• The 2025 Birthing Survey revealed that 60% of women in Gauteng and KwaZulu-Natal experienced obstetric violence, including verbal abuse, neglect, and nonconsensual procedures, affecting an estimated 1.79 million women.
• Advocates for trained birth companions highlighted their importance in providing emotional support, improving birth outcomes, and ensuring respectful maternity care, though access remains inconsistent in public healthcare facilities.
• The findings show systemic healthcare failures, with calls for stronger oversight, enforcement of policies, and resource allocation to ensure dignity, quality care, and accountability in maternity services.

A mother who lost her baby during childbirth says she is still searching for answers years later, describing how she felt powerless and unheard while trying to understand what happened.

"The abuse happened behind closed doors. I wanted to scream for my husband to come in because I could see something was wrong," she said.

Stories like hers formed part of the testimony shared during the release of the Embrace Movement for Mothers birthing survey, which examined women’s experiences of childbirth in Gauteng and KwaZulu-Natal.

The findings point to widespread reports of mistreatment, with many respondents describing experiences such as being shouted at, ignored during labour, or subjected to medical procedures without consent and a lack of support during labour.

News24 previously reported that 60% of mothers in Gauteng and KwaZulu-Natal experienced mistreatment during pregnancy, childbirth, or postpartum care, affecting an estimated 1.79 million women over a decade.

For many, the mother’s testimony also highlighted another issue: many women go through childbirth without anyone present to advocate for them.

READ | 60% of mothers experience abuse by healthcare workers in Gauteng and KZN – survey

The mother said the trauma did not end after the birth.

"When the doctor came to tell me my son had passed away, he asked me what happened. I said, 'I don't know. No one has given me any answers.'"

She said it took years to access her medical records.

"My medical file was hidden for almost five years," she said.

"When we finally found the file, most of the information was missing."

She also questioned the circumstances surrounding her baby's death.

She said:

According to the mother, attempts to seek answers were met with resistance.

"You try to speak for yourself, but no one listens."

She said she was also made to sign documents she did not understand before being taken into the theatre.

"I signed papers outside the theatre, and to this day, I don't know what I signed. Later, I found out I had been sterilised,” she said.

"This does happen in South Africa. The department should not act as if it does not."

Kefilwe Sibenya from Doulas of South Africa (DOSA) said trained birth companions can play an important role in improving women's experiences during labour.

"Respectful maternity care is not only about clinical outcomes. It is also about how women experience childbirth," she said.

Sibenya explained that birth companions provide continuous support during pregnancy, labour and the postpartum period.

READ | The abuse of pregnant women by healthcare workers: Expert explains obstetric violence

"This includes emotional reassurance, comfort measures, guidance and helping women communicate their needs with healthcare providers."

Sibenya said research has consistently shown that labour support improves women's experiences and birth outcomes.

"The World Health Organisation recommends that every woman should have a companion of choice. Yet in many healthcare facilities in South Africa, women still go through labour without continuous support."

Despite this, access for trained birth companions remains inconsistent across the country.

"Over the years, DOSA has made several requests for access to public healthcare facilities, but access has been inconsistent and processes remain unclear,” Sibenya said.

"Birth companions are not a disruption to care. We are partners in creating a safe, respectful birth experience for women, families and healthcare providers."

Civil society organisations say the survey findings also highlight broader systemic failures in the healthcare system.

Kholofelo Mphahlele from Section27 said the results were deeply troubling.

"The results are shocking. They are heartbreaking. You don't know whether to cry, to stand up in anger, or to sit in complete shock," she said.

She said access to healthcare services must include dignity and quality care.

According to the survey, 92% of women who reported abuse said it involved nurses or midwives, while 14% identified doctors.

The report also documents women being shouted at, ignored during labour or subjected to procedures without consent.

"The experiences documented in this report clearly violate constitutional rights and medical ethics," Mphahlele said.

Advocacy organisations say accountability and stronger oversight are essential.

Zintle Tyuku from amandla.mobi said the report reflects the experiences of many working-class South Africans who rely on public healthcare.

"These are the same people we mobilise in our campaigns – mostly grant recipients and working-class South Africans who cannot afford private healthcare," she said.

READ | Obstetric violence? Mothers share being mistreated when giving birth

"You cannot have beautiful policies and guidelines if you cannot enforce them. Where is the monitoring? Where is the evaluation?"

Government officials acknowledged that implementing respectful maternity care requires addressing broader health system challenges.

Professor Lesley Bamford from the National Department of Health said guidelines alone would not resolve the problem.

"Putting something into guidelines is only the first step. We must also understand the implementation challenges and learn from examples where it works," she said.

She noted that resource constraints continue to affect maternal health services.

Julie Mentor from Embrace said the goal of the research was to ensure women's experiences lead to real change.

"We did not want to create another document that would simply be filed away," she said.

"These stories are painful to hear, but they are shared because people want change. Our commitment is to make sure these voices are not silent, and that accountability remains at the forefront."