Obstetric violence: A scandal hindering women’s reproductive justice today

This year will mark 70 years since the historic 1956 Women’s March, as President Cyril Ramaphosa noted in his 2026 State of the Nation Address.

On 9 August 1956, more than 20,000 women marched to the Union Buildings in Pretoria to protest against the extension of pass laws to women. The march was led by activists such as Lilian Ngoyi, Helen Joseph, Rahima Moosa and Sophia Williams-De Bruyn.

The march also became associated with the enduring rallying cry “Wathint’ abafazi, wathint’ imbokodo” or “You strike a woman, you strike a rock” – a phrase that has since become synonymous with the strength and resilience of women in South Africa’s struggle for justice.

The Women’s March remains one of the most powerful examples of how women’s movements have challenged injustice and forced political change in South Africa. As the President noted in his address, women “…have made enormous sacrifices in our struggle for freedom” and “women have always been at the forefront of change, ready to stand up, speak out and never back down in the fight for justice”.

Seventy years later, two things remain clear. Women continue to face profound injustice in this country. They remain disproportionately affected by gender-based violence, earn less than men, have fewer opportunities in the labour market and continue to shoulder the vast majority of unpaid care work. Yet, women also remain a powerful force for change. The words “You strike a woman, you strike a rock” are as true today as they were in 1956.

In many ways, this is a hopeful story. Across the country, women’s movements continue to organise, speak out and demand change.

Maternal health advocacy

One area where women’s movements have recently forced public recognition of injustice is in relation to violence against women during pregnancy and birth. Movements such as Embrace: The movement for Mothers, with their members and partner organisations, show how collective action can expose injustice and push institutions to respond.

Briefly, Embrace began in 2014 as a small effort to connect people across socioeconomic, geographic and racial divides to build networks of care for mothers. What started as a local initiative in Cape Town has since grown into a national movement.

Today, Embrace brings together mothers and birthing individuals, civil society organisations, practitioners, academics and allies from across South Africa who are working collectively to improve maternal care and advocate for respectful treatment during pregnancy and childbirth.

Obstetric violence in SA

One of the issues that Embrace and its partners have helped bring into the public conversation is obstetric violence. Obstetric violence is abuse or neglect that many women and birthing individuals experience during pregnancy and childbirth in healthcare settings. Obstetric violence can take many forms, including procedures performed without consent (like being sterilised), verbal abuse, neglect during labour or the denial of dignity and respect during one of the most vulnerable moments in a woman’s life.

For many years, these experiences were dismissed as isolated incidents or attributed to overstretched public health services. Yet women’s movements have long used a combination of protest, advocacy, research, storytelling and (where necessary) litigation to make hidden harms visible and demand accountability. Through these strategies, organisations such as Embrace and its partners have helped expose the systemic nature of obstetric violence.

A form of gender-based violence

One of the earliest and most significant moments came in 2022 at the Second Presidential Summit on Gender-Based Violence and Femicide. There, Embrace, with women from partner organisations such as Section27, Women’s Legal Centre, and the Centre for Applied Legal Studies, successfully advocated for obstetric violence to be included as a form of gender-based violence.

This recognition was incorporated into one of the summit’s resolutions, which called for strengthened state accountability in addressing violence experienced by women in reproductive and maternal healthcare settings.

Alongside its advocacy at the Presidential Summit, Embrace also launched a documentary called Push Comes to Shove – Stories of Obstetric Violence, in which survivors recount their experiences of mistreatment and violation during pregnancy and childbirth.

The documentary created an important platform for women to share their stories and articulate their demands for dignity and justice. It also helped open broader conversations about maternal care, bringing together mothers, doulas, healthcare and legal practitioners to reflect on how maternity services can better respect women’s rights and bodily autonomy.

Respectful care

Advocacy by Embrace and its partners has also contributed to shifts within the health sector itself. The National Integrated Maternal and Perinatal Care Guidelines for South Africa now emphasise the importance of respectful maternity care, recognising that women have the right to dignity, informed consent and supportive treatment during pregnancy and childbirth.

On 27 February 2026, women from across Gauteng joined Embrace’s #LaundryDay protest outside the Department of Health in Tshwane. The protest included survivors, allies, as well as solidarity from women’s movements such as the Woman Affected by Mining United in Action (Wamua).

Embrace invited its members to write their experiences of obstetric violence on hospital bed sheets, which were then hung on washing lines outside the department’s offices. The symbolism was deliberate.

For years, survivors of obstetric violence have been made to feel as though these experiences were something to hide, as if the “dirty laundry” belonged to them.

But the protest made clear that the real stain lies with the failures of the health system. The laundry was not the survivors’ shame, but the Department of Health’s.

Sexual and Reproductive Justice Strategy

By a striking coincidence, this continued work by women’s movements coincides with the Cabinet’s approval of South Africa’s Sexual and Reproductive Justice Strategy, circulated by the Department of Social Development on 2 March 2026.

The strategy adopts a rights-based and intersectional approach to sexual and reproductive health, and calls for stronger coordination across government and civil society to address structural inequalities, gender-based violence and barriers to accessing reproductive healthcare.

As Mark Gevisser and Katie Redford observe in the maxim behind their book, The Revolution Will Not Be Litigated, “it takes a lawyer, an activist and a storyteller to change the world”. The phrase captures an important truth: meaningful social change rarely comes from a single voice or strategy. Women’s movements have long understood this, drawing on their networks to organise protest, advocacy, research, storytelling and litigation to expose injustice and push institutions to respond.

Widespread abuse

It is in this spirit that Embrace launched its Extent and Nature of Obstetric Violence in South Africa report on 11 March 2026 at the University of the Witwatersrand. Based on interviews with 845 women in Gauteng and KwaZulu-Natal who had given birth in the past decade, the report provides empirical weight to the stories, advocacy and organising described above.

The findings reveal how widespread obstetric violence is within our maternity wards. The most alarming finding is that 60% of women experienced some form of obstetric violence during childbirth. According to the report, this represents an estimated 1.79 million women who may have suffered this harm in the past 10 years.

The report also confirmed that around 25% of women giving birth were not asked for consent before a medical procedure was performed on their bodies, and almost 20% of women were denied pain medication during labour.

When almost 1.8 million women have already been harmed within maternity wards, this cannot solely be attributed to overstretched health services; this reflects a profound failure of accountability within the health system to acknowledge these women as human and worthy of dignified treatment.

But the report also tells another story – that the mothers who bring life into this nation are not simply passive victims.

Through organising, storytelling, research and protest, they have forced this issue into the public light. Seventy years after women marched to the Union Buildings demanding justice, mothers across South Africa continue to insist on dignity in the spaces where life begins.

Through their movements, they have shaped the democracy we live in today and they continue to fight to build a more just democracy for the future.

As the women of 1956 declared: “Wathint’ abafazi, wathint’ imbokodo” – “you strike a woman, you strike a rock”. DM

Dr Sheena Swemmer is the head of the Gender Justice programme at the Centre for Applied Legal Studies, Wits University.