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'I saw death’: Kenyan mothers narrate horror stories in labour rooms
Pregnant woman visits a doctor. Healthcare providers perpetrated obstetric violence
What you need to know:
- Kenyan women face abuse, neglect, and trauma during childbirth, exposing systemic obstetric violence in health facilities.
- Obstetric violence leaves mothers traumatised, babies harmed, and accountability largely absent across systems.
When Julia from Kisumu started experiencing labour pain early last year, it could not overshadow her joy. She was excited that she would soon be a mother and looked forward to the moment she would deliver and hold the baby in her arms.
Full of hope, Julia went to hospital ready to give birth. However, she was shocked by the treatment she got. “I was about to give birth and kept telling the nurses to attend to me, but they were just talking about their sweet moment in catching up and laughing. Without notice, my newborn arrived and slid down the table to the floor. The nurse started abusing me, asking why I did not notify them that I was about to have the baby,” Julia tells the Nation.
It was her first childbirth. She was shocked by the mistreatment she received. More than 300km away in Nairobi, the experience was no different for Beryl. She recounts going to hospital in 2023, having gone into labour. However, she would stay with labour pain for days. Her frantic requests to doctors to have a Caesarean section done, as she had already lost the amniotic fluids, fell on deaf ears—until there was no foetal movement.
“When the foetal movements stopped, they rushed me to the theatre as an emergency. The labour wasn't progressing either. I saw death. By mistake, they cut some veins and only noticed when stitching the opening, so they had to restart. It was such a long time before they took me back to the theatre,” Beryl says.
The ordeals of the two mirror those of many other women in health facilities. Obstetric violence refers to a form of mistreatment and abuse that women undergo during pregnancy, childbirth, and postpartum period. A survey has lifted the lid off the high obstetric violence prevalence in Kenya.
The survey by Nguvu Collective, in conjunction with the Bright Harriet Foundation and LVCT Health Kenya, shows that 83 per cent of pregnant women who visited hospitals between 2018 and 2024 to deliver suffered violence. The survey interviewed 189 women from 27 counties. Sixty-two per cent of them reported psychological and emotional abuse such as disregard for needs and pain, verbal abuse and humiliation, dehumanising and rude treatment, and discrimination.
Ten per cent of those interviewed reported physical violence and coercion such as pressuring or manipulating them into accepting medical interventions or procedures they did not want or need, hitting, slapping, kicking, or restraining them. Another 28 per cent reported medical neglect, malpractice, and unnecessary interventions such as denial of care, unsanitary maternity settings, non-consensual pelvic exams, forced sterilisation, and unnecessary Caesarean section without medical justification.
Most incidents (55 per cent) were reported during childbirth, with respondents experiencing mistreatment. The report says 27 per cent of incidents occurred during pregnancy, highlighting that mistreatment is not confined to labour and delivery, while 14 per cent occurred during the postpartum period, underscoring the importance of addressing obstetric violence throughout the continuum of care.
Forty-six women who had experienced violence were aged 25–34. Further, 51 per cent came from low-income and below-poverty-line households. Fifty-nine per cent received care at public hospitals and 16 per cent at private hospitals. Additionally, obstetric violence incidents occurred in various healthcare settings, including health centres (4.0 per cent), maternity clinics (2.0 per cent), and faith-based hospitals.
Violence perpetrators
Multiple healthcare providers perpetrated obstetric violence. However, nurses led at 51 per cent. The survey found that 25 per cent of doctors (obstetricians/gynecologists) and 19 per cent of non-clinical staff such as receptionists, catering staff, maintenance and cleaning staff were also liable. It further shows 9.0 per cent of incidents reportedly resulted in infant death, while 13 per cent had a long-term negative impact on the child's health and development.
Another 21 per cent of incidents affected both mother and child’s health and development in the long run. About 13 per cent of the women reported that they were harmed and had physical injuries during childbirth. Of concern to the researchers was that 94 per cent of the women said they did not report their experiences to the authorities.
The common factor that influenced survivors' decision not to report was a feeling that nothing would be done about it, with 38 per cent of respondents citing this concern. Another 32 per cent said they feared retaliation or further mistreatment.
Ajra Abdullatif Mohamed, a partnerships specialist at Nguvu Collective, says even though the findings do not represent a national prevalence, they are deeply disturbing and mirror a growing crisis of dignity and accountability in maternal healthcare.
“At Nguvu Collective, we believe no woman should have to endure harm or humiliation when giving life. Obstetric violence is a human rights violation and thrives in silence, underreporting, and systemic neglect. Most survivors in our survey did not report their experiences because they believed nothing would change or feared retaliation,” Ajra said in an interview with the Nation.
To address the crisis, he has called for parliamentary action to pass the long-delayed Maternal, Newborn and Child Health Bill by Senator Beatrice Ogolla. He notes the need for mandatory training for all healthcare workers on respectful maternity care and trauma-informed practices.
“We also need stronger grievance mechanisms in hospitals and facilities where women can report obstetric violence safely and confidently. A cultural shift: We must move from normalising mistreatment to protecting dignity as a non-negotiable part of care. Allocating more money from the national and county budgets to free maternal healthcare,” he says.
Deborah Monari, a Nguvu change leader and survivor of medical negligence who participated in the survey, says obstetric violence should not be condoned in health institutions. “Healthcare workers who mistreat expectant mothers betray their sacred duty. No excuse justifies violating human rights. Accountability must be swift and uncompromising,” says Deborah, also a gender, health, and reproductive rights advocate from Nairobi working as a nurse.
In Kenya, it is inadequately addressed despite its widespread impact on maternal, infant, and child health. This can be attributed to its normalisation of victims’ silence. In 2014, Josephine, a victim, sought relief in court for violations meted out to her at Bungoma County Referral Hospital. She was supported to seek legal redress by the Center for Reproductive Rights, the Women’s Link Worldwide and the African Gender and Media Trust.
The court delivered a judgment in 2018. Justice Ali Aroni found the hospital liable for the violations and ordered it to pay damages. Dissatisfied with the decision, the county government appealed. The Court of Appeal in Kisumu recently said healthcare systems must respect women’s sexual and reproductive rights, and other constitutional rights like the right to dignity. “These rights are supposed to be immediate, not for progressive realisation,” the court said.
