April 11 is the International Day for Maternal Health and Rights, which aims to encourage rights-based, respectful care of women during pregnancy and childbirth. The day was launched last year by the Center for Health and Gender Equity, and co-sponsored by a consortium of maternal health organisations, including Women Deliver and the International Planned Parenthood Federation. These organisations are calling on governments, international institutions, and the global community to officially recognise the day and promote and support this issue.
Such an initiative is sadly necessary. Every woman should have the right to dignity, respect, and skilled care during pregnancy and childbirth but not every woman receives it. Evidence is growing about the disrespect and abuse women can face when accessing maternity care in countries at all levels of development. Such abuse includes physical abuse, humiliation and verbal abuse, unconsented clinical care, lack of confidential care, and abandonment or denial of care. This abuse not only affects mothers but their babies too. Some groups of women are also more likely to experience disrespectful and abusive treatment, including women with HIV, those from ethnic minorities, and unmarried women. Such abuse is a human rights violation and can also deter women from accessing health services in the future—whether for another pregnancy or for other health reasons.
The issue is complex and is not only about a lack of training and compassionate care. A Comment in The Lancet‘s 2014 Midwifery Series notes that discrimination and abuse is linked to, and reinforced by, systemic conditions, such as degrading, disrespectful working conditions and multiple demands, and can be seen as a signal of a “health system in crisis”. It is also tied to power dynamics and the vulnerability of women and their babies during pregnancy and birth. An international day can raise awareness about the need to provide respectful care for women and babies, but achieving it in reality will need deep soul searching and discussion about the underlying causes of abuse, including health system pressures and the culture of maternity care.