A 22-year-old woman from Musina has accused staff at Messina Hospital of negligence after she was allegedly left to give birth on her own in a general ward, without medical assistance. Her premature baby was born without a heartbeat.
Monica Madumi, who was five months pregnant at the time, was admitted to the hospital on the evening of 28 June after her water broke. Although a doctor initially said everything appeared normal, Madumi was later informed that her womb had begun opening and that a miscarriage was likely.
She claims her condition deteriorated overnight, with repeated calls for help ignored by staff. When she eventually went into labour, she said she delivered the baby on her own in bed before a passing nurse noticed and fetched help.
“I pushed on my own. The baby came out, but the head was still inside. A nurse walked past and saw me, then ran to get help,” Madumi recalled.
She alleges that hospital staff were dismissive of her pleas and even chastised her afterwards for initially refusing labour-inducing medication, which she declined at first based on advice from her mother.
Her mother, Precious Madumi, said this was not the first time the hospital had failed her daughter. “She was forced to carry a deceased foetus for almost a week the last time she miscarried here. She got an infection. Now it’s happened again.”
The family believes her treatment may have been influenced by her previous miscarriage at the same hospital.
Limpopo Department of Health Response
Neil Shikwambana, spokesperson for the Limpopo Department of Health, confirmed that the department had received a formal complaint from the patient’s fiancé.
“Our preliminary checks indicate that the patient was attended to accordingly,” he said. “The hospital had sufficient staff on the night in question, three professionals were on duty for 25 inpatients across male and female wards.”
Shikwambana said that while the patient had initially refused induction medication, she was later placed on a drip and induced.
He added that the patient and her family were referred for psychological support, which they declined, and that the department’s complaint management team was investigating the matter further.
SAMA weighs in
Health-e News sought expert opinion from the South African Medical Association (SAMA) to explore the legal and ethical grey areas raised in this case, particularly around the implications of patients refusing treatment in high-risk hospital settings.
“Refusing care does not mean healthcare workers walk away,” said Dr Mzulungile Theo Nodikida from SAMA.
He emphasised that while patients have a legal right to refuse treatment, especially if they are mentally competent, that refusal does not strip the hospital of its duty to provide ongoing support and basic medical care.
“Healthcare workers must ensure that refusal is informed, documented, and doesn’t result in abandonment,” said Dr Nodikida. “If a patient is left to deliver alone despite being in active labour, and there’s no record of monitoring or staff response, then even a refusal of induction cannot shield a hospital from accountability.”
According to SAMA, under the National Health Act (Section 6(1)(d) and Section 7), patients must be properly informed of the risks of refusing treatment, particularly in emergencies such as obstetric complications.
“Clinicians must explain risks thoroughly and use support staff or interpreters if needed,” said Dr Nodikida. “In maternal-foetal cases, the stakes are higher, and extra steps must be taken.”
He said it is not enough to have a patient sign a form; clinicians must document the conversation in detail, confirm the patient understood the consequences, and ensure the person is still monitored.
“Refusal of one intervention doesn’t equal refusal of all care,” he added.
In disputes like this, SAMA explained that both medical and legal reviews examine more than just whether treatment was refused. They look at staff responsiveness, documentation, the level of patient monitoring, and whether the refusal was truly informed.
“If a patient is left alone, bleeding heavily, delivering without assistance, that is a red flag, regardless of whether she refused induction,” said Dr Nodikida.
“Hospitals can still be held liable if basic duties were neglected.”
SAMA advises members of the public to actively engage with medical staff and ask questions before refusing any form of treatment. At the same time, they urge healthcare workers to never view a refusal as an excuse to disengage.
“Informed consent is not a once-off signature, it’s an ongoing conversation,” said Dr Nodikida. “And compassion must remain the cornerstone of care, especially in childbirth.”
The association says that proper documentation, continued support, and patient monitoring are essential for both patient safety and legal protection.
The Limpopo Department of Health says its investigation is ongoing, and remedial action will be taken if shortcomings are found.-Health-e News
