Cruelty in Kenyan delivery wards includes vaginal examination in public and being left naked after giving birth
By Camy Achieng’- Gecaga
Kenyan mothers-especially first time maternity screamers-go through hell at the hands of midwives during deliveries in public hospitals. Besides poor quality services, lack of medical supplies, high costs, thin staffing, long distance to hospitals and deficient transport, majority of Kenyan women cited disrespect, verbal abuse and bad attitude of garrulous medics as reasons for giving hospital births… a wide berth.
Among the indignities Kenyans mothers endure include; being blamed or intimidated during childbirth, being threatened with Caesarian- Section if one continued shouting and slanderous remarks like “umekuja na underwear kuzaa kwa kitanda ulikua umevaa?”
Other women recall being scolded, shouted at or called stupid. Then there were those who underwent vaginal examination in public, others gave birth in front of many people while others were left naked after giving birth!
So severe were rising mortality rates and falling maternity births President Uhuru Kenyatta in June 2013 scrapped fees for delivering mothers. This was in the face of 50 percent of mothers in Kenya avoiding skilled health services from nurses, midwives and doctors who could have prevented bleeding during and after delivery, high blood pressure, and infections which caused neonatal and maternal deaths.
Single mothers, or those who spoke like form four graduates, were more likely to be subjected to a string of choice insults
The World Health Organization (WHO) reckoned that disrespect and abuse were a worldwide problem by 2014 as it violates women’s rights to respectful care and also threatens their lives, freedom and bodily integrity.
But Kenyan midwives and maternity nurses are a special case and class of their own and the prevalence in most counties could be higher “due to under reporting and normalizing of disrespect and abuse by both clients and service providers,” notes Ishmael Wango Makumi in his research on ‘Disrespect and Abuse of Women during Facility based Deliveries’ at the University of Nairobi in 2015.
He added that single mothers, or pregnant women without male company and who spoke like form four graduates, were more likely to be subjected to a string of choice insults. Age is another factor. Nurses and midwives become moral priests against teenage mothers or those who seemed to have known ‘bad manners’ before clearing college. As punishment, some are denied pain killers, worsening post-traumatic stress disorder.
Makumi listed the litany of physical abuse women face as including; being tied during labour, being beaten, slapped or pinched. Breasts being touched as well as buttocks and private parts and being forced to go through rough vaginal exams. Other women were denied companionship of the husband or close relative, were left unattended and birth attendant failed to intervene when medically indicated.
Ward staff feigning exhaustion and also disclosing one’s age, medical history including HIV status without consent
One woman recalled “there were many students. I felt ashamed as four of them were looking at me as I gave birth and I was completely naked. Even when I was being stitched they were still looking. When I came back home I told my husband when I get another pregnancy I will not give birth in that hospital.”
This scenario is worse in places like Nyanza where 27 percent of adolescent girls deliver by their 19th birthday with some even delivering at the age of 12 years according to the National council for Population and Development.
Makumi’s study, though centred in Meru County is representative of what majority of delivering mothers suffer in the country including; ward staff feigning exhaustion and also disclosing one’s age, medical history including HIV status without consent.
Makumi revealed that about 71.9 percent of all women interviewed experienced a form of disrespect and abuse during their most recent facility delivery.
Another woman lamented that “when I gave birth I was cut down there but they did not stitch me. Instead I was told to take my baby and I go where women who have just given birth go. On the way I bled so much until I fainted and fell down. That is when another ‘doctor’ picked me, took me back stitched and infused me.”
A doctor or nurse exposed to cultural or structural violence subjects violence to patients in the form of slapping, pinching, shoving, and verbal abuse
The same abuse was not the case with a pregnant woman who looked like she had an annual club membership and was likely to have her lawyer’s number on speed dial.
Just why do medics turn the delivery ward into some sort of Gomorrah?
Well, Makumi informs us that “a doctor or nurse exposed to cultural or structural violence-by for example tribalism and poor pay- is more likely to engage in face to face acts of violence against the patient. This direct violence takes the form of slapping, pinching, shoving, and verbal abuse.”
The abuses are also about power relations since with their medical knowledge, medics are more powerful than the patient who has no choice but obedience which they can misuse while playing God.