The Knitting Midwife
A midwife sits in a dark room. She has a shawl wrapped around her shoulders. A candle flickers on the table. She is knitting. From another room, you hear the soft moan of a woman. The midwife continues knitting. The woman in the other room becomes silent again. The midwife continues knitting. After a few minutes, you hear the moan from the other room again and the midwife smiles to herself while she continues to knit. Some time goes by and the midwife gets up and leaves the room. She goes to the kitchen. You hear her switch on the kettle. The labouring woman continues to moan and groan – the pains seem to be intensifying. The midwife comes back with a steaming cup of tea and a plate of biscuits. She dips her biscuits and sips her tea. The labouring woman continues to moan softly in the next room. The midwife is sitting on a rocking chair and now she rocks herself quietly while the woman in labour continues with her noises. The midwife falls asleep. The midwife sleeps for a while… the mother’s noises intensify. The mother begins to shriek. She feels that the pain is too much. She is afraid that she is going to die. The midwife opens her eyes and quietly listens. She slowly gets up (her bones creak a little) and she shuffles out of the room towards the sounds of the labouring woman. Quietly, like a cat, the midwife slips into the room where the mother is. The mother is grunting and screaming and the baby is born. The baby is crying. The midwife comes out of the room. The mother is cooing to her baby. The midwife shuffles back to her chair, sits down, smiles softly to herself and continues to...
Read MoreSai Girl
This is story of my daughter Sai Ngiah’s birth eleven years ago on Tuesday 21 September 2004…she is my second child and my first daughter and she decided to emerge face to pubis, nine days after her ‘due date’ on Spring Equinox. I woke up at 12. Midnight. With pains. Ever increasing pains. And so woke Derek up. He sat up and rubbed his eyes. “ Are you sure?” he asked. “ Yes! It’s really sore this time!” He had reason to ask. For the last three weeks I had been having pangs of pre-labour. I had phoned the midwife (Karen) and my mother countless times. I decided to sit and wait a bit. Just to make sure. I didn’t really want to be caught crying wolf again… This baby’s gotta come out at some stage…it’s nine days overdue. The pains increased. I tried to lie down and rest but couldn’t. Instead, I wriggled around trying to breathe into the pain. I finally decided to phone Karen at two. She came around. “ These pains look more intense,” she smiled reassuringly. Karen checked how dilated I was, “ Three cm dilated ,” she said, pulling off her rubber glove. “ If I may, just give one piece of advice, don’t hold back with each contraction. Let go into it, you’ll find it goes much easier…” Karen smiled (her smile so reassuring), “you’re doing fine, I’ll come back later, phone me when you need me.” I phoned my mother. My mother asked, “are you sure?” I rolled my eyes and reassured her that yes, this time I was definitely in labour. Derek and I went downstairs (we didn’t want to wake San) and made a fire. The pains were increasing. I began to moan softly to myself. I breathed deeply and moved with each one. This labour felt so different from my first. I didn’t feel frightened. I didn’t feel scared. I didn’t feel bewildered. I didn’t feel freaked out by the pain. I allowed myself to go with each pain. I allowed each pain to take over my body. I rode it. And within that I felt unbelievably strong and powerful. The pains began to increase. Derek phoned Karen. My mother wasn’t there yet. Where was she? I phoned her. Between contractions. Just to check where she was. She answered her phone. Mumbling. Still fast asleep. “ Mom! It’s happening! Where the fuck are you?” “I’m still in Prince Alfred Hamlet,” she mumbled, “ I thought it was another false alarm when you phoned earlier, so I went back to sleep.” “Well, it’s happening and I need you to be here to look after San, so get moving!” I switched the phone off. I was livid. My mother! Karen arrived at about five. My mother soon after. My mother sat and watched me. Karen made tea. I squirmed and writhed on the floor. Derek held me. Breathed with me. Rubbed me. Spoke soothing reassuring words to me. I squirmed and writhed in pain. On the floor. On the mat. In front of the blazing fire. The pain increased. I began to do push-ups. I felt strong, so powerful. I grunted and moaned. My mother sat. On the red velvety piano stool. Her hands clutched between her thighs. Watching me. I wonder what she thinks and feels watching her daughter go through this? I sat. Kneeling with knees apart. Breathing softly. No pain. Relaxing. The pain starting again. It began to build up. Coursing through me. As the pain reached its crescendo, I jerked forward and arched my back. And roared....
