Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital

Abstract Background Research into the mistreatment of women during childbirth has increased over recent years. Overt violence is an important focus of research, but recently there has been increasing recognition that there are other ways in which women in labour may be uncared for or even hurt. As p...

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Main Authors: Maura Lappeman, Leslie Swartz
Format: Article
Language:English
Published: BMC 2019-10-01
Series:BMC International Health and Human Rights
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12914-019-0218-2
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author Maura Lappeman
Leslie Swartz
author_facet Maura Lappeman
Leslie Swartz
author_sort Maura Lappeman
collection DOAJ
description Abstract Background Research into the mistreatment of women during childbirth has increased over recent years. Overt violence is an important focus of research, but recently there has been increasing recognition that there are other ways in which women in labour may be uncared for or even hurt. As part of a larger study focussing on staff responses to stillbirths, we wanted to gain contextual information on how high risk pregnancies are handled in general in Khayelitsha Hospital, a district hospital in an impoverished urban setting in the Western Cape Province of South Africa. This health care system experiences an immense patient load, the poverty of the community it serves, and the numerous traumas affecting both patients and staff. Methods In order to obtain rich exploratory data, a qualitative research methodology was used. The primary data source was observations in the labour ward, interviewing labour ward staff (doctors, nurse, and cleaners). The secondary data source was the analysis of hospital documents, specifically those related to labour ward policy. Results From our numerous observations and discussions, it is clear that no one is being overtly mistreated in this hospital and patients are medically well attended to. Although we saw no physical abuse, we noted the silence in the ward. Beside medical related interactions, we also noted that there were limited interactions between the women and the health care providers. Conclusions Silence can be a form of neglect as it leaves the women feeling uncared for and not seen. In an overburdened health care system where both staff and patients are often overwhelmed or traumatised, silence can be a way in which a system defends itself against what it knows it cannot provide.
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spelling doaj.art-097500faa2b743139136db3380d1f5312022-12-21T23:21:56ZengBMCBMC International Health and Human Rights1472-698X2019-10-0119111110.1186/s12914-019-0218-2Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospitalMaura Lappeman0Leslie Swartz1Department of Psychology, Stellenbosch UniversityDepartment of Psychology, Stellenbosch UniversityAbstract Background Research into the mistreatment of women during childbirth has increased over recent years. Overt violence is an important focus of research, but recently there has been increasing recognition that there are other ways in which women in labour may be uncared for or even hurt. As part of a larger study focussing on staff responses to stillbirths, we wanted to gain contextual information on how high risk pregnancies are handled in general in Khayelitsha Hospital, a district hospital in an impoverished urban setting in the Western Cape Province of South Africa. This health care system experiences an immense patient load, the poverty of the community it serves, and the numerous traumas affecting both patients and staff. Methods In order to obtain rich exploratory data, a qualitative research methodology was used. The primary data source was observations in the labour ward, interviewing labour ward staff (doctors, nurse, and cleaners). The secondary data source was the analysis of hospital documents, specifically those related to labour ward policy. Results From our numerous observations and discussions, it is clear that no one is being overtly mistreated in this hospital and patients are medically well attended to. Although we saw no physical abuse, we noted the silence in the ward. Beside medical related interactions, we also noted that there were limited interactions between the women and the health care providers. Conclusions Silence can be a form of neglect as it leaves the women feeling uncared for and not seen. In an overburdened health care system where both staff and patients are often overwhelmed or traumatised, silence can be a way in which a system defends itself against what it knows it cannot provide.http://link.springer.com/article/10.1186/s12914-019-0218-2South AfricaObstetric violenceMilieuNeglectQualitative
spellingShingle Maura Lappeman
Leslie Swartz
Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital
BMC International Health and Human Rights
South Africa
Obstetric violence
Milieu
Neglect
Qualitative
title Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital
title_full Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital
title_fullStr Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital
title_full_unstemmed Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital
title_short Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital
title_sort rethinking obstetric violence and the neglect of neglect the silence of a labour ward milieu in a south african district hospital
topic South Africa
Obstetric violence
Milieu
Neglect
Qualitative
url http://link.springer.com/article/10.1186/s12914-019-0218-2
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