Reproductive Justice and the Constitutional Promise to Zimbabwean Women

(Rights-based maternal care for every woman in Zimbabwe)

Introduction

Giving birth is arguably one of the most profound moments in a woman’s life, yet everyday countless Zimbabwean women are met with neglect, discrimination or disrespect in maternity wards (Gwatidzo et al., 2019). “Birth with dignity” encompasses the right of every woman to be treated with respect, to make informed choices about her care and to receive that care in a safe and supportive environment (World Health Organization, 2018).

Constitutional Protection

Section 76(1) of the Constitution of the Republic of Zimbabwe (2013) guarantees each citizen and permanent resident of Zimbabwe the right to have access to basic healthcare services, including reproductive healthcare services (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, s. 76(1)). This provision is not merely symbolic but is a binding law. When read along broader constitutional commitments to dignity and equality such as section 51 which provides that, “Every person has inherent dignity in their private and public life, and the right to have that dignity respected and protected”, section 56(1) which affirms that, “All persons are equal before the law and have the right to equal protection and benefit of the law” and section 80(3) which guarantees that, “All laws, customs, traditions and cultural practices that infringe the rights of women conferred by this Constitution are void to the extent of the infringement”- it becomes clear that birth with dignity is not a luxury but a right (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, ss. 51, 56(1), 80(3)).

To get a better understanding of the right to a dignified birth, we need to view it through the lens of Reproductive Justice, a framework which affirms that women have the right to have a child, the right to not have a child and the right to raise a child in safe and supportive environments (Ross & Solinger, 2017) . Reproductive Justice therefore is centred on equality, autonomy and respect, which aligns with Section 76. The Constitution already affirms that women have the right to a dignified birth, the work remains to ensure that this is upheld in practice.

Section 76(1) and (4) guarantee the right to have access to basic healthcare services, including reproductive healthcare services and it further protects the right to emergency medical treatment and obliges the State to take reasonable legislative and other measures to progressively realize these rights within available resources (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, ss. 76(1), 76(4)). “Access” is not only limited to physical entry into a building or facility, but it extends to safety, equality and non-discrimination. Access therefore means if a pregnant unmarried or disabled woman seeks care at a healthcare facility, she is treated fairly, without any harassment or discrimination because of her marital status or physical disability (Gwatidzo et al., 2019). Dignity, consent and equality must be upheld at all times.

Section 51 guarantees the right to human dignity, while section 56 prohibits discrimination and section 80 affirms the right to equality in all spaces (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, ss. 51, 56, 80). All these provisions form a legal framework which recognizes and affirms women’s equality in all spheres, including maternity wards. Therefore, “Birth with dignity” is embedded in the supreme law of the Republic of Zimbabwe, it is not a foreign concept, merely borrowed from global discourse.

Reproductive healthcare is broad and includes antenatal care, labour and delivery services, postnatal care and many more systems which support maternal well-being (World Health Organization, 2018; UNFPA, 2022).

Reproductive Justice

Reproductive Justice insists that women have a right to have children, a right to not have children and a right to parent children in safe and supportive environments, therefore expanding the conversation beyond just access to healthcare or reduction in maternal mortality (Ross & Solinger, 2017). This framework profoundly resonates with the principle of Ubuntu- I am because we are (Mbiti, 1969). As the Shona proverb reminds us, munhu munhu nekuda kwevamwe vanhu, a person is a person through the goodwill of others (Mbiti, 1969). Historically, childbirth embodied this ethic through collective care and maternal wellbeing has always been a collective responsibility, not an individual one (Mbiti, 1969). Women laboured within supportive spaces, with the understanding that birth leads to the sustenance of a whole society. When women are stripped of their dignity during this period of their lives, it does not only violate individuals, but the community as whole. The moral fabric of the community is fractured. Therefore, such treatment is not only unconstitutional in terms of section 76 of the Constitution (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, s. 76) but also culturally discordant with the values of Ubuntu which have existed within society for generations (Mbiti, 1969).

Colonisation disrupted these communal systems of maternal care. Authority shifted from relational, community-based female networks to institutional hierarchies. Modernity further fragmented extended family structures through urbanisation and economic pressures. While institutional healthcare has improved clinical outcomes (WHO, 2018), it has sometimes failed to retain the relational ethos that once defined maternal care.

