Last Week we Gathered to Chat About Home Birth
We do this every three months here in Cape Town, in a lovely home in the seaside village of Muizenberg. Lana and I have been running these gatherings for the last five years. They were born out of a need and a desperation to provide support and information to those seeking direction and advice around this obscure birthing option and the gatherings have gained a momentum of their own. When we first started them we would work so hard to spread the word, posting flyers to all the midwives and interested antenatal teachers. We would arrange speakers and explore themes. We would advertise and spread the word and we would always lose money running them but loved it and loved the responses and stories we got. They were always worth it. And then something shifted. The gatherings grew. And so did the stories. And the variety and range of people who came. It has become such a safe space to listen and share. Mothers, fathers, doulas, midwives, interested parties attend and all seem to leave humbled and moved. As do we. Every time. Mothers share their birthing experiences, their eyes still glowing with oxytocin. These women, these strong strong women, share what made them feel strong and empowered. They share their vulnerable and beautiful stories to a hungry audience, an audience who needs affirmation and support in the choices they are making. “Stories teach us in ways we can remember. They teach us that each woman responds to birth in her unique way and how very wide-ranging that way can be. Sometimes they teach us about silly practices once widely held that were finally discarded. They teach us the occasional difference between accepted medical knowledge and the real bodily experiences that women have – including those that are never reported in medical textbooks nor admitted as possibilities in the medical world. They also demonstrate the mind/body connection in a way that medical studies cannot. Birth stories told by women who were active participants in giving birth often express a good deal of practical wisdom, inspiration, and information for other women. Positive stories shared by women who have had wonderful childbirth experiences are an irreplaceable way to transmit knowledge of a woman’s true capacities in pregnancy and birth.” – Ina May Gaskin I feel honoured and blessed to be part of these gatherings every three months. I do wish we could run them more often but for now, every three months will have to do. Thanks again to all who come and share....
Read MoreThis is Marthe and she had a Home Birth…
When Marthe was eighteen years old and newly married, she went into labour one Cape Town spring morning. She was living down the road from her Aunty Maggie and Aunty Martha’s house and the two busy body aunties came to see if the pains the expectant mother was complaining about were indeed the pains of labour, they were there to keep the nervous young husband at bay, and to send a young boy to summon the midwife. The local midwife soon arrived on her bicycle and stayed with young Marthe for three days before deciding to send the young woman off to Groote Schuur hospital. The labour was taking too long and the baby was not coming. The midwife was concerned. After three days of labour and after being transferred to the hospital, Marthe gave birth to a skinny little baby girl. The doctors were baffled as to why the tiny girl had taken so long to come. Eighteen months later, Marthe was in labour again. Again she was at home, and again the local midwife joined her. This time the labour seemed to be progressing smoothly and soon Marthe began bearing down. By some strange twist of fate, the house across the road caught alight. While Marthe easily heaved out a large ten-pound baby girl, a woman died as the house opposite burnt to the ground. (Birth and death walked side by side down that road that day…) Marthe was my grandmother and the large baby girl was my mother. Marthe was pregnant again three years later, and she gave birth easily, at home, attended by a midwife, to another girl. Smaller this time. Life went on and many things changed, especially my grandparents’ social status and when my grandmother fell pregnant in her thirties it was only natural, that this laatlammetjie(1) birth would take place in a hospital, under the care of the best doctors that money could buy. It was years later, when my grandmother was hard of hearing, and cataracts had begun to form in her eyes, that I took her along to a birth film festival I had organised in Cape Town at the Labia theatre. On the drive home, she divulged her birthing stories to me, and she admitted that giving birth at home, had been for her first prize and that paying all that money to have her baby “delivered” in a hospital had been a disappointment. After watching these beautiful birthing films that night, she had only one regret. She would have liked to have had a water birth! * (1) Afrikaans: a child born many years after his or her siblings * My grandmother died in France two years ago, whilst on holiday with my aunts. She had been quite ill and been a given a short time to live so she took herself and her daughters off on one last holiday and shopping spree before she passed away in Nice. She was cremated and has been at rest in a crematorium in Nice. This week my aunts bring her back to Cape Town where she will be buried, alongside my grandfather (who passed away over twenty years ago). Rest in Peace Jiajia, and welcome...
