Human rights in childbirth: reality of rhetoric?

Mother and baby, Bangladesh

Disrespect and abuse during pregnancy and childbirth is a global problem, that occurs in all settings. Not treating a woman with respect and dignity when providing healthcare is a violation of their rights as a human being. Women’s experiences with maternity caregivers can comfort and empower them, or inflict lasting damage and emotional trauma.

A common goal of every person who works in maternity care is a healthy mother and healthy babies. The World Health Organisation (WHO), United Nations Children’s Fund (UNICEF) and United Nations Population Fund (UNFPA) have declared that, for women, human rights include access to services that will ensure safe pregnancy and childbirth. Inequalities in healthcare are well documented. In many places across the world, ethnicity, socioeconomic status and race play a role in the care that women and their families receive. Maternal and infant mortality rates are higher in poor, working class, marginalised and minority peoples as these groups often receive insufficient or indeed no care in maternity settings.

However, here is more than just survival at stake in pregnancy and childbirth. The Human Rights in Childbirth organisation (HRiC) states that ‘the care that women receive during pregnancy and childbirth intersects with the rights to physical integrity, self-determination, privacy, family life, and spiritual freedom’. Disrespect and abuse during pregnancy and childbirth is a global problem, that occurs in all settings. Not treating a woman with respect and dignity when providing healthcare is a violation of their rights as a human being. Women’s experiences with maternity caregivers can comfort and empower them, or inflict lasting damage and emotional trauma.

Respectful Maternity Care (RCM) is a universal human right that is due to every childbearing woman in every health system. While many interventions to reduce inequalities in health aim to improve access to skilled birth care, the quality and the dynamics that occur between birthing women and their healthcare providers has received less attention. Evidence suggests that in countries with high maternal mortality, fear of disrespect and abuse that women often encounter in facility-based maternity care is a powerful deterrent to accessing maternity services and skilled care. In the UK, USA and Australia a growing number of women are choosing to free-birth or have home births even if they have medical or obstetric risk factors due to the perceived prescriptive, risk adverse and dictatorial system that has become prevalent in maternal health care in these counties.

Governments have an obligation to provide maternity care that is affordable and accessible to all citizens. Recently, CMNH partnered with the Royal Exchange Theatre and The Oglesby Charitable Trust to provoke debate and discussion around global inequalities in maternal healthcare. This dynamic fusion of science and art focuses on human rights in childbirth with plays highlighting issues ranging from forced sterilisation in India, obstetric fistula in Kenya and the rising Caesarean section rate in Brazil. This project is great example of activism and advocacy, two essential elements that must be engaged and encouraged if we are to create maternity care systems that provide choice and control for pregnant women and reduce maternal and newborn mortality and morbidity rates worldwide. Let’s keep women’s rights at the top of the agenda and make them a reality and not just rhetoric.

About the author

Hannah McCauley has worked as a midwife for over ten years, both in the UK and internationally, and is currently working as a Senior Research Associate in the CMNH at LSTM. She is passionate about improving the quality of care for woman and their new-borns, supporting women’s choices in pregnancy and childbirth and promoting and empowering midwives in their professional role, both in the UK and internationally.