By Chipo Tsitsi Mlambo
On November 26, 2024, as I prepared to address the issue of obstetric violence against pregnant children, a significant case emerged. Sixteen-year-old Tariro* (not her real name) went into labor and arrived at the home of one of our Purple Door Advocates, who promptly escorted her to the local clinic. A few hours later, I received a call from our community advocate informing me that Tariro had been advised her baby was too large for a normal delivery and required a C-section at the hospital. To facilitate her transfer, she needed $40 for an ambulance—money I did not have. I escalated the matter to a senior government official, and shortly thereafter, Tariro was en route to the hospital.
However, before her transfer, the nurse reprimanded her for seeking assistance from “your people—Vanhu vako ivavo,” claiming it attracted unnecessary attention to her and the clinic. This was Tariro’s second pregnancy; she had lost her first child just last year. Sadly, mistreatment and being treated as adults is a common experience for vulnerable pregnant children in Zimbabwe.
Obstetric violence—defined as mistreatment and abuse during pregnancy, childbirth, and postpartum care—is an under-recognized form of gender-based violence (GBV) that disproportionately affects pregnant children and teenage mothers in Zimbabwe. At its core are power imbalances, discrimination, and systemic neglect, which exacerbate the physical and emotional challenges faced by pregnant girls under 18, violating their rights to dignity, safety, and equitable healthcare.
For the pregnant girls we assist at RhoNaFlo, pregnancy often results from coerced sexual activity, exploitation, or early marriage—each linked to gender-based violence. When they seek maternal care, they frequently encounter further harm within clinical settings. The very caregivers who should support them often become perpetrators of abuse. Reports of verbal mistreatment, neglect, and even physical abuse during childbirth are alarmingly common. Statements like “Maimhanyirei—Why did you rush into sex?” are frequently directed at these young mothers. Instead of offering the compassion and care they need, healthcare providers sometimes dismiss their pain or blame them for their circumstances.
Earlier this year, a 16-year-old in our program delivered her own baby at a clinic. She recounted how nurses ignored her pleas for help, instead scolding her for “wanting sex early—Kuda zvevakuru.” She repeatedly told them her baby was coming, only for a nurse to respond dismissively, questioning how she could know better than a trained professional. The nurse then went to rest, only taking action after the girl had delivered her baby and cried out for help once more.
A critical factor worsening the vulnerability of pregnant minors is their adultification in clinical settings. Despite their young age and limited life experience, they are often perceived and treated as adults solely because they are pregnant. This perspective disregards their biological age and mental maturity, stripping them of the special protections they deserve. Instead of receiving age-appropriate care, they are subjected to unrealistic expectations—to endure medical procedures and maternal responsibilities with the resilience of adults.
Such mistreatment during pregnancy and childbirth can have lasting effects, including birth trauma, postpartum depression, distrust in the healthcare system, and deep-seated feelings of humiliation and unworthiness. In Zimbabwe, where thousands of young girls become pregnant each year, obstetric violence requires urgent attention. The intersection of gender-based violence, child rights violations, and systemic healthcare failures underscores the need for holistic reforms.
We must train healthcare workers to provide child-sensitive care, eliminate retaliation against those who report abuse, and ensure that medical facilities are safe for all pregnant mothers. The normalization of verbal abuse and mistreatment in maternity wards must end.
As a maternal health advocate, I recognize that obstetric violence also undermines efforts to promote facility-based deliveries. Pregnant minors often discourage one another from seeking care at clinics and hospitals, fearing mistreatment, and instead turn to community-based traditional birth attendants. This choice, however, can have devastating consequences for both mother and baby.
It is critical to acknowledge obstetric violence as a form of gender-based violence, as this recognition is key to addressing its root causes. Zimbabwe’s pregnant children deserve dignity, respect, and support—not scorn and mistreatment. Addressing this issue goes beyond healthcare reform; it is a necessary step toward protecting children and breaking the cycle of violence against girls.
Pregnant minors should not fear healthcare providers when seeking care in health facilities. I urge our clinicians to remember their training:
DO NO HARM.