Read MoreIn This Moment I can Only Love you.
In this moment I can only love you. I can only be there for you. Open my heart. And just be. Open. Empty. You grip my hand, tightly, your nails digging into my flesh. You are on your knees, on the floor. Your body bearing down. All concepts and ideas of how to birth are gone and all you can do is just be with your body. Allow your body to just take over. I am here. And yet I am not. I try to disappear because the space you are taking up is huge. Massive. The universe groans as it makes space for you to birth this baby. It does feel as though time suspends itself. It really does. Nothing else can exist in this moment. I have to become nothing. Empty. Open hearted. Here. and nowhere else. For you. You are incredible. Amazing. Did you know that you were capable of this? I am in awe. In this moment. I can only love...
Read MoreAnamboya means ‘midwife’ in Shona
I have heard about this Zimbabwean midwife in the informal settlement of Masiphumelele for about a year now. I have heard that she is a traditional midwife and that many women in the Zimbabwean community in Cape Town seek her out during their pregnancies for their births. I have also heard that she has expert fingers that can detect when a baby is lying breech and that those same nimble fingers can also turn the baby so that it can be born head first. Grace, who is also from Zimbabwe, and who lives on Red Hill, first told me about this midwife and Grace was the one who arranged for me to meet the midwife. On Sunday morning, I drove up to Red Hill and fetched Grace. Grace would take me to see the midwife and also act as interpreter, since the midwife spoke very little English. Grace’s sister Alice, and Grace sister-in-law Privilege, with her 18 months old daughter, also called Grace, tagged along – they also wanted to consult the midwife. It was a beautiful day and as we drove through the labyrinth of shacks and RDP houses in Masiphumelele, people walked about, many in their Sunday best, clutching Bibles. The midwife, Clara, came and met us along the way, she got into my car and directed us the rest of the way – she did not want us to get lost. I was surprised at how young she was. I was told to park my car on a pavement and then we were guided down a sandy corridor between shacks to a small one roomed shack where another woman met us. This was Clara’s sister in law, Masiiwa, and it seems, that they are two midwives, who live and work together. The shack was small and simple, made of wood and sheets of metal. The walls were lined with cardboards and large pieces of paper. It was fitted with only a single bed, a television, and some some simple kitchen equipment. There was very little floor space and most things seemed to be stored under the bed or at the foot of the bed or hung behind the door or on the walls. Water was stored in empty oil buckets.We crowded into the tiny shack and I was given the best seat in the house – an upturned crate with a cushion on it. The women who had come along all had readily agreed for me to sit in with their consultations and were happy for me to ask questions, write this blog and take some photos. It seems the midwives did not only work with pregnancy and birth but were known as general healers for women and children, so many came for their advice and wisdom. We were lucky that it was not so busy that day, sometimes there was a queue of people standing outside to see them. Adult Grace had a check up first. She had skipped a period and wanted to know if anything was amiss. Clara asked her to lie down and Grace’s belly was massaged and palpated with cooking oil. This took some time but eventually Grace was told that all was well and she need not worry. Next was little Grace’s turn. She had been constipated and had developed a terrible fever and cough. She had not been eating properly for days and had lost weight. Her worried parents had rushed her to False Bay Hospital on Friday night, they live on Red Hill and have no transport themselves, and they had to pay someone to take them. They had been given some...
Read MoreWhat is Oxytocin?
