By Caroline Katana
As Kenya continues to make strides in improving maternal healthcare, experts are warning that many women leave maternity wards carrying invisible wounds that extend far beyond childbirth.
During a webinar organized by the Coalition Action for Preventive Mental Health Kenya (CAPMHK) and the Kenya Legal and Ethical Issues Network on HIV & AIDS (KELIN) to mark World Maternal Mental Health Day, legal experts, mental health practitioners, and journalists raised concerns over the growing prevalence of obstetric violence — a form of gender-based violence experienced by women during pregnancy, childbirth, and the postpartum period within healthcare settings.
The discussions highlighted that despite progress in reducing maternal mortality, many women continue to face disrespect, abuse, discrimination, and neglect while seeking maternity services.
According to legal experts, obstetric violence remains largely hidden despite being widespread across healthcare facilities.
Speaking during the webinar, Melinda Mugambi, Program Officer for Strategic Litigation at KELIN and an Advocate of the High Court of Kenya, described obstetric violence as a systemic and multidimensional form of gender-based violence embedded within healthcare systems.
“It affects women differently depending on factors such as age, disability, socioeconomic status, HIV status, and ethnicity,” she said.
Obstetric violence can manifest in various forms, including physical abuse during labour, verbal humiliation, medical procedures performed without informed consent, discrimination, detention in health facilities over unpaid medical bills, and denial of emergency obstetric care.
Despite its prevalence, Kenya has no specific legislation criminalizing obstetric violence.
As a result, survivors seeking justice must rely on constitutional provisions that guarantee the right to health, human dignity, privacy, freedom from torture, and protection from discrimination.
Mugambi cited landmark court cases that have shaped accountability in maternal healthcare, including rulings involving the forced sterilization of women living with HIV and a 2023 judgment against Bungoma County Referral Hospital, where a woman was verbally and physically abused after delivering on a hospital floor.
The court found the state liable for failing to provide respectful maternal healthcare, reinforcing the government’s obligation to safeguard women’s rights during childbirth.
However, survivors often encounter significant barriers when pursuing justice, including high legal costs, lengthy court processes, inadequate evidence, limited cooperation from healthcare providers, and the normalization of abusive treatment during childbirth.
While physical injuries may heal, experts warned that the psychological consequences of obstetric violence can persist for years.
Agnes Gathemia, Maternal Mental Health Lead at CAPMHK, said many women experience profound emotional trauma after being ignored, shamed, threatened, or subjected to medical procedures without their consent.
Research presented during the webinar showed that 48 percent of mothers seeking services at Pumwani Maternity Hospital reported pregnancy-related anxiety.
Nationally, nearly 30 percent of women describe childbirth as traumatic, while approximately 20 percent develop Post-Traumatic Stress Disorder (PTSD) following traumatic birth experiences.
Mental health experts noted that traumatic maternity care often triggers acute stress responses which, if left unaddressed, can develop into postpartum depression, anxiety disorders, PTSD, birth trauma, and difficulties bonding with newborns.
The long-term effects, they said, can be devastating.
Some women avoid future pregnancies, withdraw from healthcare services altogether, or struggle with diminished self-worth and confidence.
“Individual counselling alone is not enough if the systems causing the trauma remain unchanged,” Gathemia emphasized.
She called for the integration of routine mental health screening into antenatal and postnatal care and urged stronger collaboration between maternity and mental health services.
Healthcare workers, she added, should receive training on trauma-informed care grounded in the principles of safety, trust, choice, empowerment, collaboration, and cultural sensitivity.
The webinar also examined the role of the media in exposing obstetric violence while ensuring survivors are protected from further harm.
Veteran health journalist Angela Kezengwa of Royal Media Services, who has publicly shared her own experience with postpartum depression, noted that many women fail to report violations because mistreatment during childbirth has become normalized.
“Maternal care is not only about surviving childbirth. It is also about dignity, respect, and humanity,” she said.
Kezengwa argued that psychological abuse often goes unnoticed because it leaves no visible injuries, making it more difficult for families, healthcare systems, and journalists to identify.
She urged journalists to adopt trauma-informed reporting practices when covering maternal health issues.
These include obtaining informed consent, protecting identities when necessary, avoiding intrusive questioning, and focusing on systemic failures rather than sensationalizing survivors’ suffering.
According to Kezengwa, investigative journalism has a critical role to play in documenting patterns of abuse, demanding accountability from health institutions, and amplifying the voices of women whose experiences are often overlooked.
She also encouraged greater use of community radio stations, podcasts, and digital platforms in local languages to break the silence surrounding maternal mental health and obstetric violence.
Participants in the webinar called for urgent policy and health system reforms to address obstetric violence and its mental health consequences.
Among the key recommendations were the enactment of legislation recognizing obstetric violence as a distinct violation of human rights, mandatory mental health screening during pregnancy and after childbirth, enhanced training for healthcare workers on respectful maternity care, stronger referral pathways between maternity and mental health services, and the adoption of survivor-centered reporting standards within the media.
As Kenya works toward improving maternal health outcomes, experts argued that success should not be measured solely by the number of women who survive childbirth, but also by whether they are treated with dignity, respect, and compassion throughout the process.
For many women, the struggle does not end in the delivery room. The emotional scars left by obstetric violence can linger long after childbirth, affecting families, communities, and future generations.
The challenge now, stakeholders say, is ensuring that every woman receives not only safe medical care but also the respect, dignity, and humanity she deserves.