Read MoreHome birth as a trend?
All good things must come to a trend, so obviously, home birth in all its fabulousness is going to have to come to the forefront, especially with rumours flying around that the future queen of England, Kate Middleton, is possibly planning a home birth (which I believe to be untrue). But what is it about home birth that is attracting more and more South African women to this particular option? Lana Petersen and I have been running Home Birth South Africa for the last 5 years – something we started purely out of frustration because there was nowhere that a South African woman could go for information on this birthing option – i.e. there was a lot of information available online and in books on home birth but all in the UK, the USA and Australia and nothing which made it seems like a tangible and doable concept within the South African context. So, Home Birth South Africa has been going for the last five years, running quarterly gatherings and information sessions – a place where those interested in home birth, planning a home birth, have had a home birth, wanted one but didn’t get to have one, doulas, midwives, birth activists and those generally interested and who support it can gather to share, ask questions and discuss. The gatherings took place for a long time at Erin Hall in Rondebosch but these days take place at Norman and Jenny Skillen’s rock star mansion in Muizenberg. We usually gather in a circle and each person shares who they are and why they are there, they might share a story and ask some questions. Discussion inevitably ensues and we usually go over time. Over the years, the gatherings have grown in momentum and yesterday’s event attracted nearly forty people to it. Our website and data base grew out of the home birth gatherings when we realised that the need for information and stories needed to be available on a national level. The website gives information, answers questions, provides stories written and shared by South African mothers and families, and offers a directory of home birth friendly practitioners – we are always on the look out for more stories, contributions, information so please feel free to share by contacting us. Stories can be published anonymously. So what is it about home birth and why are we so passionate about it? In this article with photographer Leah Hawker we touch on what drives both Lana and me but I think to summarise, for both Lana and myself it is not home birth per se which is our agenda but being able to provide information and knowledge to women and their families that helps them tap into their own needs around birthing their babies. And both of us are in awe of women when that certain something is unlocked in labour and the new raging, power of that woman is opened as she finds a new part of herself. Innately women seem to want to give birth where they feel safest and most comfortable, and within the South African health care system, while medically very sound, that feeling of safety, of feeling cared for, of being nurtured, of being heard and valued, is so often not there. (And no, there are not really any midwife run birth centres for those women seeking the middle ground.) Not sure when it happened that healthy pregnant women were considered ‘sick’ and deemed only fit to birth in hospital and not sure how it happened that women accepted that this would be the norm. But what I do see are that...
Read MoreAre We Creating an Epidemic of High-Risk Women?
