Rethinking obstetric violence and the “neglect of neglect” : the silence of a labour ward milieu in a South African district hospital
Date
2019-10-30
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Research into the mistreatment of women during childbirth has increased over recent years. Overt
violence is an important focus of research, but recently there has been increasing recognition that there are other
ways in which women in labour may be uncared for or even hurt. As part of a larger study focussing on staff
responses to stillbirths, we wanted to gain contextual information on how high risk pregnancies are handled in
general in Khayelitsha Hospital, a district hospital in an impoverished urban setting in the Western Cape Province of
South Africa. This health care system experiences an immense patient load, the poverty of the community it serves,
and the numerous traumas affecting both patients and staff.
Methods: In order to obtain rich exploratory data, a qualitative research methodology was used. The primary data
source was observations in the labour ward, interviewing labour ward staff (doctors, nurse, and cleaners). The
secondary data source was the analysis of hospital documents, specifically those related to labour ward policy.
Results: From our numerous observations and discussions, it is clear that no one is being overtly mistreated in this
hospital and patients are medically well attended to. Although we saw no physical abuse, we noted the silence in
the ward. Beside medical related interactions, we also noted that there were limited interactions between the
women and the health care providers.
Conclusions: Silence can be a form of neglect as it leaves the women feeling uncared for and not seen. In an
overburdened health care system where both staff and patients are often overwhelmed or traumatised, silence can
be a way in which a system defends itself against what it knows it cannot provide.
Description
CITATION: Lappeman, M. & Swartz, L. 2019. Rethinking obstetric violence and the “neglect of neglect” : the silence of a labour ward milieu in a South African district hospital. BMC International Health and Human Rights, 19:30, doi:10.1186/s12914-019-0218-2.
The original publication is available at https://bmcinthealthhumrights.biomedcentral.com/
The original publication is available at https://bmcinthealthhumrights.biomedcentral.com/
Keywords
Obstetric violence, Delivery (Obstetrics) -- Care, Women -- Abuse of
Citation
Lappeman, M. & Swartz, L. 2019. Rethinking obstetric violence and the “neglect of neglect” : the silence of a labour ward milieu in a South African district hospital. BMC International Health and Human Rights, 19:30, doi:10.1186/s12914-019-0218-2