Do we Need More Midwives in South Africa?
Apparently, if you call up the South African Nursing Council (SANC) (under which all registered South African midwives must fall) then you will be told that there is a long list of registered midwives in South Africa – their database seems to reflect an adequate amount of trained and registered midwives. Midwives are known to improve the outcomes of births and yet here in South Africa, our maternal mortality rates do not reflect this. Since the Millenium Development Goals were set in 1990, with decreasing maternal mortality by 75% by 2015 being one of the goals, South Africa’s maternal mortality have risen. If you scratch below the surface, you will discover that South African midwifery training at present requires four years of nursing which includes only six months of midwifery. There is an option to study Advanced Midwifery at university level after qualifying as a midwife and some midwives may choose to go this route. What essentially happens, is that many nurses are trained who can call themselves midwives, are registered and listed as midwives, and can work as midwives but who may not choose to work as midwives, or who feel no particular compassion for the pregnant and labouring women they serve, or may not have a passion or drive for midwifery. And even if they do feel passionate about midwifery, they often feel inadequately equipped to work in the settings they are placed in after qualifying. Some Facebook support groups have sprung up for midwives in South Africa and they have grown as a place for midwives to voice their fears and concerns, as well as a place for them to share stories and information.When I see that midwives are too afraid to work in the labour ward – I feel that our midwifery education system has failed them. Jason Marcus and Jenna Morgan, both midwifery educators in South Africa, refer to the current South African midwifery training as ‘the fruit salad’ and both feel strongly that South Africa needs to look at the needs of our pregnant population and meet those needs through our midwifery training. At present, both feel that those needs are not being properly looked at and, therefore, are not being met. When I hear stories of abuse in South African maternity wards, from mothers, medical students, midwives, doulas and through the media (and I have witnessed it on numerous occasions), then I know that something vital is missing. That we are failing pregnant and labouring women. Last year, I sat with a support group of mothers from SWEAT (Sex Workers Education and Advocacy Taskforce) and discovered that out of about ten of the mothers present, four had chosen to give birth at home unassisted, some because of precipitous labour, but primarily because it felt easier and safer to give birth alone than to be mistreated and shunned. And when they called me a couple of weeks later to let me know that a first time single mother, who lived under a bridge and survived as a sex worker, had died whilst trying to birth on her own under that bridge, I knew our maternity system had failed her. When I drive past Red Hill informal settlement and I give lifts to the women who are hitch-hiking to have their antenatal check-ups, or to take their sick babies to the clinic and I hear the stories of how many women avoid those antenatal checks, or don’t even book at the hospital, and try to arrive at the hospital as late as possible, or not at all, because it is too far, or too tedious or because of how...
Read MoreMy Father Wasn’t at my Birth
My father wasn’t at my birth. My mother had hoped for and planned a home birth for my entrance into the world, but she was a single mother living in a communal house in Switzerland at the time. She was an older mother (She was 29 when she fell pregnant with me) and was advised against having a home birth by her doctor. The man of the house she was living in was also dead set against having her birth in his home – there was no way that African girl was going to squat down and birth in his house. My mother then found out about a natural birthing centre in the neighbouring canton of Graubünden, and while she drove to take a look at it and loved the pink rooms and the deep birthing pools and the midwives in attendance, there was no one who was willing and able to drive her there once she was in labour (which I have now worked out via Google maps is only 1 hour and 23 minutes away!). So she settled for the very fancy and exclusive private hospital at Stefanshorn. My father wasn’t at my birth. I was a planned pregnancy. Very much so. I was very much hoped for and wanted, but it was an unusual arrangement of sorts. I’ll let you in on a little secret. You see, my father was married to someone else when he met my mother and he stayed married to his first wife (my parents actually never married) while embarking on a relationship with my mother. My mother was a staunch feminist at the time and had all sorts of theories about different ways of having relationships and so they embarked on an ‘open relationship’ – which my father’s wife was actually rather reluctant about. So the plan was for my father to impregnate my mother and that she would be a single mother and that he would be a long distant parent and visit once a month or when time and travel allowed him. My father lived in England and in South Africa at the time. My father wasn’t at my birth. He was in England at the time, at home with his wife. My mother was admitted a week before her due date to be induced for no medical reason other than that her doctor was going to be away on holiday. She was admitted on my father’s wife’s birthday, which his wife always saw as a personal affront to her and made her resent my presence even more. My father wasn’t at my birth. A friend drove my mother to the hospital, but my mother was alone when she went into labour with me. I know that she laboured for twelve hours and that she had the latest in foetal heart monitoring technology strapped to her while she laboured. I know she laboured on her back. I also know that she held on to a little green statue. A little bust of an African woman. It had been given to her by a grateful woman my mother had counselled when my mother had volunteered as a rape counsellor in South Africa. I know that this little statue was a lifeline back to South Africa for my mother while she laboured. My father wasn’t at my birth. He was in England at the time, at home with his wife and while she hung out a load of wet laundry he snuck a call to my mother and shouted instructions on how to breathe through the heavy black phone. I know...
