Health care is a basic human right, not a privilege. But in far too many parts of the globe, that simply isn’t the reality—especially if you are a pregnant woman. According to the World Health Organization, approximately 800 women die every day worldwide from pregnancy complications.
So many of these deaths are avoidable—but the governments responsible for ensuring that women’s health and human rights are respected and protected have been asleep at the wheel.
In Kenya, President Uhuru Kenyatta directed all Kenyan public health care facilities to offer free maternity health care services as of June 1, 2013. But the government has failed to issue clear guidelines on how to implement this directive, and the reality is that pregnant women are still being forced to pay for maternal health services—even medications. Moreover, some women have faced being illegally detained at the hospital until they can settle their bill. Others experience abuse and neglect, including physical abuse, at maternity hospitals.
In the cases of Margaret and Maimuna, these women were held against their will after giving birth at a local Kenyan hospital when they couldn’t pay their medical fees. Margaret was detained for nearly a week, ending up with a ruptured bladder after being left unattended and bleeding on a bench for hours on end. Maimuna was held for 20 days after delivering her baby, sleeping on a cold floor next to a toilet while her other children were left at home unattended.
Then there’s the story of Josephine Majani, a pregnant woman who was physically and verbally abused by nurses and repeatedly denied quality medical care at another Kenyan hospital last year. Not only was she forced to buy the medicine necessary to induce her labor, but she was neglected, despite requesting care—ultimately collapsing and giving birth on the hospital floor when she tried to walk by herself to the delivery room. And as if that experience weren’t tragic enough, two nurses later slapped and verbally abused Josephine because she dirtied the floor when she delivered her baby. Despite the emotional scarring inflicted, the hospital administration has not apologized for the abuse or made any attempt to support Josephine’s recovery to date.
These women’s experiences reflect those of countless more pregnant women whose health and human rights have been disregarded by a lack of quality care in Kenyan hospitals and failure to effectively implement policies that protect patients. Which is exactly why the Center for Reproductive Rights has brought two cases before the High Court of Kenya in the last two years to hold hospitals and government officials accountable for the ill treatment these women endured and the violations of human rights guaranteed to all under Kenya’s constitution and international law.
The truth is, Kenya is not alone in its mistreatment of pregnant women. On the other side of the globe, more than 4,000 Brazilian women die from pregnancy complications every year—most of which could be prevented if only quality medical care was accessible. Although Brazil has reduced its maternal mortality rate in the last decade, maternal mortality remains the leading cause of death among women of childbearing age, disproportionately affecting low-income, Afro-Brazilian, indigenous women, and those living in rural areas and the Brazilian North and Northeast.
Alyne da Silva Pimentel, a 28-year-old Afro-Brazilian woman, was six-months pregnant with her second child when she died in November 2002—five days after she initially sought medical attention for her high-risk pregnancy. First, she was turned away from a hospital after experiencing severe nausea. Then, two days later, after her condition worsened, doctors finally determined that her fetus had died and induced labor. Her health condition severely deteriorated, but she suffered nearly 24 hours of delays for the medical treatment that could have saved her life. But it was too late.
In 2011, United Nations Committee on the Elimination of Discrimination against Women (CEDAW) declared Brazil responsible for the death of Alyne and called on the state to provide access to quality maternal health care without discrimination. And in March 2014, the Brazilian government finally took a first step to implement the CEDAW decision, providing Alyne’s mother with monetary reparations—making Brazil the first country to ever pay reparations for a maternal death. In addition, a plaque telling Alyne’s story was placed on April 3 at a maternity ward in Nova Iguaçu Hospital that was renamed in her honor last year. It’s an historic moment, but Brazilian officials still have a lot more work to do to ensure quality maternal health care is guaranteed for all Brazilian women.
All women deserve quality maternal health care when they need it—no matter where they live, their income, or their ethnic background. And every government has an obligation to ensure that women can obtain that care when they need it.
On this International Day of Action for Women’s Health, it’s time we remind world leaders that women’s health, dignity, and lives must be prioritized—along with the right to reproductive health care when they need it. Anything less demonstrates a violation of women’s fundamental human rights.