Women and girls in Malawi continue to face obstetric violence abuse, and mistreatment when seeking reproductive health services, according to the Malawi Human Rights 2025 Report.
The report shows that the country’s maternal mortality rate remains high at 381 deaths per 100,000 live births, placing Malawi among the top 25 countries globally with the highest maternal mortality rates.
Supporting data from a 2017 Biomedical Center Silesia study, which observed 2,109 maternal care interactions across 40 health facilities, revealed that while most women were greeted respectfully, 13.9% were not. Moreover, 73.1% of women were denied privacy, and 58.2% were not encouraged to have a support person during delivery.
A report by the Office of the Ombudsman, ‘Woes of the Womb’, investigated medical malpractices involving uterine removals in public hospitals and highlighted systemic gaps in reproductive healthcare. The Medical Council of Malawi recorded nine cases of malpractice in 2017 and ten between 2018 and 2019.
The Young Women’s Consortium on Sexual and Reproductive Health and Rights (YOWCO) says obstetric violence (defined as mistreatment and violence against women during childbirth) remains one of the biggest barriers to safe and quality reproductive care.
YOWCO legal consultant Zaithwa Milanzi said that despite 96% of women giving birth under skilled attendance and 97% delivering in health facilities, Malawi’s maternal mortality rate remains alarmingly high, pointing to poor quality care.
“Obstetric violence is a key contributing factor to this persistence. The violence manifests in various forms including, verbal abuse, physical mistreatment, neglect and denial of care, discrimination, forced procedures such as episiotomies as highlighted by the 2019 report from the Office of the Ombudsman, among others,” she said.
Milanzi noted that overburdened facilities, provider burnout, power imbalances and harmful cultural norms all contribute to obstetric violence and substandard care.
“YOWCO engages comprehensively with various local stakeholders to advance reproductive rights and health on human rights advocacy groups, community leaders, healthcare providers, government officials and the Malawi Law Commission to advocate for the revision of the Termination of Pregnancy (ToP) bill so that the power to choose to have an abortion lies with the individual seeking the service, regardless of circumstances,” she said.
She added that more young women and girls must be empowered to champion sexual and reproductive justice, create demand for SRHR services, and promote awareness at the community level.
Frolence, a Standard 7 learner at Kalulu Primary School in Lilongwe, stressed the need for widespread awareness among adolescent girls about the dangers of child marriage and teenage pregnancy.
“Sometimes child marriage contributes to violence against women because most of them do not know their rights and also it’s a pity that most parents force their daughters into abusive marriage,” she said.
Christopher Kandionamaso, Health Systems Advisor for Ipas Health Africa, called for greater investment in promoting girls’ rights to reduce vulnerabilities.
“We need to critically examine the challenges faced by girls and consider how we can address them, promoting girl child empowerment, and ensure the fulfilment of their human rights. The consequences of unintended pregnancies and child marriages leading to unsafe abortions are deeply concerning,” he said.