Read MoreIt was at a Home Birth That I Learned to fry an egg Properly
It was at a home birth that I learned to fry an egg properly. Sunny side up. The yolk not quite runny but not hard either. Somewhere inbetween. Heat the pan, add the oil (coconut oil was used in this case I think), crack the eggs into the pan. Sizzle sizzle. Crackle crackle. Pop pop. Then cover the pan with a lid and turn off the heat. This was served on toast smeared with avocado and cracked pepper and salt. At the same home birth I also weeded the garden in the sun. It was at a home birth that I first learned to follow the lead of the cat. I learned the patience to sit in the garden while the sun set silently and the new mother found her rhythm. It was at a home birth that I found out that birth is unpredictable and that midwives need to think quickly on their feet and that they need the necessary skills, to deal with the rare emergencies that present themselves, burned into their muscle memories. It was at a home birth that I learned what excellent reflexes I had when a baby bungie jumped without warning out of her mother as her mother waddled across the kitchen floor. It was at a home birth that I learned that labour can rock to any tune and that a mother may roar to Linkin Park at full blast, sigh to Miles Davis accompanied by the soft splashes of the birth pool, or swing and twist her hips like a snake,to Ravi Shankar, evoking images of a belly dancer. It was also at a home birth that I learned that Dr. Phil could even be suitable background music. It was at a home birth that I learned to master knitting a sock. And at the next home birth I very nearly finished the pair. It was at a home birth that I sat with a wide eyed little girl on my lap as we looked at her vernix covered sister for the first time. It was also at a home birth that I saw a five year old boy reach out his hand as his sister’s head emerged – he was the first one to touch his sister. He gasped in amazement. It was at a home birth that I learned to draw the curtains and turn off the lights. And to keep my mouth...
Read MoreWhy do we Even Give a Fuck?
Why do we even give a fuck? Why care how mothers birth and babies are born? What the mother’s experience is? Her sense of being, bonding, self? Is it some personal agenda, a crusade of some sort? What makes us available at three in the morning to drive across town to rub a labouring woman’s back with scented oils? Why sit for hours on end encouraging, believing, knowing that she can do it? Why wait wait wait patiently? Sit for hours on end? Wait for this delicate yet awe inspiring process to unfold? Why trust? Why keep your hands to yourself while a mother rocks her hips, finds her rhythm, learns to trust herself? Why wait for the cord to finish pulsating? Why bother with slippery slimy skin to skin while a woman discovers she is a mother and falls in love like she never knew possible? Why wait and watch and wonder and see while the newborn, sticky with vernix, unfolds from her intra uterine state, licks her lips and slowly shuffles towards her mother’s nipple? Why the fuck would we want to do this work? We must be...
Read MoreDear Zuma…
What is this nonsense I hear about you wanting to separate teenage mothers from their babies, and wanting to send those same teenage mothers away to a place like Robben Island to finish their education? “They must be … forced to go to school far away,” You said, “They must be educated by government until they are empowered. Take them to Robben Island … make them sit there and study until they are qualified to come back and work to look after their kids.” Wow! This makes me so angry – how dare you? No talk of support? Or education? Have you ever been a teenage girl in South Africa? South Africa – this wonderful country of ours but where women are more likely to be raped than educated? South Africa – this beautiful country of ours where one in 6 girls before the age of twelve has been sexually abused? The same South Africa? Have you ever been pregnant? Given birth? Been flooded with the hormones of labour and then had your baby snatched from you? Taken away? Been separated? Had your breasts aching with milk and longing? How archaic is your thinking? ...
Read MoreAn’ Nooi’s Birth Story
Before my mother began attending the births of the local women on our farm, a woman in labour would be driven to Ceres Provincial hospital to give birth. This is the story of a birth which took place one year on Christmas Eve. I must warn you that this is not a happy birth story. * It was the night before Christmas and the house was dark. There was a soft tap tap tapping on the window. Chaka the dog jumped up from his designated place at the foot of the bed and growled. Baas (my stepfather and a paranoid sleeper) sat bolt upright and jerked towards the window behind him. There was a candle burning softly on the window sill. Oom (Uncle) Jiems was peering in through the window, his face pressed right against it, his breath, steaming it up. My mother, Carol, with my sleeping sister Gypsy at her breast, lay still. My mother was awake now but she did not stir, not wanting to wake her baby. Baas, irritated, opened the latch and tried to swing open the window but the drunken man outside continued to press his face against the window, looking in; not seeing Baas. Baas quietly motioned for Jiems to move, waving his hand. Jiems noticed him and stumbled from the window, falling over. Poepdronk (literal translation: fart-drunk; meaning: incredibly drunk). Baas pushed the window open and peered through the window at the man sitting drunk in a bed of African marigolds. “Wat issit?” (“What is it?”) Baas hissed. “Baas, Nooi is besig om the kraam. Die baba kom vanaand,” (“Baas, Nooi is in labour. The baby is coming tonight.”) Jiems mumbled. Jiems looked dizzy and confused, his large bottom lip protruding. This was not the confusion of a first-time father though. This man was well into his fifties and already had three teenage daughters and one grandchild. This was the confusion of someone who was hopelessly and helplessly inebriated. Baas sighed, closed the window and dragged himself out of the comfort of the king-size bed. He pulled on a T-shirt (he always slept in his jeans) and slipped his feet into his mud-caked Dakotas. He fumbled for his cigarettes (Gunston, extra strong ) and lit one, then coughed. He was awake now and wouldn’t be able to go back to sleep. He looked at my mother who was watching him, her head propped up on one arm. He could see in her eyes that she was wondering what he was going to do. Baas coughed and left the room, his cigarette cupped in his left hand, gangster-style. My mother gently lifted Gypsy’s head from her arm and turned my baby sister onto her tummy and covered her well. My mother gave the little girl child’s face a little stroke. Then Carol buttoned up the front of her nightie and got out of bed. She pulled on her brown striped towelling dressing gown. My mother lifted the candle from the windowsill, yawned and then made her way to the kitchen. The kitchen door was open. Baas was outside talking to Jiems. She could hear their low mumbling. Men’s voices. My mother filled the aluminium kettle with water and lit the gas stove. Then she took three cups from the cupboard and filled each one with two teaspoons of Ricoffy and sugar and milk. Then she stood next to the gas stove and waited for the kettle to begin steaming and rattling. Baas came back inside, rubbing his hands. Jiems was gone. Jiems was gone. The coffee was not ready yet. Baas walked past my mother and through to...
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