Sounding the Alarm: Government of the Republic of Namibia v LM and Women's Rights during Childbirth in South Africa

Authors

  • Camilla Marion Sperling Pickles Constitutional Court

DOI:

https://doi.org/10.17159/1727-3781/2018/v21i0a4303

Keywords:

Involuntary sterilisation, childbirth, informed consent, obstetric violence, capacity, human rights

Abstract

Government of the Republic of Namibia v LM [2014] NASC 19 (hereafter the LM case) concerns the involuntary sterilisation of women during childbirth. The Supreme Court of Namibia found that obtaining consent during the height of labour is inappropriate because labouring women lack the capacity to consent because of the intensity of their labour pains. This article recognises that the LM case may make its way into current litigation strategies against involuntary sterilisations in South Africa and for this reason I evaluate the soundness of the court's reasoning in the LM case. I argue that the court relied on the harmful gender stereotype that labouring women lack the capacity to make decisions, I expose this stereotype as baseless and demonstrate the harmful consequences of its perpetuation. Finally, I demonstrate why the reasoning in the LM case is particularly problematic in the South African context, and I conclude that the adoption of this sort of reasoning will result in many women facing serious injustices, because it strikes at the core of a woman's agency during childbirth.

 

Google_Scholar52.png  ScienceOpen_Log03431050.png

Downloads

Download data is not yet available.

Author Biography

  • Camilla Marion Sperling Pickles, Constitutional Court

    Camilla Pickles completed her LLD at the University of Pretoria, where she also obtained her LLB and research LLM (Public Law). Her research focuses on addressing pregnancy and birth-related concerns in through the application of criminal, medical, status and human rights law. Currently, she is a British Academy Postdoctoral Research Fellow at the Univeristy of Oxford. She served as a law research clerk for Chief Justice Mogoeng at the Constitutional Court of South Africa. She has held junior academic posts and occasionally assisted the South African Law Society and as a researcher. Camilla’s research has been presented at conferences and published in academic journals at both national and international level.

References

BIBLIOGRAPHY

Literature

Albertyn 2007 SAJHR

Albertyn C "Substantive Equality and Transformation in South Africa" 2007 SAJHR 253-276

Appelbaum 2007 N Engl J Med

Appelbaum PS "Assessment of Patients' Competence to Consent to Treatment" 2007 N Engl J Med 1834-1840

Badul and Strode 2013 AHRLJ

Badul CJ and Strode A "LM and Others v Government of the Republic of Namibia: The First Sub-Saharan African Case Dealing with Coerced Sterilisations of HIV-Positive Women – Quo Vadis?" 2013 AHRLJ 214-228

Bonnington et al 2013 Contraception

Bonnington A et al "Abortion Providers as Stigmatizers: Provider Judgment and Stereotyping of Patients Seeking Abortion" 2013 Contraception 443

Broaddus and Chandrasekhar 2011 Anesth Analg

Broaddus BM and Chandrasekhar S "Informed Consent in Obstetric Anesthesia" 2011 Anesth Analg 912-915

Brooks and Sullivan 2002 Int J Obstet Anesth

Brooks H and Sullivan WJ "The Importance of Patient Autonomy at Birth" 2002 Int J Obstet Anesth 196-203

Burrows 2012 Techné

Burrow S "Reproductive Autonomy and Reproductive Technology" 2012 Techné: Research in Philosophy and Technology 31-44

Cahill 1999 Nursing Ethics

Cahill H "An Orwellian Scenario: Court Ordered Caesarean Section and Women's Autonomy" 1999 Nursing Ethics 494-505

Carstens and Pearmain Foundational Principles

Carstens P and Pearmain D Foundational Principles of South African Medical Law (LexisNexis Durban 2007)

Casarett, Karlawish and Hirschman 2003 J Pain Symptom Manage

Casarett DJ, Karlawish JHT and Hirschman KB "Identifying Ambulatory Cancer Patients at Risk of Impaired Capacity to Consent to Research" 2003 J Pain Symptom Manage 615-624

Chadwick 2014 Afr J Midwifery Women's Health

Chadwick R "Raising Concerns: Quality of Care and Maternal Health Services in South Africa" 2014 Afr J Midwifery Women's Health 177-181

