Editorial Note
At Hello ICON, we believe everyone has an art, and for some, their art is advocacy. This feature is adapted from the reference article “OBSTETRIC VIOLENCE: Nigeria’s Invisible Human Rights Crisis” by legal creative Ifechi Aleke Esq. of Lawyers Alert. In her work, she uses her art, the law, to spotlight Nigeria’s invisible crisis of dignity in childbirth and call for a more humane system.
OBSTETRIC VIOLENCE
Despite Nigeria’s commitment to reducing its high maternal mortality rate, policy discussions and interventions are often focused on the availability of medical services while overlooking the quality, dignity, and respect with which women are treated during pregnancy and childbirth.
Although the concept of respectful maternity care as a universal human right gained formal global recognition in September 2014, when the World Health Organization declared that “every woman has the right to the highest attainable standard of health, including the right to dignified and respectful care during pregnancy and childbirth;” evidence from different regions of Nigeria indicates that obstetric violence and other forms of disrespectful maternity care remain widespread in healthcare facilities.
According to Naiyeju et al. (2024), findings from a cross-sectional study carried out in Lagos show that 82% of women experienced at least one form of disrespect and abuse during childbirth, with non-consented care and abandonment or neglect being the most frequently reported forms.
Similarly, in research carried out by Farouk et al. (2021) in Kano State, there is an overall obstetric violence prevalence of 32.3% among women in Kano, increasing to 48.6% among those who delivered in hospitals, with neglect and abandonment emerging as the most common manifestations. Likewise, Nwafor et al. (2022) reported that 47.6% of women who delivered at a tertiary hospital in Abakaliki experienced disrespectful maternity care and abuse, including detention for inability to pay hospital bills (40.2%), non-dignified care (37.2%), physical abuse (34.1%), and non-consented care (20.1%).
Despite the above findings and numerous media reports and investigated stories documenting obstetric violence cases, including one published by BBC Africa, no judicial precedent or legislation defines or expressly prohibits “obstetric violence” in Nigeria. Also, no hospital or medical practitioner has been held accountable for the commission of obstetric violence. The term itself is rarely used in Nigeria’s public discourse because many women perceive abusive treatment during childbirth as inevitable rather than unlawful. Cultural expectations surrounding childbirth, fear of retaliation by healthcare providers, poor complaint mechanisms, and limited public awareness, particularly among women in rural communities and other underserved populations, have all contributed to the normalization of practices that would otherwise be recognized as violations of human rights. As a result, many women regard harsh treatment during labour and childbirth as a standard part of the birthing process rather than as conduct that infringes upon their dignity and fundamental rights.
Although Nigerian law does not expressly recognize “obstetric violence” as a distinct legal concept, acts and conducts constituting obstetric violence violate sections 33, 34 and 37 of the Constitution of the Federal Republic of Nigeria, 1999 (as amended), which guarantee the right to life, the right to the dignity of the human person, and the right to privacy. Also, the National Health Act 2014 further reinforces patients’ rights by requiring informed consent before treatment, except in limited emergencies, and prohibiting the refusal of emergency medical treatment.
In addition, Nigeria has also ratified several international and regional human rights instruments that impose obligations on the State to protect women’s rights to health, dignity, equality, bodily integrity, and freedom from cruel, inhuman, or degrading treatment, including the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the African Charter on Human and Peoples’ Rights, and the Protocol to the African Charter on the Rights of Women in Africa (Maputo Protocol).
Beyond these provisions of the constitution and the National Health Act, there is an urgent need for a law or national guidelines explicitly prohibiting disrespect and abuse during childbirth in Nigeria. There is also a need to establish confidential and accessible complaint mechanisms within healthcare facilities, as few victims who are aware of their rights rarely report abusive treatment due to fear of retaliation or the belief that no meaningful remedy exists.
The fight against the high maternal mortality rate in Nigeria does not only require timely clinical and medical interventions at the time of birth but also respect for the dignity, autonomy, and fundamental human rights of every pregnant woman and girl during childbirth. Every woman has the right to experience pregnancy and childbirth free from abuse, coercion, humiliation, and neglect.