Current challenges

Despite Constitutional protections, women in low income and rural areas often face challenges such a traveling long distances to maternity facilities, understaffed and ill-equipped facilities and a lack of privacy at these facilities (Gwatidzo et al., 2019; WHO, 2019). Young, unmarried, disabled or marginalized women may experience verbal abuse, coercion or disregard for their preferences due to stigma and an and unawareness from some healthcare providers of Section 76 and the requirement to provide, respectful maternal care (Gwatidzo et al., 2019).

The disconnect between law and practice is clear, highlighting the need for section 76 to be central in advocacy relating to this issue (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, s. 76). Section 76 obliges the State to take reasonable legislative and other measures to progressively realize these rights within available resources (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, s. 76(4)). In practice, this means that the State has to:

• Strengthen accountability mechanisms in healthcare facilities and ensure accessible complaint and redress systems for women whose rights are violated (Gwatidzo et al., 2019).
• Address systemic resource inequities and the legacy of colonial healthcare disparities in infrastructure (WHO, 2019; UNFPA, 2022).
• Provide gender-sensitive training for healthcare professionals (WHO, 2018).
• Address cultural practices that undermine women’s autonomy (Mbiti, 1969).
• Address economic inequalities that limit women’s healthcare choices (UNFPA, 2022).

The State must move from a place of passive acknowledgement to a place of active transformation by aligning Policy with Section 76 through:

• Increased budget allocations to maternal health (UNFPA, 2022).
• Community engagement strategies grounded in Ubuntu (Mbiti, 1969)
• Legal enforcement mechanisms for respectful maternity care (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, s. 76).
• Bridging Law and Lived Realities

It is not sufficient for Section 76 to simply be there in writing, it has to be applied to the lived experiences of the women in Zimbabwe. Civil society organisations, healthcare professionals, communities and policymakers all have a role to play. Women must be aware that equality in childbirth is not a luxury but a right. Healthcare workers must play their role in providing respectful care and the courts must be prepared to uphold women’s rights were they are violated (Constitution of Zimbabwe Amendment (No. 20) Act, 2013, s. 76; Gwatidzo et al., 2019).

Conclusion

Birth with dignity is not simply a moral ideal; it is a constitutional and cultural imperative in Zimbabwe. Section 76 of the Constitution guarantees women equality in all spheres, including the right to access reproductive healthcare, while sections 51, 56 and 80 reinforce dignity, non-discrimination and equality. Yet legal guarantees alone are insufficient if they do not translate into respectful, safe and supportive maternal care.

Reproductive justice provides the framework to emphasise women’s rights to make autonomous decisions about childbirth and to raise children within secure and supportive communities. This approach aligns with the principles of Ubuntu, recognising that maternal wellbeing is a communal responsibility: “munhu munhu nekuda kwevamwe vanhu”,  a person is a person through the goodwill of others. When women are denied dignity during childbirth, the harm is not only to the individual, but to the social fabric that binds communities together.

Addressing the persistent gaps between law and lived experience requires proactive state action: strengthening healthcare infrastructure, training professionals in respectful care, addressing inequities and fostering community-based support systems. Civil society, healthcare providers and policymakers all have a role in ensuring that the constitutional promise of equality is realised in practice.

Ultimately, a dignified birth is a measure of a society that values both its women and its communities. Ensuring that every woman in Zimbabwe can experience childbirth with respect, autonomy and support is not just a legal obligation, it is a moral, cultural and social imperative. Birth with dignity is equality in action and Section 76 provides the blueprint to make it a reality.

References

Constitution of Zimbabwe Amendment (No. 20) Act, 2013 (Zimbabwe).

Gwatidzo, S. D., et al. (2019). Respectful maternity care in Zimbabwe: A review of maternal
health practices. BMC Pregnancy and Childbirth, 19(1), 1–9.

Mbiti, J. S. (1969). African religions and philosophy. Johannesburg: Heinemann.

Ross, L., & Solinger, R. (2017). Reproductive justice: An introduction. University of
California Press.

United Nations Population Fund. (2022). State of world population 2022. UNFPA.
World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive
childbirth experience. https://www.ncbi.nlm.nih.gov/books/NBK513809/

World Health Organization, UNICEF, UNFPA, World Bank Group, & United Nations
Population Division. (2019). Trends in maternal mortality 2000–2017. https://www.unfpa.org/sites/default/files/pub-pdf/Maternal_mortality_report.