Every Mother Matters
About a year ago a young mother, pregnant and living under a bridge, went into labour. She was a sex worker and we can only assume she stayed under the bridge to birth her baby because she was afraid to go to the hospital to birth her baby. I don’t know. Sadly, the baby got stuck and both the mother and her baby died. Dudu from SWEAT (Sex Workers Education and Advocacy Taskforce) phoned me when she and a group of other mothers were returning from their friend and colleague’s funeral. “We must do this training Ruth!” she said. I had some time ago been invited to help facilitate some of the SWEAT Mothers of the Future meetings and there we had shared our birth stories and chatted about pregnancy and other reproductive issues. Mothers shared how they were slapped and hit and shouted at by nurses and midwives for being uncooperative. They felt they were stigmatised for the work they do whilst giving birth. They often felt unsupported. Three or four mothers shared their stories of birthing at home with no assistance when labour had gone more quickly than expected and how different and empowering and different those experiences were. We talked about how the mothers in this group could be of better support for one another and we eventually decided that perhaps a doula training would be a good idea. As part the Compassionate Birth Project, we envision the option of a doula for every labouring mother and initially we thought that our job was to train doulas who could be employed by facilities so that any mother arriving in labour could gain access to a doula. But the SWEAT Mothers of the Future have decided for themselves that what they want to do is ensure that there are doulas within their own networks and communities. Fellow mothers who understand each other and who have walked similar paths. Makes total sense. Dudu is a real visionary and she has plans to roll out this doula training to sex worker mothers countrywide. I like how she thinks. Yesterday, Robyn Sheldon and I started our training with five beautiful souls who made the journey from their various dwellings, catching buses and taxis to get there. They have made the commitment to be part of this training for the next week. Yesterday one of the mothers said: “ If I understand it correctly, to be a doula I need to be able to let go of everything and to just be there for the mother. To be able to fill her with positive energy.” Couldn’t have said it better myself…the perfect definition of the...
Read MoreDo 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...
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