Sampada Anuranjanee Khatiwada

Pregnancy is the most crucial phase in every woman's life, both, physically and emotionally. During pregnancy, expectant mothers require utmost care from everyone around her, especially from her family, colleagues and health service providers.
Regular prenatal and postnatal care is important during and after pregnancy. During pre and postnatal care visits, health practitioners like doctors, nurses and midwives perform regular check-ups as to prevent potential risks throughout and after pregnancy.
It is essential for the mother and infant to receive health practitioner's guidance for having a smooth experience of safe pre-pregnancy, pregnancy and birthing process.
In the context of Nepal, The Constitution of Nepal, 2015, Article 38 (2) has guaranteed every woman's right to safe motherhood and reproductive health.
Section 6 and 7 of The Right to Safe Motherhood and Reproductive Health Act, 2018, has obliged health institutions and trained and competent health workers to provide appropriate counseling relating to health care to expectant mothers.
The Act also asserts that safety measures and minimum care to be given must be provided to women during pregnancy and every health workers must provide obstetric care in respectful manner.
Even though the legislations relating to safe motherhood have explicitly guaranteed expectant mothers' right to be cared and treated in a chivalrous manner, the laws doesn’t seem to be executed adequately.
Sita Phuyal, 38, said, "I gave birth to my first child six years ago in one of the famed hospitals of Kathmandu."
"After immediately being rushed to the hospital during my labor, it took two hours for the hospital staffs to arrange a bed for me," said Phuyal. "I was in extreme pain and was crying restlessly."
Phuyal said that the medical professional completely trivialised her. "They were acting as if it was their everyday scene and I wasn’t being treated with respect."
Every mother requires care and affection during birthing as she is already going through a lot of pain. Rather than being mocked or discouraged, she should be encouraged during her birthing, to ensure healthy delivery.
Upon asking Phuyal if she was aware about her right to safe motherhood and right to be treated respectfully, she was astonished and said that she was unaware about her rights.
Shiwani Poudel, 34, on the other hand said that she didn’t have any horrid experience and was treated in a courteous manner during her birthing. "I think since I went to a private clinic for my prenatal and postnatal care, I was received respectfully. I am sure this is not the case everywhere."
"I have seen nurses and mid-wives in hospital being rude to the expectant mothers. This is the reason I chose private clinic for my pre/post natal care," said Poudel.
Dr. Laxmi Tamang, President, Midwifery Society of Nepal (MIDSON), said that cent per cent violence existed in the service, that doctors, nurses and mid-wives provided to women at their pre and post natal stage.
"Women, throughout their pregnancy, during their birthing and even after their birthing play a submissive role, they are often ill-treated by the health professionals," said Tamang. "Anecdotally speaking, especially in the rural context, full autonomy is given to auxiliary nurses and mid-wives during birthing," said Tamang. "Inexperienced health workers mostly are involved while delivering infants, this further increases chance of new mothers being misbehaved."
Tamang also said that the mothers-to-be were not awarw about their legal and constitutional rights. "Majority of women themselves do not know about their right to get obstetric care during their pregnancies," she said. Women being unaware about their reproductive rights and right to safe motherhood and inexperienced and untrained health workers are the major reasons that the services provided to mother-to-be aren’t up to the mark.
Tamang said that strong implementation of safe motherhood legislations was vital to ensure rights of expectant mothers. Effective collaboration must be done between ministerial level and national level as to overcome problems associated with birthing. In India, safe motherhood campaign is run under PM Modi's programme, same needs to be done in Nepal, said Tamang. Campaigns to promote safe motherhood targeting both, service receivers and service providers should be done under Prime Minister's initiative, she added.
Providing proper training to mid-wives, nurses and other health workers about respectful maternity care is also necessary. "Practical training should be viewed with much importance over theoretical training," said Tamang.
The plight of ill birthing practices by health service providers will come to an end only when both, service receivers become clued up about their legal and constitutional rights and providers about their duties.