Maternity should be a memorable experience

Women’s rights are now centre stage and an important message is getting across ― abuse of these rights whether emotional or physical — is a non-negotiable no. Among the important rights that we must respect is also the right to respect and dignity when women seek health care, especially treatment during childbirth, which should be an experience filled with warmth and a sense of caring. A growing body of anecdotal and research evidence collected in maternity care systems from the wealthiest to poorest nations worldwide paints a disturbing picture. In fact, disrespect and abuse of women seeking maternity care is becoming an urgent problem and is creating a growing community of concern across the world.

In India, women’s health has largely centred on reducing maternal mortality rates. The fact that India’s maternal mortality has gone down is cause for celebration. But now we need to look further and concentrate on the quality of care, including respectful care, since women’s experiences with maternity caregivers can empower and comfort them, or inflict lasting damage and emotional trauma. Studies done in many states have thrown up instances of disrespectful behaviour and even abuse. They range from lack of privacy, no consent being taken, rough handling and a bias against those from a lower socio-economic stratum. The experience that should be the most memorable for a woman, is often reduced to an experience where her dignity is of little or no concern.

The problem is global, though the manifestations differ. A major drawback in tackling it is the lack of a measurement of what constitutes disrespect and abuse. Many countries haven’t been able to form normative standards for measuring respectful care and the reaction is usually, “Let’s look at other more pressing issues first’ or “How do you identify and measure behaviour that can be termed as disrespectful?”

Some years ago, the White Ribbon Alliance (a global alliance of advocates on issues relating to maternal health and care) developed the Respectful Maternity Care (RMC) Charter which was endorsed internationally by the World Health Organization, the International Federation of Gynaecology and Obstetrics and the International Confederation of Midwives; and in India by more than 80 organisations. It may not be the final word on the issue, but it is a starting point to talk about women’s rights to respectful care.

Perhaps the first step is to ensure that RMC gets institutional recognition and becomes an integral part of policies. The second would be working with health providers to ensure that conversations on disrespect and abuse do not inevitably end up being against the providers. The providers have their backs to the wall, with limited resources, infrastructure and a stressful environment. We need to engage with the providers as well and jointly work towards creating an enabling environment for them as well.

The danger of putting these issues on the backburner is that disrespect and abuse are slowly become the norm, with women believing that they are not entitled to anything better and that the experience of childbirth comes packaged with such treatment. The danger is that this sense of outrage can slip away slowly, effectively blurring the importance of this issue. We must not let this happen and we need to foreground this issue and act now.

Aparajita Gogoi is the Executive director of the NGO, Centre for Catalyzing Change

The views expressed are personal

First Published: Nov 19, 2018 12:15 IST