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Memorandum to end obstetric violence in South Africa

- Embrace: The Movement for Mothers

CALS endorses a memorandum submitted today to the Department of Health calling for an end to obstetric violence in South Africa's maternity health care system

To: Minister of Health, Dr Aaron Motsoaledi

Pregnant women and birthing people experience obstetric violence daily in public and private hospitals and clinics across South Africa. This includes verbal and physical abuse, humiliation, forced medical procedures, and denial of care, denial of privacy and dignity. Obstetric violence harms pregnant women and girls from all socio-economic, racial, national and migratory backgrounds. This particular gender-based violence results in poor outcomes for mothers and babies, including disability and death.

Women and girls deserve dignity, safety, and respect during pregnancy, childbirth and postpartum. Anything less is a failure of the State’s constitutional and moral obligations to protect women’s rights to dignity, equality, bodily integrity, access to health and the right to live free from violence. We demand your immediate, decisive action; the development of a concrete, time-bound, financed action plan to address the prevalence of healthcare facility-based gender-based violence in South Africa. We, the undersigned Obstetric Justice Coalition and others demand the action plan include:

1. ACCOUNTABILITY & REPARATIVE JUSTICE FOR SURVIVORS

1.1. Initiate a formal interdepartmental process, including referral to the Minister of Justice and the South African Law Reform Commission, to investigate and develop legislative recognition of obstetric violence as a distinct legal harm by 31 August 2026.

1.2. Implement standardised monitoring and consequence management protocols for obstetric violence. To ensure impactful supervision and oversight, that holds Provincial Heads, District Managers, Heads of health facilities, units and perpetrators accountable for obstetric violence. Integrate Respectful Maternity Care (RMC) metrics into district performance dashboards within 12 months i.e. by 31 August 2026.

1.3. Institute independent investigations into allegations of obstetric violence, including structural and systematic causes, and publish the findings by 28 February 2027.

1.4. Recognise obstetric violence as a distinct violation giving rise to established special redress mechanism that ensures survivors of obstetric violence have access to medical redress, psychosocial support and financial restitution. 

2. ADEQUATE BUDGETARY RESOURCES

2.1. Adequately fund the maternal health budget to resource maternal health services within 12 months. The explicit purpose of which is to ensure the achievement of quality, dignified maternal healthcare that meets legal obligations within five years. Including operationalising RMC, enforcement of bans on hiring freezes in sexual and reproductive healthcare services, achieving adequate staffing and training, equipment, medicines and infrastructure upgrades.

2.2. Provision of mandatory continuous trauma-informed RMC training for all maternity care staff, including informed consent, contraception, sterilisation and choice of termination of pregnancy commencing by 27 February 2027.

2.3. Invest in improving working conditions for health workers, ensuring safe and adequately resourced facilities, reasonable workloads and shifts and access to mental healthcare and peer support.

3. EMPOWER WOMEN AND COMMUNITIES

3.1. Display clear, visible posters in all maternity wards, providing information on RMC and a functional national complaints hotline complaints processes within 3 months i.e. by 31 May 2026.

3.2. Provision of ongoing public education campaigns on health rights during pregnancy, childbirth, and postpartum including information on a functional national complaints hotline and reporting procedures.

3.3. Mandate every facility, in policy and practice, to allow birth companions in labour, delivery and post-natal wards, as well as, during antenatal visits.

We request your office respond in writing within 10 working days. Furthermore, any action plan to address obstetric violence must include the meaningful consultation of survivors. We request the attendance of a senior director of the National Department of Health at the launch of the 2025 Birthing Survey Launch at Wits University on 11 March 2025. We urge the Department to commit to:

  1. Commence discussions with the coalition on a time-bound, financed action plan to respond to and prevent obstetric violence; and
  2. Engage with the findings of this national prevalence research study report.

Failure to meet these deadlines or to commence discussions with the coalition will be interpreted as a lack of accountability and political will to protect the rights, dignity and safety of users of South Africa’s maternal healthcare system.

Contact details:

  • Julie Mentor at julie@embrace.org.za, Movement Leader, Embrace: The Movement for Mothers on behalf of the Obstetric Justice Coalition

Signatories: 

  • Embrace: The Movement for Mothers 
  • SECTION27 
  • Sexual Reproductive Justice Coalition
  • Centre for Applied Legal Studies
  • Women Affected by Mining United in Action
  • Perinatal Mental Health Project
  • Women’s Legal Center
  • Grow Great
  • DGMT
  • Native Roots Community Development
  • Wombniverse SA
  • Abortion Support South Africa
  • Future Ready Foundation SA NPC
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