Young researcher explores the violence many women endure while giving birth

“A woman goes to the hospital expecting care but is met with neglect.”

These are the words of Zilungile Silinda, a young researcher who used her mother’s experiences as a midwife to expose the hidden crisis of obstetric violence in South Africa.

It started with mother and daughter conversations.

“I was listening to my mother and also paying attention to what had been going on and the kind of activism that was happening around gender-based violence,” said Silinda, a master’s graduate of the University of Pretoria’s political science department. Her dissertation was obstetric violence as a form of gender-based violence.

Her mother, a midwife, would often speak about the difficult conditions health-care workers endured in labour wards during the Covid-19 pandemic.

“The more she spoke about it, the more I kept asking follow-up questions. If that’s the condition you’re working under, a woman going into a labour ward is expecting to be met with care. You’re going there to reproduce life, to give birth.

It’s become institutionalised to the point where people don’t even recognise that this is abuse any more. We think this is how women are supposed to be cared for when they give birth in public health-care facilities, and that is just not right

—  Zilungile Silinda

“What are the conditions you’re being met with if providers themselves are under this kind of strain? What kind of treatment are women receiving?” she wanted to know.

Those questions would eventually become the foundation of her research into the largely overlooked issue in South Africa.

The 27-year-old Mpumalanga-born researcher from the township of Tekatakho says obstetric violence is often hidden in plain sight.

“Simply put, it refers to the abuse, disrespect or mistreatment that people encounter when they go into health-care facilities to give birth, or for prenatal or postnatal care. Instead of being met with care, they are often met with neglect, verbal abuse and physical abuse,” she said.

Over the past 10 years, 60% of women who have given birth in Gauteng and KwaZulu-Natal have experienced some form of obstetric violence, she added.

“The Extent and Nature of Obstetric Violence in South Africa: 2025 Birthing Survey Findings Report" highlights women’s concerns and experiences during childbirth.

What alarmed Silinda the most was not necessarily the incidents themselves but how normalised they have become.

“The most alarming thing is how common it is, how expected it is and how pervasive it is. It’s become institutionalised to the point where people don’t even recognise that this is abuse any more. We think this is how women are supposed to be cared for when they give birth in public health-care facilities, and that is just not right.”

That element of neglect and verbal abuse keeps women silenced, which makes it difficult to report obstetric violence. Everything indicates that it is a widespread problem, especially in our public health-care sector. It’s a pervasive issue

—  Zilungile Silinda

Her research found repeated patterns emerging in women’s experiences.

“Women are given the most minimal resources, the least attention possible. Until you are on the verge of labour, there are no painkillers, no attention and a complete neglect of women who are expressing discomfort and pain while bringing life into the world.

“That element of neglect and verbal abuse keeps women silenced, which makes it difficult to report obstetric violence. Everything indicates that it is a widespread problem, especially in our public health-care sector. It’s a pervasive issue.”

Even incidents that South Africans had become accustomed to seeing, such as pregnant women sleeping on hospital floors, should be considered forms of obstetric violence, she said.

“That is part of the minimal provision of services. You’ve gone to give birth and now you’re sleeping on a cold, hard floor. That’s a violation of dignity and it’s very dehumanising.

“Obstetric violence is often subsumed under broader conversations around gender-based violence, but it isn’t specifically recognised. That makes it difficult to understand just how widespread it is.”

Sowetan