Chadwick, Cooper and Harries 2014 Midwifery

Chadwick RJ, Cooper D and Harries J "Narratives of Distress about Birth in South African Public Maternity Settings: A Qualitative Study" 2014 Midwifery 862-868

Cohen Shabot 2017 Eur J Women Stud

Cohen Shabot S "Constructing Subjectivity through Labour Pain: A Beauvoirian Analysis" 2017 Eur J Women Stud 128-142

Cook and Cusack Gender Stereotyping

Cook RJ and Cusack S Gender Stereotyping: Transnational Legal Perspectives (University of Pennsylvania Press Philadelphia 2010)

Cook, Cusack and Dickens 2010 Int J Gynaecol Obstet

Cook RJ, Cusack S and Dickens BM "Unethical Female Stereotyping in Reproductive Health" 2010 Int J Gynaecol Obstet 255-258

Cusack and Cook 2009 JCRSJ

Cusack S and Cook RJ "Stereotyping Women in the Health Sector: Lessons from CEDAW" 2009 JCRSJ 47-78

D'Gregorio 2010 Int J Gynaecol Obstet

D'Gregorio RP "Obstetric Violence: A New Legal Term Introduced in Venezuela" 2010 Int J Gynaecol Obstet 201-202

Dickens and Cook 2015 Int J Gynaecol Obstet

Dickens BM and Cook RJ "Patients' Refusal of Recommended Treatment" 2015 Int J Gynaecol Obstet 105-108

Dixon 2015 Med Anthropol Q

Dixon LZ "Obstetrics in a Time of Violence: Mexican Midwives Critique Hospital Practices" 2015 Med Anthropol Q 437-454

Donnelly 2007 JSIJ

Donnelly M "Assessing Legal Capacity: Process and the Operation of the Functional Test" 2007 JSIJ 141-168

Essack and Strode 2012 Agenda

Essack Z and Strode A "'I Feel Like Half a Woman All the Time': The Impacts of Coerced and Forced Sterilisations on HIV-Positive Women in South Africa" 2012 Agenda 24-34

Farrell and Pattinson 2004 SAMJ

Farrell E and Pattinson RC "Out of the Mouths of Babes – Innocent Reporting of Harmful Labour Practices" 2004 SAMJ 896-897

Flanigan 2016 Ethical Theory Moral Pract

Flanigan J "Obstetric Autonomy and Informed Consent" 2016 Ethical Theory Moral Pract 225-244

Gerancher et al 2000 Int J Obstet Anesth

Gerancher JC et al "An Evaluation of Informed Consent Prior to Epidural Analgesia for Labor and Delivery" 2000 Int J Obstet Anesth 168-173

Gillmor 2000 Int J Childbirth Educ

Gillmor M "The Hazards of Stereotyping" 2000 Int J Childbirth Educ 8

Glennon "Regulation of Reproductive Decision-Making"

Glennon T "Regulation of Reproductive Decision-Making" in Sclater SD et al (eds) Regulating Autonomy: Sex, Reproduction and Family (Hart Oxford 2009) 149-168

Halliday Autonomy and Pregnancy

Halliday S Autonomy and Pregnancy: A Comparative Analysis of Compelled Obstetric Intervention (Routledge London 2016)

Hastings, Nolte and Temane 2017 Women and Birth (in press)

Hastings-Tolsma M, Nolte AG and Temane A "Birth Stories from South Africa: Voices Unheard" 2017 Women and Birth (in press)

Heaton South African Law of Persons

Heaton J The South African Law of Persons 4th ed (LexisNexis Durban 2012)

Himonga "Persons and Family"

Himonga C "Persons and Family" in Du Bois F (ed) Wille's Principles of South African Law 9th ed (Juta Cape Town 2007) 145-404

Honikman, Fawcus and Meintjes 2015 SAMJ

Honikman S, Fawcus S and Meintjes I "Abuse in South African Maternity Settings is a Disgrace: Potential Solutions to the Problem" 2015 SAMJ 284

