Disrespect and abuse experienced by women during childbirth in midwife-led obstetric units in Tshwane district, South Africa: A qualitative study

The disrespect and abuse (D&A) of women during childbirth is common and a great concern in midwifery-led obstetric units (MOUs) in South Africa. This paper used the seven chapters of the Respectful Maternity Care Charter as a framework to explore women’s experiences of care during childbirth and examine the occurrence of D&A during childbirth in MOUs. Five focus group interviews were conducted with postnatal women aged 18 to 45 years selected purposively from MOUs in Tshwane District in South Africa. The discussions were audio-recorded, transcribed, and analyzed using a thematic approach and NVivo11 computer software. D&A of women was common during labor and childbirth. Verbal abuse in the form of shouting, labeling, judging, and rude remarks was the common form of D&A. Some of the women were abandoned and neglected, which resulted in their giving birth without assistance. Furthermore, the midwives violated their rights and denied them care such as pain relief medication, birth companions during childbirth, and access to ambulance services. Midwives are at the center of the provision of maternity care in MOUs in South Africa. Therefore, there is a need to strengthen interventions to adopt and implement policies that promotes respectful, nonabusive care during childbirth in MOUs.