“I
have practiced medicine for 20 years and this is the first meeting I have
attended that made me want to go back to work and apologize to all the women I
have yelled at.”
This thoughtful comment, from a doctor
attending a national stakeholders meeting on respectful maternity care (RMC) in
Rwanda, was echoed by others in attendance. “We are teaching midwives to do
good vaginal exams, but not to be kind!” said another participant.
These vibrant exchanges were part of a
larger discussion on common types and causes of mistreatment during maternity
care. During the November 2015 meeting—convened by the Rwandan Ministry of
Health, Rwanda Gender Monitoring Office, USAID’s flagship Maternal and Child
Survival Program (MCSP), and USAID/Rwanda—participants agreed that more work is
needed to achieve high-quality care that is both safe and respectful.
In a second break-out session, participants
discussed locally appropriate solutions for combating mistreatment and
promoting RMC, acknowledging that multiple stakeholders, including
representatives of government, civil society, facilities and professional associations,
need to work together to ensure that women receive dignified care during
childbirth.
And these issues are not unique to Rwanda.
A
rights based approach to RMC may seem to be an obvious standard embraced by all
stakeholders. However, in
many countries, mistreatment is an all-too familiar experience for women
who give birth in facilities.
The effects of mistreatment may ripple far
beyond the individual woman who experiences verbal or physical abuse, neglect,
humiliation or discrimination. One woman’s negative experience may be enough to
dissuade her family, neighbors or friends from giving birth in a facility.
RMC
is sometimes framed as a ‘soft issue’ without the same urgency as emergency
obstetric services, but the consequences of mistreatment can be serious and
far-reaching.
In many settings, fear of mistreatment has
proved to be an important deterrent to seeking childbirth care in facilities.
In many parts of the world, the percentage of women who give birth in
facilities remains low, with mistreatment a known, important contributing
factor. This includes Tanzania, where the rate of facility childbirth has
stagnated at or below 51% for more than 20 years.
Read more here
By: Claire Baldwin, MCSP Communications
Susan
Moffson, MCSP Senior Program Officer
Photo credit: Mother and newborn at the district hospital
in Allahabad, Uttar Pradesh. (Indrani Kashyap/Jhpiego)