Thursday, 20 September 2012

Who's your midwife?

So who is your midwife?

Normalizing natural birth...

We seem to have reached a place in obstetric care where interventions, even unnecessary interventions, are so normal that they aren't even noticed. Here in South Africa, most middle to upper-class women automatically hire a gynae (pronounced guy-knee aka OB-GYN) to deliver their babies. For me, that felt like calling a paramedic when I have a cough

In private hospitals here, the midwives employed by the hospitals actually get into trouble if they deliver the baby as then the gynae can't collect his full fee, but they also get into trouble if they call the gynae too early, because he (sometimes she) has a busy practice to run. And they need those busy practices because of the incredible insurance they have to pay.
I digress...

Within the last week I attended two screenings of the documentary Freedom for Birth (trailer above) which is about how women's rights are being violated in childbirth  - among a host of other issues related to birth. While I will be addressing this issue again, it really struck me how natural birth needs to be re-normalized.

I am always trying to encourage women to find a caregiver who trusts that a woman's body is designed to give birth, not someone who sees a pregnant women as a emergency waiting to happen. So I chose to have a private midwife in PMB, Arlen Ege, attend the birth of my second daughter at home. When I had my daughter, she was allowed to deliver babies at the local Mediclinic, but has since received notice that this would no longer be allowed. UPDATE: Sr Arlen Ege is once again able to do water births at Mediclinic in Pietermaritzburg as they have installed an outlet pipe for her birth pool! I was able to attend the birth at which this pipe was first used, also the first birth in a while in which a doula was allowed at Mediclinic - It was a beautiful VBAC in December 2013 - Birth Story to follow! 

Why I have to be a midwife...
But, how do we normalize natural birth? How do we help women to see that over 80% of them should be able to give birth naturally, when the current caesarean rate in our private hospitals is over 70%? Because when the number of caesarean births gets too high, they actually start causing more harm than they prevent...

Which brings me to my little revelation... In the city in which I live, Durban, with a population of 3.5 million, there are two practicing private midwives that I know of. If I am mistaken, please correct me, but even if there were 10, or even 50, that would still be too few.

How do we change the tide and restore midwifery care as the norm rather than the exception?

Well, what I've decided to do as my first step, is that whenever I get into a conversation with a pregnant lady, 'Who is your gynae?' will not be one of my opening questions as it usually is among my peers. My first question will be 'Who is your midwife?', and after that perhaps 'Have you found a doula yet?' You get the idea.

Language is such a powerful thing. Doctors use it all the time when they play the big baby card, or the 'but-your-vagina-will-never-be-the-same' card, or the 'If-you-were-my-wife-I'd-recommend-a-caesarean' card. What are you going to do to help normalize natural birth?


  1. A very relevant link about the One World Birth project:

  2. Totally agree with you - vaginal birth should be the norm, not the exception! The big baby and vaginal tearing scare tactics that drs use to bully pregnant women are ridiculous. My gynae tried to do the same- kept hammering on how big she was and that I could have a vaginal birth but that it would be my perineum paying the price. Wtf. I was dead set against scheduling a c-section though and eventually delivered my 2.9kg (big???) baby vaginally. Yes, I did tear, but it was such a non-event that I didn't even realise until the nurses wanted to inspect my stitches later that day. People are flabbergasted when they learn that I had a vaginal birth *without* epidural - even the medical staff thought I was quite strange and even more so when I refused pain meds after the birth - I simply didn't need them! They didn't believe me. The whole experience was quite surreal.

    1. I had a very similar experience when I gave birth at hospital with no drugs - for two shift changes the nurses were coming into the ward to congratulate me, seemingly in awe that I had done it with minimal intervention, even saying that it was incredibly rare. That was actually what first got me started down the path of researching in this field and look where we are now!

  3. I came up against all sorts of negativity when I wanted a water birth at home. My gynae told me at my 12 week scan that I had better have a c-section because this was a big baby. When I told him I wanted a water birth he got very rude and told me that he doesn't own scuba equipment and I was risking my baby's life. I had already found my birth guru - Liza Harkess - and my baby was born at home (3.35kg) without him and his disgusting attitude. Instead my daughter was delivered by Liza and my husband and doula were by my side... perfection :)

    I see red when I think of how these doctors take advantage of nervous, undecided first-time moms and railroad their decisions through fearmongering. In a normal situation I really don't see how a scheduled c-section is better for a baby than to be born when ready, the way nature intended.

    1. Scuba equipment! Haha! At least he has a sense of humour... and 3.35kg! That's MASSIVE! :-P
      When I told my doctor I wanted a home birth, he told me that 100 years ago, 50% of women died in childbirth! No I knew that figure was absolute trash because I had *just* finished reading the book 'Birth: A History', and the instance in which there was a death rate of around 50% was IN A HOSPITAL (Hotel de Dieu, I think) because of bad hygiene practices before the days of handwashing. So I lost all respect for him right there... But another mom who didn't already know differently may have been swayed...