Here are a collection of articles we are slowly putting together.
We want you to meet the home birthing community here in South Africa…
Who are those that support and nurture and protect this valuable birthing choice?
We also share our thoughts, feelings and personal stories here.
Ruth and Lana
These are my birth slippers.
What I wear on my feet when attending a homebirth.
They’re mostly for my comfort and to be as discreet as I can when I’m pottering around someone’s home while they’re in Labour.
However, there was a particular incident some years ago that prompted my need to wear ‘something’ on my feet.
I’d been called to assist at a homebirth as it appeared that the mother was approaching transition and the birth would soon be imminent.
As per usual I kicked off my shoes to be bare foot on entering the home and found the birth team in the tiny lounge and the mother labouring in the birth pool.
I settled into the corner of the couch away from the mothers gaze so as not to make her feel observed by my presence and waited for the midwifes cues for me to assist if the need arose.
Some while later it was evident that the baby was having difficulty negotiating it’s exit due to a deflexed head and the midwife made the call to transfer in to the back up hospital for further assistance. This was my cue to assist the mother out of the bath and into some clothes for the ride to the hospital whilst the midwife called ahead to the back up obstetrician to expect their arrival.
As the mother exited the pool a hard bearing down surge hit her and forced her into a squat alongside the birth pool. We hastily helped her to dress and into the car and off they went.
I offered to stay behind to tidy up the lounge and dismantle the birth pool so that the soon to be parents would have one less thing to worry about on their return…
And then it happened…
As I approached the pool on the same side that the mother had had that hard surge when climbing out of the pool, I trod into a ‘poo pebble’ which was surrounded by a puddle of now cold water on the plastic sheet on the floor!
(If I close my eyes I can still hear the squishing sound it made)
There was not nearly enough wet wipes in my bag that day to get rid of the sensation…
But, I survived… And hence the need to slippers at births!
Cape Town-based couple Dawn & Dean McFarlane share their recent experience of birthing their second child at home with HBSA.
For our first birth, we were under the care of an obstetrician at a private hospital. At 37 weeks I was diagnosed with intrauterine growth retardation (IUGR) and was told I would need to be induced to birth my baby safely. Although I ended up birthing my baby vaginally, it was not quite the “natural” birth I had hoped for. The usual cascade of interventions meant I needed the relief of an epidural when the pains became unbearable and the most traumatic part was the manual removal of my placenta performed by the doctor a mere 5 minutes after my son was born. I knew that I wanted a different experience this time.
What made you decide on a homebirth for your second pregnancy?
I was doing my doula training after the birth of my first child and had heard from the women there who had these amazing experiences at home. It definitely piqued my interest. I was seeing a gynae for my prenatal care in the second pregnancy when she informed me at 13 weeks that the medical aid plan I was on no longer covered her fees and I would, therefore, have to make a significant co-payment or find another doctor on my network. So this change also prompted the decision to explore homebirth.
What was your husband’s reaction to your decision to birth at home?
His response was a resounding “NO!” His concerns were around safety – “what if something went wrong?” “What about the blood?” and also what about all the noise as we live on the same property as my in-laws! So although he had said no, I asked him to keep an open mind and come and meet with a midwife who could answer all those questions, as they were concerns of mine too.
How did you find your midwife and what were your criteria for selecting her?
I had contacted a few midwives and I can’t say that there were many options as some didn’t offer services in my area and some didn’t respond to my initial contact and because I was due in the middle of December, many were on leave and therefore unavailable. But I managed to find one midwife who was happy to meet with us and answer our questions – and luckily had availability when we were due. She satisfied all our questions in terms of situations that would risk out homebirth and she advised on having the back up of the public hospital in our area and made arrangements for us to consult with an obstetrician there. She also suggested we attend an information session at a homebirth gathering to help us come to a decision either way. We left that initial meeting feeling comfortable that we were on the right track but decided to wait to make our final decision once we had attended the homebirth gathering.
What was your experience of prenatal care with a midwife like?
One of the advantages for us was that the midwife was willing to do all our prenatal care at our home on days when hubby could be present. The visits were usually an hour long each time and so we had many opportunities to discuss any concerns or questions we had. What was also nice was being able to whats app her whenever I had any questions in between our visits which she’d always respond to. She arranged for us to consult with an obstetrician at our local referral hospital as part of our back up plan. Because of my previous history of intrauterine growth restriction and the baby presenting breech in this pregnancy, we ended up having 3 consultations at the public hospital. We were very pleasantly surprised by how efficient and pleasant the public hospital service was. Even the admin and security staff remembered us by our 2nd and 3rd visits and we got to see the same doctor for all 3 visits. This really helped us feel secure in knowing we had a good back up.
Why did you feel it necessary to have a doula, and how did you go about selecting one and how was her role different to that of the midwife?