Hope 2005 Medicine

Hope T "Consent" 2005 Medicine 3-7

Jackson et al 2000 Can J Anesth

Jackson A et al "Informed Consent for Labour Epidurals: What Labouring Women Want to Know" 2000 Can J Anesth 1068-1073

Jewkes, Abrahams and Mvo 1998 Soc Sci Med

Jewkes R, Abrahams N and Mvo Z "Why do Nurses Abuse Patients? Reflections from South African Obstetric Services" 1998 Soc Sci Med 1781-1795

Johanson, Newburn and Macfarlane 2002 BMJ

Johanson R, Newburn M and Macfarlane A "Has the Medicalisation of Childbirth Gone too far?" 2002 BMJ 892-895

Kruger and Schoombee 2010 J Reprod Infant Psychol

Kruger L and Schoombee C "The Other Side of Caring: Abuse in a South African Maternity Ward" 2010 J Reprod Infant Psychol 84-101

Ladd 1989 Hypatia

Ladd RE "Women in Labor: Some Issues about Informed Consent" 1989 Hypatia 37-44

Lothain 2006 JOGNN

Lothain J "Birth Plans: The Good, the Bad, and the Future" 2006 JOGNN 295-303

Murphy 2009 Ave Maria L Rev

Murphy SD "Labor Pains in Feminist Jurisprudence: An Examination of Birthing Rights" 2009 Ave Maria L Rev 443-471

Nair 2010 Harv Hum Rts J

Nair P "Litigating against the Forced Sterilisation of HIV-Positive Women: Recent Developments in Chile and Namibia" 2010 Harv Hum Rts J 223-231

Nicholas and Nicholas 2010 TOG

Nicholas N and Nicholas S "Understanding the Mental Capacity Act 2005: A Guide for Clinicians" 2010 TOG 29-34

Patel 2017 Public Health Rev

Patel P "Forced Sterilization of Women as Discrimination" 2017 Public Health Rev 15-27

Pickles 2015 SAQC

Pickles C "Eliminating Abusive 'Care': A Criminal Law Response to Obstetric Violence" 2015 SAQC 5-16

Reid et al 2011 Aust N Z J Obstet Gynaecol

Reid R et al "The Ethics of Obtaining Consent in Labour for Research" 2011 Aust N Z J Obstet Gynaecol 485-492

Sekhar and Vyas 2013 Ann Med Health Sci Res

Sekhar MS and Vyas N "Defensive Medicine: A Bane to Healthcare" 2013 Ann Med Health Sci Res 295-296

Siegel 2008 Duke LJ

Siegel RB "The Right's Reasons: Constitutional Conflict and the Spread of Woman-Protective Antiabortion Argument" 2008 Duke LJ 1641-1692

Skegg 2011 U Queensland LJ

Skegg PDG "Presuming Competence to Consent: Could Anything be Sillier?" 2011 U Queensland LJ 165-187

Spence 2012 Cardozo JL & Gender

Spence RA "Abandoning Women to their Rights: What Happens when Feminist Jurisprudence Ignores Birthing Rights" 2012 Cardozo JL & Gender 101-123

Strode, Mthembu and Essack 2012 RHM

Strode A, Mthembu S, and Essack Z "'She Made Up a Choice for Me': 22 HIV-Positive Women's Experiences of Involuntary Sterilization in Two South African Provinces" 2012 RHM 61-69

Tan 2002 Singapore Med J

Tan N "Deconstructing Paternalism – What Serves the Patient Best?" 2002 Singapore Med J 148-151

Thornton and Moore 1995 Int J Obstet Anesth

Thornton J and Moore M "Controversies in Obstetric Anaesthesia" 1995 Int J Obstet Anesth 41-43

Van Oosten Doctrine of Informed Consent

Van Oosten FL The Doctrine of Informed Consent in Medical Law (PhD thesis, University of South Africa 1989)

Wei 2016 Legal Issues

Wei M "The Illusion of Choice – Have Enforced Caesarean Cases Introduced a New Class of Incompetent Adults?" 2016 Legal Issues 85-98

Case law

AB v Minister of Social Development 2016 2 SA 27 (GP)

AB v Minister of Social Development 2017 3 SA 570 (CC)

