OPINION: Every woman deserves a safe and respectful birth

There is a core issue in the Zambian health system that numbers alone cannot show. It is not simply a shortage of drugs or ambulances, but the need to give dignity to the many women who still give birth in environments that deny them privacy and respect. In these life-defining moments, the system can fail them through lack of equipment and, equally, through lack of humanity.

Respectful Maternity Care (RMC) poses a radical but simple question: what would maternal health look like if every woman were treated as fully human? The answer could transform our health system more profoundly than any single reform or policy.

Zambia has made strong progress in recent years. Maternal mortality has fallen, driven by political commitment, better services and strong partnerships across the country. More women now deliver with skilled care, yet the experience inside delivery rooms still varies widely. For many, the biggest concerns remain transport, the equipment available on arrival and, above all, the way they are treated once they enter the facility.

The Hidden Cost of Disrespect

Every story of a mother shouted at during labour or left unattended because she is “not cooperative” reveals a deeper injustice that is both gendered and systemic. 

Disrespect in maternity wards mirrors long-entrenched power imbalances, reflecting how women are valued, how health workers are trained and how leadership defines accountability. 

If women cannot expect dignity in childbirth, what faith can they have in the broader social contract?

Respectful Care as a Measure of Justice

A nation that invests in maternity annexes but not in the empathy, communication and accountability that make those spaces humane risks building walls instead of bridges. That is why we must shift the conversation from access alone to the quality of the experience. 

Tone of voice, privacy and respect for consent are not minor details; they are indicators of justice.

The Politics of Care

Zambia’s reforms, from the Zambia Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition Roadmap (2022–2026) to the RMC Roadmap, provide a strong policy foundation. But policy must now give way to political will that prioritizes funding for postnatal care, accountability for mistreatment and incentives for kindness.

Parliamentary oversight in maternal and adolescent health is essential to ensure that investments in annexes through the Constituency Development Funds (CDF) are matched by systems that value respectful practice. 

Parliamentarians, civil society and communities must push for CDF budget oversight and quality of care to include emotional safety and informed consent as measurable outcomes. 

Midwives as the Moral Centre of Health Systems

In every health facility, midwives carry the moral weight of the system. They are the bridge between a woman’s body and the bureaucracy of care. When they are undertrained, overworked or undervalued, respect is often the first casualty.

Empathy must be taught and supported as rigorously as any clinical skill. This requires integrating respectful care into curricula, supervision and performance standards, and creating spaces where midwives can debrief, reflect and learn from both medical outcomes and the emotional journeys of the women they serve. 

Protection is also part of empowerment: midwives who speak out against abusive practices need institutional backing.

From Policy to Power

Too often, women, especially those from rural or marginalized communities, enter health facilities stripped of respect. Changing this dynamic requires redistributing power: training health workers in rights-based approaches, involving communities in service design and giving patients accessible channels to voice complaints and expect redress.

For decades, maternal health progress has been measured by survival. That remains vital, but survival is the baseline, not the goal. The next challenge is ensuring women emerge from childbirth respected and supported. 

RMC should be embedded in the DNA of the health system, and data on dignity should inform national indicators alongside mortality and morbidity.

Political Leadership for Women’s and Adolescents’ Health

President Hakainde Hichilema’s pledge to build maternity annexes in every constituency has created momentum across the country. 

When confidence in the system grows, it strengthens every part of our democracy. Now we must ensure that these annexes become sanctuaries of dignity and not just structures of service. 

Through the Parliamentary Caucus on Sexual and Reproductive Health, Zambia is shaping political leadership and accountability for women’s and adolescents’ health. 

The Caucus is deepening MPs’ understanding of the value of investing in health as a form of capacity development and is helping to align national priorities with community needs.

Maternal health does not end with childbirth. We must also focus on postnatal care so that mothers and newborns continue to receive the support they deserve once they leave the delivery room.

The Future We Must Build Together

Respectful maternity care is a national test of empathy and equity. No woman should die giving life, and no woman should lose her dignity doing so. The future of Zambia’s maternal health lies not only in the strength of our hospitals but in the gentleness of our hands.

As Zambia strengthens its health system and lives up to its political commitments, renewed collaboration among parliamentarians, civil society and health professionals offers a clear path forward. 

Integrating respectful and quality care into broader system-strengthening efforts will help ensure that maternity annexes across all constituencies become fully operational and truly serve every woman. Wherever she lives, every woman deserves to give birth in safety and dignity.