that I could not understand her because I did not speak the language, she replied that she did not speak mine either. I eventually found the station myself.
Later, I was instructed to change into hospital clothing. There were no skirts available, so I was given two tops and told to use one as a skirt. It did not fit around my pregnant body, leaving me exposed from the waist down while I was in labour.
As the contractions intensified, I screamed. A nurse told me to shut up because I was making too much noise and warned that I would not receive help if I continued. I was not screaming for attention. I was screaming because I was in pain.
Later, I was told to turn onto my left side, but I could not move myself. I was suffering from sciatica and had a drip in my right arm, making movement difficult. When I asked a nurse to help me, she laughed and told her colleagues about my inability to turn.
A doctor overheard what was happening and entered my cubicle. He explained that my baby’s position could become a concern if I remained where I was and, when I told him I could not turn without assistance, he helped me.
Eventually, I delivered my son naturally. He was healthy, weighing 3.3kg. But having a healthy baby did not erase what had happened before his birth.
The following morning, women waiting to be discharged were made to sit on wooden benches from around 8am until 2pm. I sat there carrying my newborn son and my bags while my body was still recovering from labour and childbirth.
I was grateful that he was healthy, but gratitude should never become the standard by which we measure whether a woman was treated well.
My experience does not mean that every doctor, nurse or midwife is abusive. Healthcare workers operate under enormous pressure, and many provide compassionate care in difficult circumstances. But pressure cannot justify humiliation, disregard for consent or the dismissal of a woman’s pain.
A successful birth cannot be measured only by whether mother and baby leave the hospital alive.
We must also ask whether the mother was heard when she cried out. Whether she understood what was being done to her. Whether her consent was respected. Whether she was treated with compassion. Whether, at the moment she was perhaps most vulnerable, she felt safe.
Because bringing a child into the world should never require a woman to surrender her dignity at the hospital door.
Beautifully written piece.