AS v Hungary Com No 4 2004 (CEDAW C/36/D/4/2004, 29 August 2009)

Bolton Hospitals NHS Trust v O [2003] 1 FLR 824

Castell v De Greef 1994 4 SA 408 (C)

Christian Lawyers Association of SA v Minister of Health 1998 4 SA 1113 (T)

Christian Lawyers Association v Minister of Health 2005 1 SA 509 (T)

Geldenhuys v Borman 1990 1 SA 161 (E)

Gonzales v Carhart 550 US 124 (2007)

Government of the Republic of Namibia v LM [2014] NASC 19

LM v Government of the Republic of Namibia [2012] NAHC 211

Masiya v Director of Public Prosecutions 2007 5 SA 30 (CC)

NB v Slovakia App No 29518/10 (ECtHR, 12 June 2012)

Norfolk and Norwich Healthcare (NHS) Trust v W (1996) 34 BMLR 16

President of the Republic of Republic of South Africa v Hugo 1997 4 SA 1 (CC)

Re L (1996) 35 BMLR 44

Re MB [1997] EWCA Civ 3093

Re T [1992] EWCA Civ 18

Rochdale Healthcare (NHS) Trust v C [1997] 1 FCR 274

S v Els 1993 1 SACR 723 (O)

S v Jordan 2002 6 SA 642 (CC)

S v Hangue 2016 JDR 0044 (NmS)

S v Rickerts 2016 JDR 0442 (Nm)

Tameside & Glossop Acute Services Trust v CH [1996] 1 FLR 762

VC v Slovakia App No 18968/07 (ECtHR, 8 November 2011)

Volks v Robinson 2005 5 BCLR 446 (CC)

Legislation

Children's Act 38 of 2005

Choice on Termination of Pregnancy Act 92 of 1996

Constitution of the Republic of South Africa, 1996

Mental Capacity Act, 2005 (UK)

Organic Law on the Right of Women to a Life Free from Violence, 2007 (Venezuela)

Partial-Birth Abortion Ban Act, 2003 (US)

Sterilisation Act 44 of 1998

Internet sources

Kangaunde and Tucker date unknown http://www.womenslinkworldwide.

org/files/gjo_summary_caseLMandOthersvNamibia_en.pdf

Kangaunde G and Tucker P date unknown Namibia SC Links Forced Sterilisation to Infringement of Constitutional Rights http://www.womenslinkworldwide.org/files/gjo_summary_caseLMandOthersvNamibia_en.pdf accessed 7 September 2016

HPCSA 2008 http://www.hpcsa.co.za/downloads/conduct_ethics/

rules/generic_ethical_rules/booklet_9_informed_consent.pdf

Health Professions Council of South Africa 2008 Guidelines for Good Practice in the Health Care Professions: Seeking Patients' Informed Consent: The Ethical Considerations http://www.hpcsa.co.za/downloads/conduct_ethics/

rules/generic_ethical_rules/booklet_9_informed_consent.pdf accessed 22 January 2018

Human Rights Watch 2011 https://www.hrw.org/sites/default/files/reports/

sawrd0811webwcover.pdf

Human Rights Watch 2011 Stop Making Excuses: Accountability for Maternal Health Care in South Africa https://www.hrw.org/sites/default/files/reports/

sawrd0811webwcover.pdf accessed 9 January 2017

WHO 2014 http://apps.who.int/iris/bitstream/10665/112848/1/978924

_eng.pdf?ua=1

World Health Organisation 2014 Eliminating Forced, Coercive and Otherwise Involuntary Sterilization http://apps.who.int/iris/bitstream/10665/112848/1/

_eng.pdf?ua=1 accessed 28 February 2016

Published

09-08-2018

Issue

Section

Case Notes

How to Cite

Pickles, C. M. S. (2018). Sounding the Alarm: Government of the Republic of Namibia v LM and Women’s Rights during Childbirth in South Africa. Potchefstroom Electronic Law Journal, 21, 1-34. https://doi.org/10.17159/1727-3781/2018/v21i0a4303

Similar Articles

261-270 of 1129

You may also start an advanced similarity search for this article.