Maternal healthcare for women globally needs improvement

Ifeanyi M. Nsofor
By Ifeanyi M. Nsofor

Dr Ifeanyi M. Nsofor is the Senior Vice President for Africa at Human Health Education and Research Foundation. He is a Senior New Voices Fellow at the Aspen Institute, a Senior Atlantic Fellow for Health Equity at George Washington University and an Innovation Fellow at PandemicTech You can follow him on Twitter @ekemma.

Posted on Wednesday, 27 April 2022 14:31

Serena Williams at the 94th Academy Awards at Dolby Theater on March 27, 2022 in Los Angeles, CA Photo via Newscom - ©2022 Kathy Hutchins / Hutchins Photo/

Serena Williams, one of the greatest tennis players in history, almost died due to blood clots after giving birth. The life-threatening blood clot wasn’t the problem. The problem was her nurse’s refusal to listen to her cry for help.

Williams had enough presence of mind to insist, and she was lucky that her doctor listened and agreed to a CAT scan, which confirmed her fears.

There are several ways blood clots could be fatal or debilitating. Primarily, blood clots block blood from getting to organs of the body. This could lead to stroke in the brain, heart attack in the heart, loss of limbs in arms and legs and death of lung tissues in the lungs. Simply put, blood clots are life-threatening and may also lead to lifelong complications. Williams gave birth and then saved her own life.

Reading Williams’ account of this near-death experience was chilling. If a woman as rich and powerful as her could not get her nurse to listen to her cry for help, what is the fate of a poor black woman?

Healthcare for black women

Indeed, sadly, Williams’ experience is the norm among African-American women, as these kinds of discriminatory practices disproportionately affect women of colour in the US.

According to the Kaiser Family Foundation, black women are three times more likely to die during pregnancy compared to white women.

In Africa, the percentage of maternal deaths is even higher. Seven hundred women die during pregnancy and childbirth in the US. In Nigeria, 58,000 women die yearly (an average of 160 per day).

Health workers not listening to the concerns of women is a global issue.

Health workers not listening to the concerns of women is a global issue. A systematic review of interactions between maternal health care providers and pregnant women during the pregnancy, delivery and postnatal periods across Asia, Africa and Latin America revealed damning results.

For example, a pregnant woman in South Africa said: “If you air your views or your opinion, they laugh at you and ridicule you.” Other findings of this review included women being shouted at, slapped and threatened.

Respectful maternity care

Women know their bodies better than anyone else. The principle of body autonomy must be upheld. During pregnancy, childbirth and the postnatal period, health workers must respond to the concerns of women by showing empathy, listening and acting. Health workers must deliver respectful maternity care.

Respectful maternity care is a human right of every woman of childbearing age. It promotes practices that recognise women’s preferences and needs, and that of their newborns. Respectful maternity care must protect women against physical, sexual, and verbal abuse, stigma and discrimination, failure to meet professional standards of care, and poor rapport between women and providers.

Williams’ experience ended well, but that is not the case for many women. Patient-centred care is the way to ensure every woman is accorded respectful maternity care that would lead to better outcomes for mother and child.

Patient-centred care

The United States Institute of Medicine defines patient-centred care as providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions. This literally means building healthcare delivery around the patient.

I agree that hospitals should be guided by sound patient-centred care policies. Patient-centred care should not be left to the whims of health care workers.

Such policies should define what patient-centred care means, expectations of health workers, routes for clients to make complaints and give feedback on the quality of care received and punitive measures to be meted out when a health worker provides any care that is below standard. These policies must be reviewed periodically, guided by client satisfaction interviews. 21st-century healthcare must be patient-centred, safe, effective, efficient, equitable and timely. These six attributes are non-negotiable.

Client services

Every hospital must have a client services department. If other service-based sectors such as banking, and telecommunications consistently look for ways to get client satisfaction feedback and use it to improve services, there is no reason hospitals should not do the same.

When clients complain of disrespectful maternity care, it must be investigated by hospital authorities. This should be done while protecting the rights and, in some instances, the anonymity of clients. In the event that a client dies, it becomes a criminal offence and must be reported to the police and the health worker involved prosecuted.

Williams spoke up and that’s what saved her. Every woman must be empowered to speak up without any fear of retribution. No woman should die while trying to give life.

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