Lack of Respectful Maternity Care Can Lead to Deaths in Childbirth

WhiteRibbonAlliance
Apr 23 · 3 min read

By Rose Mlay, National Coordinator, White Ribbon Alliance Tanzania

As a midwife I have witnessed seen the connection between disrespect and abuse during childbirth and maternal newborn deaths. This became more amplified as I got more involved in White Ribbon Alliance efforts to ensure Respectful Maternity Care (RMC) for all women. This year, White Ribbon Alliance for Safe Motherhood in Tanzania (WRA Tanzania) is implementing a campaign to ensure women’s and girls’ rights are protected across family, community and facility levels.

As I sat in a citizen hearing in Bukoba, Kagera on March 15, a young woman named Halima Mohamed came up from among the crowd to tell her story to the politicians, decision makers, media and more than 1,000 fellow citizens in attendance. Full of anguish, Halima began, “When I knew I was pregnant I attended antenatal clinics as required. I followed all instructions given me by health workers. One of the instructions given me was to give birth at a hospital. At term I was okay.”

Halima testifying on the dire consequences of giving birth without Respectful Maternity Care. Photo: WRA Tanzania.

From the outset and as her labor pains grew, Halima feared for her and her baby’s safety and pled for the required referral to the fully equipped health center. “The health workers told me she was going to try. The labor pains were getting stronger and stronger but no progress. All the time I told this worker to refer me, but she would not. After a long time she noticed that my baby’s heart beats were no longer heard. My condition was very poor… I could see my death. That is when they rushed me to Bukoba Regional Hospital.”

Part of providing respectful maternity care is to listen to women and trust that they best know their needs. Detailed in the Respectful Maternity Care Charter, every woman has the right to consent and refusal, and respect for her choice and preference. By ignoring Halima’s request to be quickly referred to the hospital, the health worker — whether purposefully or not — violated her rights and disrespected her decision to give birth in a hospital versus the community clinic.

“On arrival they rushed me to operating theater straight away and removed the dead baby from my womb. I thank the Regional Hospital because without them I would be dead today. But I am lamenting for the needless death of my baby. The health worker at the dispensary did not want to hear me out,” Halima wept.

Similar stories were heard from other women who endured devastating consequences, including the death and impairment of their babies. Women whose wishes were not respected; whose voices went unheard.

Attendees at the citizen hearing in Bukoba, Kagera listen to Halima’s story. Photo: WRA Tanzania.

As part of the What Women Want campaign, we spoken to more than 110,000 women and girls in Tanzania — and nearly 1.2 million worldwide — about what they need most when it comes to quality reproductive and maternal healthcare. While the results are still being analyzed, one thing is clear: women want to be listened to and to be trusted as experts in their own healthcare.

The Regional Medical Officer emphasizes the importance of reducing maternal deaths after listening to Halima’s story. Photo: WRA Tanzania.

High-level findings of the campaign will be released at an official side event at Women Deliver followed by in-country dialogues to further analyze results and create advocacy agendas that are based on women’s and girls’ self-articulated needs. We invite all our partners to be part of this groundbreaking process of shifting the power dynamic so that it lies firmly where it belongs: with women and girls.


White Ribbon Alliance unites citizens to demand the right to a safe birth for every woman, everywhere. We harness the power of local women and men to achieve lasting change. Our approach is working. Donate to White Ribbon Alliance and help protect and promote women’s health. Subscribe to WRA Voices and follow WRA on Facebook and Twitter to learn more about the work White Ribbon Alliance does around the world.

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Inspiring and convening advocates to uphold the right of all women to be safe and healthy before, during and after pregnancy.

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