Going into labour is like falling asleep… Labour is a different state of being, a state of being with a lot of similarities to sleep. For a start, they are both states that cannot be forced. They just happen! Sometimes when we least expect it. We cannot decide or control the moment when we fall asleep. We can also not decide or control the moment when we “fall into labour.” But we can make it difficult for both to happen easily and most effectively. Labour is like sleep because we need the same conditions to “fall into labour” as we need to “fall asleep.” We need to feel safe and warm and relaxed. We need to be in a place in which we feel comfortable, and we need to be free from pressure, anxiety or fear. Oxytocin When a woman is in labour she releases a hormone called oxytocin. Oxytocin is the hormone that makes the uterus contract during labour. It is also the hormone of love. Oxytocin is the hormone we release when we are enjoying a meal, or having a stimulating conversation. It is the hormone we release when we are making love and when we orgasm. It is the hormone that makes us feel in love, and it is the hormone that releases the milk when a mother is breastfeeding. Isn’t it amazing that it is the love hormone that brings the baby into the world? In hospitals synthetic oxytocin is often given to women. It has different names like Pitocin or Syntocinon. Synthetic oxytocin is given to make the mother’s uterus contract, which can help to birth the baby. But this synthetic oxytocin is not a love hormone. It is not like the oxytocin that is naturally secreted by the mother’s body. Synthetic oxytocin is just a hormone that contracts the uterus and helps to push the baby out. It is important that we know more about the effects and function of natural oxytocin, because when a labouring woman is under the effect of synthetic oxytocin she may have a decreased ability to produce natural oxytocin. How is synthetic oxytocin used? Synthetic oxytocin is used to induce a labour (this means starting a labour artificially) or to augment a labour (this means to speed up a labour that has stopped or slowed down). Synthetic oxytocin is also used for active management of the third stage of labour when the placenta is delivered (an injection of synthetic oxytocin is given to the mother to help deliver the placenta quickly). It is also used to stop a mother bleeding if she has a postpartum haemorrhage (when the mother’s uterus doesn’t contract after birth and she begins to bleed heavily). Induction These days it is very common for a woman to be induced to start her labour. She may be given many reasons for this: she may be over her due date, or her caregivers may be worried that her baby is getting too big, or that her baby is ill, or that she is ill. Augmentation When a woman is in labour, it is common for her labour to slow down or even to stop when she arrives in the hospital. There could be many reasons for this sudden slowing down of the labour: the lights are too bright, she is given a vaginal examination, a stranger enters the room, she is feeling watched or self-conscious, she is feeling rushed, cold or scared. Usually, if the labour doesn’t start up again after a certain amount of time, synthetic oxytocin will be used to get the labour...
Read MoreBeing on Call
Being on call… I was asked some time ago: If there was one thing you had known about becoming a midwife before you began training that you know now, would you still have chosen to become a midwife on call for home births? My answer was: “The realities of being on call.Knowing that I would be on call 24/7. That my phone would have to be charged and near me at all times!” I knew that attending home births and being on call would entail all of these when I chose to walk the path of midwifery and attending home births but the realities of it are quite different from any selfless fantasies one might have about it. Seeing the disappointed faces of my children as we turn around the moment we walk into the library or leave the beach, or miss a much loved extra-mural activity. Having to miss birthdays. Leaving for a birth on Christmas day. Missing New Year’s. Missing my very good friend’s wedding. Or feeling too tired to enjoy any of the above… And having that bloody phone so close to my head as I sleep and having to jump up and check EVERY SINGLE MESSAGE that pings its way into my world at all hours of the day. I curse at pointless emojis and kisses and notifications that I have won R500 000 from Coca-Coal via sms – I am trying to sleep! And having to check and answer every message and call even when you need to desperately sleep after two back to back births. Being on call means being available. 100% available. It means being willing, and able, to drop everything, no matter how important and valuable, to go and sit and just be at someone’s birth. If you want to practice a path of non-attachment then being an on-call midwife is it. I have had a nice break from being on call, teaching in Spain and Portugal in July. Being able to leave my phone in my caravan while I taught, or letting it die completely for a day or two was a rare treat. Now I am back in South Africa and life carries on. Being with my children. Four children. Homeschooling. Extra murals. Outings. Housework. Meetings. Teaching. Seeing clients. Walking on the beach. Life! And somehow I am supposed to drop everything and fit a birth into all of this? This busy, full, demanding life I have created for myself? And yet, somehow, when that phone rings or pings, and it is time to go – whether in the library, or the beach, or at breakfast, or more than likely, in the middle of the night, while it is raining and I am in the deepest sleep – time is somehow able suspend itself and I am able to make space for this woman birthing her baby. My mother was a midwife and her attending births was often more of a nuisance and an annoyance than fascinating to me while growing up. It meant that she would be tired and unavailable. But, it also meant, that when I fell pregnant, she dropped everything to be with me in labour and for the first time I saw how essential the work she did was for the woman in labour – her calm and presence held me through that experience and afterwards I thought, “This is the coolest job on the planet!” and wanted to be able to do just that for women in labour after that. But why do it? Why sacrifice family, children, friends? Is it worth it? It is. It really...
Read More