Motherhood is a social justice and human rights issue.
In every country and community worldwide, pregnancy and childbirth are momentous events in the lives of women and families, representing a time of great joy, but also intense vulnerability. The concept of ‘safe motherhood’ is usually restricted to physical safety, but childbearing is also an important rite of passage, with deep personal and cultural significance for women and their families.
Because motherhood is specific to women, issues of gender equity sit at the core of maternity care. The notion of safe motherhood must be expanded beyond the prevention of morbidity or mortality to encompass respect for women’s basic human rights, including respect for women’s autonomy, dignity, feelings, choices, and preferences, including decisons about who is present at birth.
All childbearing women deserve respectful care and protection; this includes special care to protect the mother-baby union as well as women in cases of heightened vulnerability, for example adolescents, ethnic minorities, and women living with physical or intellectual disabilities or HIV.
Its Universal Rights of Childbearing Women Charter addresses the disrespect and abuse to which women seeking maternity care are sometimes subjected. It provides a platform for change via:
- Raising public awareness regarding the inclusion of childbearing women’s rights in the human rights guarantees recognised in internationally adopted United Nations and other multinational declarations, conventions, and covenants;
- Highlighting the connection between human rights language and key program issues relevant to maternity care;
- Increasing the capacity of maternal health advocates to participate in human rights processes;
- Aligning childbearing women’s sense of entitlement to high-quality maternity care with international human rights community standards; and
- Providing a basis for holding the maternal care system and communities accountable to these rights.
The Charter purposely focuses specifically on the interpersonal aspects of care received by women seeking maternity services. A woman’s relationship with maternity care providers and the maternity care system during pregnancy and childbirth is vitally important.
These relationships are the vehicle for essential and potentially lifesaving health services. Equally, women’s experiences with caregivers at this time can either empower and comfort, or inflict lasting damage and emotional trauma; adding to or detracting from women’s confidence and self-esteem.
Imagine the personal treatment you would expect from a maternity care provider entrusted to help you or a woman you love give birth. Naturally, we envision a relationship characterised by caring, empathy, support, trust, confidence, and empowerment, as well as gentle, respectful, and effective communication to enable informed decision making. Unfortunately, too many women experience care that is anything but.
A growing body of research evidence, experience, and case reports collected in maternity care systems – from the wealthiest to poorest nations worldwide – paints a different and disturbing picture.
In fact, disrespect and abuse of women seeking maternity care is becoming an urgent problem and creating a growing community of concern that spans the domains of healthcare research, quality, and education; human rights; and civil rights advocacy.
Disrespect and abuse during maternity care are a violation of women’s basic human rights.
Human Rights are recognised by societies and governments around the globe and are enshrined in international declarations and conventions. Bowser and Hill (2010) described seven major categories of disrespect and abuse that childbearing women encounter during maternity care. These categories occur along a continuum from subtle disrespect and humiliation to overt violence:
- Physical abuse
- Non-consented clinical care
- Non-confidential care
- Non-dignified care (including verbal abuse)
- Discrimination based on specific patient attributes
- Abandonment or denial of care
- Detention in facilities
Until now, no instrument has specifically delineated how human rights are implicated in the childbearing process or affirmed their application to childbearing women as basic, inalienable rights. The White Ribbon Alliance for Safe Motherhood is promoting respectful maternity care through tackling disrespect and abuse defining the Seven Rights of Childbearing Women, in seeking and receiving maternity care.
Every woman has the right to:
- Freedom from harm and ill treatment
- Information, the right to provide informed consent and refusal to consent, and respect for choices and preferences, including companionship during maternity care
- Privacy and Confidentiality
- Dignity and respect
- Equality, freedom from discrimination and access to equitable care
- Healthcare and the highest attainable level of health
- Liberty, autonomy, self-determination, and freedom from coercion
The seven rights are drawn from the categories of disrespect and abuse identified by researchers and rights advocates in the current literature. By drawing on relevant extracts from established human rights instruments, the Charter demonstrates the legitimate place of maternal health rights within the broader context of human rights.
All rights are grounded in established international human rights instruments, including the Universal Declaration of Human Rights; the Universal Declaration on Bioethics and Human Rights; the International Covenant on Economic, Social and Cultural Rights; the International Covenant on Civil and Political Rights; the Convention on the Elimination of All Forms of Discrimination Against Women; the Declaration of the Elimination of Violence Against Women; the Report of the Office of the United Nations High Commissioner for Human Rights on preventable maternal mortality and morbidity and human rights; and the United Nations Fourth World Conference on Women, Beijing. National instruments are also referenced if they make specific mention of childbearing women.
Safe Motherhood for All calls for maternity care that is comprehensive, participatory, rights based, using evidence-based best practice.
Safe Motherhood for All, now and into the future, because healthy women make healthy babies make healthy nations.
Sources
Respectful Maternity Care – http://www.whiteribbonalliance.org/index.cfm/act-now/respectful-maternity-care/
