The release of the new National Integrated Maternal and Perinatal Care Guidelines (IMPCGs) marks a pivotal moment for women’s healthcare in South Africa.
These guidelines introduce much-needed reforms in the areas of respectful maternity care, maternal mental health and intimate partner violence. For women across the country, this is a significant step toward ensuring that their health and well-being are prioritised and protected.
“Good maternal health is a basic human right,” says Associate Professor Simone Honikman, founder and director of the Perinatal Mental Health Project (PMHP), a Cape Town-based organisation that played a crucial role in developing the IMPCGs.
“And these guidelines will ensure that right is better upheld.”
The guidelines, which took over two years to draft, involved a consultative process with researchers, healthcare providers, NGOs, and other key stakeholders.
They build upon the Maternal, Perinatal, and Neonatal Health Policy 2021 and represent one of the most comprehensive overhauls in maternal health policy in the country’s history.
Why the IMPCGs matter
Women’s health is under the spotlight as the government launches the fifth edition of the National Integrated Maternal and Perinatal Care Guidelines.
This latest version introduces significant advancements that were missing in previous editions, particularly in the areas of respectful care, maternal mental health and intimate partner violence.
Respectful maternity care
One of the most groundbreaking aspects of the new guidelines is the focus on Respectful Maternity Care.
South African healthcare facilities have long been criticised for instances of disrespect and abuse toward pregnant women, including verbal and physical mistreatment during childbirth.
The 2017 version of the guidelines only briefly touched on this issue but the new IMPCGs make it a central focus.
By addressing these violations, the guidelines aim to improve the quality of care women receive, ensuring that healthcare workers treat patients with dignity and compassion.
This is not just a matter of ethics, it’s critical for improving maternal outcomes. Studies have shown that disrespectful care can deter women from seeking prenatal and postnatal care, which can lead to complications that might otherwise have been prevented.
Maternal mental health
Maternal mental health has been largely overlooked in previous healthcare guidelines, but the new IMPCGs bring it to the forefront. Depression and anxiety are common during and after pregnancy, affecting one in three women in South Africa.
These mental health issues can lead to negative outcomes for both the mother and the baby, including difficulties in bonding, delayed infant development, and even maternal suicide.
Honikman points out that these conditions are often linked to social factors such as poverty, domestic violence and a lack of social support.
“As we have a relatively high uptake by women of Maternal and Child Healthcare services in this country, these services are uniquely placed to bring about a substantial positive transformation in the lives of millions of women,” she said.
“We have the opportunity to shift the vicious cycles of adversity and mental health problems into virtuous cycles of psychosocial wellbeing.”
The guidelines stress the need for integrated mental health support within maternal care services.
This means that healthcare providers will be trained not only to identify mental health issues but also to provide immediate support or refer women to specialised services when necessary.
Intimate partner violence
Another key addition to the IMPCGs is the focus on Intimate Partner Violence (IPV). Approximately 25% of South African women experience violence from their partners during or after pregnancy, a statistic that underscores the urgency of addressing this issue.
IPV is linked to a range of adverse outcomes, including mental health challenges, physical injury, and even maternal mortality.
Integrating IPV screening and support services into maternal care, the guidelines aim to protect women from harm and ensure that healthcare providers are equipped to offer help when needed.
This is a major step forward in a country where domestic violence is often under-reported and inadequately addressed.
South Africa’s maternal health crisis
South Africa’s maternal health statistics highlight the need for urgent action. According to 2022 data, the country has a maternal mortality ratio (MMR) of 109.6 deaths per 100,000 live births, far higher than the target of less than 70 by 2030. In comparison, the United Kingdom boasts an MMR of just 13.41.
The high maternal mortality rate in South Africa is a stark reminder of the disparities in healthcare access and quality.
The IMPCGs represent a critical tool for addressing this crisis. By improving the quality of care, tackling mental health issues, and addressing violence, the guidelines aim to reduce preventable maternal deaths and improve outcomes for both mothers and babies.