Two weeks ago I wrote about the first unnecessary caesar I attended. It was the first but it was also not the last. It did prompt me to do my homework and to really make sure that the women I was attending as a doula were well informed. One of the things I did was call up all the maternity wards of all the private hospitals here in Cape Town and ask them directly what their their caesarean section rates were. I knew from discussions with other doulas and midwives that many caesars were taking place but I did not have clear numbers. The conversations went something like this: “Hi…I am a doula supporting mothers wanting to birth vaginally in private hospitals here in Cape Town and I would just like to know what your caesarean rates are so that they can make an informed decision about where the best possible place to birth is.” Or something along those lines. Responses were everything from helpful and obliging to irritated, rude and irate: “Oh one doctor here has about a 60% caesar rate…he really tries, but the others are definitely around 80 – 90%” “About 65% but I think it is the private midwives that do deliveries here that bring the rates down…the doctors have much higher rates than that.” “Between 60 and 90%.” “I don’t see why we should divulge this sort of information, I don’t see how a high caesarean rate can make a difference to a woman’s chances to birth naturally!” “It is definitely upward of 80% but I am not telling you how much higher – I don’t think it is any of your business!” So in private hospitals in Cape Town, we are looking at a caesarean rate of 60 – 90%. And from my experience in two of the major government hospitals in Cape Town, it seems to be around 50% in the public sector. The World Health Organisation recommended a caesar rate of between 10 – 15% as being healthy, so WHY is our caesarean section rate so high? And why is it not my business to find out the caesarean rate of a hospital that is often promising to be supportive of women’s wishes to birth as they wished? And why is it suddenly okay to slice open perfectly healthy women and change their obstetric history forever? (I need to stress that I am not anti caesarean. I am eternally grateful for the operation that saves the lives of mothers and babies. I am not putting down this very necessary intervention and the skilled people who can perform it.) Since then I have worked within home birth midwifery practices and met midwives from all over the world who maintain a caesarean rate of between 2 and 20 %. Why do they get it right and the hospitals do not? I think the saddest and hardest thing for me is meeting the women who have undergone these unnecessary caesars. Who come with their stories. And who really want to give birth vaginally this time around, sometimes after one, sometimes after two, sometimes after more caesareans… I was induced at 38 weeks and didn’t progress so I had to have a caesar. The doctor said my baby was getting to big and I would never be able to birth her – but then she was an average size! I had a supportive doctor but she was on holiday when I went into labour and I got the doctor with the highest caesar rate in the hospital. The environment was too clinical for me, the beeping machines,...
Read MoreMy First Unnecesarean
When I first became a doula I was quite naive. Yes, I had been given all the information and statistics during my training but there was a part of me that smugly believed I could ‘save’ any birthing situation with good intentions, homeopathic remedies and aromatherapy oils. *humble blush* I attended my first unnecesarean very soon after becoming a doula. I met with a young couple who were keen on a natural birth but in hospital. She had originally wanted a home water birth with midwives but he did not trust midwives and therefore they had chosen a female doctor who seemed to resonate with the young woman’s wish to birth physiologically. They had chosen (or rather, their medical aid had chosen) a hospital which was nicknamed Caesar’s Palace due to its alarmingly high c-section rate (anywhere between 80 – 100%). We went through their birthing plan, which was beautiful, and it was decided that I would join them at home in labour and that we would go through to the hospital once labour was strong and well established. They felt optimistic that with the birth preparation they had done attending an antenatal class and with the support of their doctor and myself, their birth plan would be successful. Simple right? They called me one early morning to tell me that her waters had broken and that the doctor had told them to come in to hospital as she needed monitoring. They would keep in touch with me. Luckily for her, her contractions started soon after her waters had broken and when I arrived at the hospital, she was already contracting regularly. I was taken aback by what I saw though, she was in a hospital gown (her birthing plan had explicitly expressed that she labour in her own clothes) and she was attached to a drip which was administering antibiotics (to ward off infection now that the waters have broken, I was told). Despite these obvious discomforts, this young woman used the breathing techniques she had learned and practiced in her antenatal classes and walked about the room, pushing the drip stand around as she laboured. At least she was not continuously strapped to a foetal heart monitor, but she did have to lie down every hour for twenty minutes or so to be monitored which was extremely uncomfortable for her. At one point a doctor came in to examine her. It was not the doctor she had built a relationship with, her doctor was unavailable and this new doctor (all in black and wearing a pearl necklace) would be taking care of her. My client tried to hide her disappointment and muttered that at least the new doctor was female. The new doctor examined her patient and declared that my client was already 4cm. The doctor congratulated my client on her progress and said she would be back in a few hours to check on my client again. We were pleased and for the next four hours, as the contractions grew stronger, the young woman continued to use her breathing techniques, and walked about the room listening to the music she had so carefully chosen for this special event. I rubbed her back and chatted to her husband who was sweetly supportive. A nurse came in every half hour or so and monitored the baby’s heart rate, checked her blood pressure and took her temperature and pulse. Labour seemed to be progressing, we were feeling positive. At one point I excused myself and went to the en suite loo. I heard the doctor coming in and when I came out of the bathroom...
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