/ 7 May 2021

What do mothers really want?

(John McCann/M&G)
(John McCann/M&G)

If you have a mother in your life, you might be feeling a mild sense of panic, wondering what to get her for Mother’s Day this Sunday. Will a card and flowers suffice, or is there an expectation of something grander? 

But what do mothers really want?

As much as we love the expressions of gratitude, we, the movement members of Embrace, would prefer a vibrant and honest conversation about the problems facing mothers in South Africa. And based on these conversations, collective action to drive structural change to address these challenges to improve the lives of mothers for our own and our children’s sake.

Here are a few suggestions of where to start:

Talk with us, not about us

Mothers need a seat at the tables where decisions that will affect their lives and those of their children are made.

In late March last year, Covid-19 hit South Africa hard. To ease the effect of the economic fallout on the most vulnerable South Africans, child support grant beneficiaries received top-up support, and an additional social grant, the Social Relief of Distress Grant, was made available. Despite the fact that women and mothers bore the brunt of the economic fallout caused by the pandemic, there was no grants or top-up funding to meet the unique needs of pregnant women.

Pregnancy is a time of increased vulnerability and cost. Mothers have increased nutritional requirements and need the means and the time to attend regular antenatal care appointments. The lack of social infrastructure ignores the reality of pregnant mothers who care for unborn children. Although our national and provincial legislative authorities publicly advocate for expanded child-focused services during the first 1 000 days, there seems to be little acknowledgement of the fact that those days begin at conception, and that critical developmental processes take place while the child is growing in the mother’s body. Support for pregnant women — especially during the crisis precipitated by the pandemic — seems a no-brainer

If pregnant women had been at the table, would the care of their unborn children have been supported?

Ask better questions

South Africa measures the health of its maternity care services by counting the dead emerging from such care. Every three years, the National Committee on Confidential Enquiries into Maternal Deaths releases the Saving Lives report. This details the proportion of perinatal fatalities caused by avoidable factors, including obstetric conditions (such as gestational diabetes, preeclampsia or HELLP syndrome) and the level and quality of perinatal care received. The enquiries committee asks what the healthcare system could have done differently to prevent each case of avoidable maternal and/or perinatal infant death.

There is evidence that the recommendations from the Saving Lives reports have led to significant improvements to our systems of antenatal care, and have helped to reduce the number of mothers and infants dying during pregnancy and birth. But this does not address the fact that many pregnant and recently postpartum mothers suffer from poor health as a result of ill-treatment during and after pregnancy.

 We must also ask if the quality of the care led to the best possible health outcomes for the mother-child dyad. Too many mothers are treated inhumanely during their pregnancies and while giving birth. The effects of this on mothers’ and children’s health can be devastating. The health problems in the country are exacerbated by the effects of neglect during pregnancy and birth. Without asking about how we develop a standard of care that prioritises health outcomes — not just the absence of death — we will not adequately address this problem.

Leave your assumptions about poverty at the door

In spite of research findings that reveal the opposite, South African society continues to believe myths about our welfare system and the citizens who are beneficiaries of it. Research by organisations such as the Health Systems Trust and Africa Check reveals that, for example, the child support grant:

●  Is overwhelmingly going to caregivers who live with the children for whom the grant is paid;

●  Where there are significant uptake rates, reduces levels of nutritional stunting in children, and improves overall health outcomes; and

●  Does not provide teenage mothers with a perverse incentive to get pregnant — only 20% of teenage mothers claim the child support grant, and only 5% of all grant recipients are teenage mothers.

 These assumptions may seem harmless — other than their contribution to continued social stigmas and prejudice. But they slow down mobilisation for public political support for further welfare provisions, such as the maternity support grant. Instead of focusing on improving our systems of disbursement, the debate remains stuck on issues that have been resolved by the research. Such support makes a difference in the lives of poor South Africans, and abuse of such support is neither widespread nor is it responsible for continued social ills.

 Count all of mothers’ work

Research by the Counting Women’s Work (CWW) initiative shows that standard measures of national productivity tend to exclude domestic labour, or “household production”, the bulk of which is performed by women. Economic productivity measures that fail to take such activity into account mismeasure the full economic contribution of women. This work includes childcare — women are disproportionately responsible for childcare and housework during their reproductive years. This means women drop out of the mainstream workforce and formal education at disproportionate rates, and are less likely to regain the access to the formal economy that this may facilitate.

 The CWW suggests policy interventions to support the domestic labour of women and to ensure that it does not unduly limit re-entry into the non-household workforce. Examples of this include tax rebates for stay-at-home parents. In countries such as Ireland, stay-at-home parents, regardless of gender, can claim up to 1200 euros a year in tax credits. This recognises the work they are doing in the home and eases the financial burden on the parent who is working outside the home. In other countries, such as Sweden, working parents are entitled to up to 12 months of paid family leave. Mothers who take such leave are more likely to return to work outside the home. In addition, such leave is also available to fathers, meaning that mothers are not necessarily the default primary caregiver.

 Understand our power (and where we don’t have it)

In the first 1 000 days of a child’s life, health practitioners have, on average, 20 days when they might interact with the child. The child’s mother is generally present for the full 1 000 days, making her the expert on her child. This expertise, which is crucial to any interventions aimed at facilitating healthy early childhood development, is often overlooked. Mothers say their concerns are dismissed by authority figures such as health professionals and ward councillors. Poor and working-class mothers often bear the worst of these dismissive attitudes. Mothers do not require perfect language skills or a formal education to mother their children well. But the reality is that without these things, they are often rendered powerless in the systems meant to serve them and their families.

 As mothers, we know better than most that our children are the future, and we appreciate the outpourings of gratitude for our role in shaping that future. But we also want you to know: gratitude alone is not enough — not while pregnant mothers go hungry; not while one in three mothers suffer from mental health disorders during and after pregnancy; not while teenage girls cannot get basic reproductive healthcare services, and not while it is possible for a woman to be beaten while she is labouring.

 Happy Mother’s Day.