Health workers have defended mistreatment of women during childbirth saying it “enhances the safety of the mother and baby”.
Many women, especially the young, also agree health workers are justified in pushing and slapping them around during childbirth.
In a national survey to determine why abuse during childbirth is still rampant, health workers interviewed said it is justified and guarantees women cooperate and focus on the birth process.
“Ideally, any mother who has delivered in a hospital is slapped around to encourage her to push because if the mothers do not push, the danger is obvious,” explains a health worker.
The report published on March 28, 2017 and which the Ministry of Health is party to, gives credence to recent episodes where self-confessed local nurses exposed their professional misconduct in social media.
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In January, during the doctors’ strike, some unidentified nurses went on Twitter and Facebook under #nursesfromhell bragging how they mistreat their patients.
The Director of Medical Services and the Nursing Council of Kenya have since said they are investigating the matter and will take action.
Ironically both the government and various national nurses’ groups have been sitting on evidence showing extensive patient mistreatment by health workers.
Last year, the Ministry of Health, National Nurses Association of Kenya, the Federation of Women Lawyers and the American NGO Population Council published data showing one in five women giving birth in local hospitals is humiliated, abused and asked for a bribe.
The data had been collected from 13 facilities in Kisumu, Kiambu, Nyandarua and Uasin Gishu, along with one maternity hospital in Nairobi.
The 13 comprised three referral hospitals, three district hospitals, two faith-based hospitals, two maternity homes, and one health centre.
Alarmed by the findings, the Population Council has now reanalysed the data to find out why the practice persists and the possible cure.
In their findings published last week in the journal BMC Pregnancy and Childbirth, the four authors say the problem is not just severe, it is also complicated by workers and even patients who claim it is justified.
Some health providers, the report says, did not perceive slapping clients as dehumanising, but considered it an act to help the woman save her life and that of the baby.
Many women who talked to the researchers reported this as normal and expected. “She slapped me on the thighs and tossed me around in an unfriendly manner, but this is normal,” said a mother.
But this still failed to sufficiently explain the behaviour especially when it became life-threatening.
For example, patients and their spouses told of cases where women scheduled for caesarean surgeries were made to wait for hours or a whole night for doctors on call to arrive.
However, not everybody goes through this humiliation as the authors found out. With a Sh200 bribe put in the right hands, things were seen to move faster and even ensured a woman did not share a bed with other patients.
“I took my wife to hospital on a motorbike and since I knew it would take long, I gave the nurse Sh200 to attend to her well. You must stretch your hand for quick processing,” revealed a husband.
The worst affected are young single girls who are thought by health workers to have been careless and deserving of some pain.
Women told of their horrific experiences in teaching hospitals where many interns poke them anyhow and disrespectfully.
Mothers who are in their third or more births are left to sort themselves out because nurses say they are experienced and know what to do.
Tribalism was also found to play a role in how women are treated while giving birth. If you come from a different tribe from the health provider, you are most likely ignored or asked to pay a bigger bribe.
“If you are not of her tribe then she will treat you badly,” said a respondent who had gone through the rude process.
The authors led by Timothy Abuya of Population Council, Nairobi, recorded cases where women skipped the nearest facility because it had workers from a different tribe.
In October 2013, the Government launched a Patients’ Rights Charter, which is supposed to protect patients against abuse.
However, medical experts say there has been no effort to enforce the charter or educate Kenyans on what to do if their rights are violated.