Having done some doula training myself I knew the advantages of having a doula and it was something I definitely could have done with my first birth. We met with two doulas and knew instantly with the doula we chose as she made our 1st meeting feel like we were just having a relaxed conversation. For me, it wasn’t important that the doula have any homebirth experience or had a homebirth herself but rather that she was passionate about being a doula, that she made both of us feel at ease and that her presence was unobtrusive. She ended up going above and beyond what our expectations were with advice and support in the pregnancy and in the labour she was of support to my husband as well. She just knew what I needed, when I needed it without me having to say anything. She took the most amazing photos of the labour for which I will be forever grateful. I can’t overemphasize how important it is to have the right doula for you – it should just flow organically.
What was the cost of having a home birth?
In our case, choosing a homebirth with a midwife and doula ended up costing us more out of pocket than if we had chosen to birth in a hospital with a doctor which would have been fully covered by our medical aid. However I knew that statistically, being due in December, had I stayed with a gynae in the private sector, I would have ended up being pressured into being induced and given the way my labour turned out, most likely be forced into some form of augmentation that was most likely not needed. We made a conscious decision to give ourselves the best chance to birth in a more empowered way and in the end that’s exactly what we got. To be clear though, the total cost for the birth at home, with a midwife, doula and hire of the birth pool came to roughly R10k. Had we chosen to birth in a hospital with a gynae it would have been double that amount, covered by the medical aid.
What did you do to prepare for your homebirth?
For us, the most important thing was to not tell anyone at all of our plans to birth at home! Only our midwife and doula knew…later on in my pregnancy I told my sister and gave her the option of attending my birth with very strict instructions as to what she could and could not do on the day. In hindsight, this decision was probably the best preparation we could have done as it just eliminated any questions or objections from anyone who was not part of the birth process. It’s enough to have to deal with your own internal doubts that do crop up now and again, and we didn’t feel the need to have to justify our decisions to anyone else. The rest of our preparation was watching positive birth videos and our interactions with our doula and midwife. That felt like enough for us.
Please tell us about the actual labour and birth
My labour started slowly and gently in my 39th week on a Tuesday evening and I ended up birthing my baby on the Thursday midday. For the most part, it was just Dean and me which was nice. We went out to supper on Tuesday and went about our day as usual on Wednesday (Dean took off from work at our midwife’s suggestion) and we just pottered about ignoring most of the surges. On the Thursday morning at 5:30 am, I told Dean “we need to go for a walk!”
Dean recalls that this was the only time in the whole process he had a mild moment of panic as taking a stroll in the neighbourhood at 5:30 am with people on their way to work to the train station was an odd thing to do!
Fortunately, after one lap around the block, I was happy to stay indoors. We let our midwife and doula know that things seem stronger but that we didn’t need them just yet. Our son was next door with my in-laws, who were oblivious to our homebirth plans!
Dean kept in touch with our midwife and doula but at some point misplaced his phone just as our doula arrived. She thankfully kept the midwife updated who eventually arrived at some point. As soon as our doula arrived was when I needed to focus inward to manage each surge. My sense of time was distorted and I was expecting to be going for quite a while but as it turns out, I didn’t have long to wait.
During our antenatal visits, one of my requests with my midwife was to avoid doing vaginal exams. She explained that it was not something she did routinely anyway as she had a “hands-off” approach when all is going well and that I should prepare to catch my baby myself. I didn’t give that part much thought afterwards but as it turns out, that’s what I instinctively did once I felt my baby move down with each surge. I felt the head crowning, I felt its body wriggling! I was doing this! As the head emerged Dean shouted, “I see the head” and with the next second the whole body was expelled into the birth pool. The baby had the umbilical cord around its neck which my midwife quickly looped over the head while still under water. I lifted her up to my chest and since we kept the gender a surprise, I had a peek and was thrilled to discover we had a daughter!
Those moments after the birth were quiet and completely unhurried. We could gaze at our baby and take our time getting to know her. We waited until the umbilical cord had stopped pulsating and Dean cut the cord and got to do some skin to skin with her. Now it was my time to deal with birthing the placenta.
This was the part of the birth that I was afraid of given how traumatic my previous experience was when 5 minutes after my son was born, the doctor went in an did a manual removal of my placenta.
My midwife reassured me that I could birth my placenta easily and guided me on what to do whenever I had a contraction. After a while, I admitted that I felt afraid and she offered to assist me by suggesting a better position and guiding me again on using very gentle traction on the cord…and out it came 40 minutes after I had birthed my baby! We all had a look at the placenta which was so fascinating to be able to see where out baby lived in its little watery cocoon. I got to touch and feel each side and that was an amazing, healing thing to have done too.
I hardly bled at all after the birth and we snuggled in bed and then invited our son to come and meet his little sister which was just such a precious moment. (My mother in law still had no idea we had birthed our baby!) Our son called her to come over to “come see the baby” and she was in complete shock and disbelief that we had just birthed at home! She’s since been bragging about her granddaughter who was born at home!
My midwife and doula finished up what they needed to do for baby & I and left. By which time my parents arrived from Sedgefield and were absolutely shocked as well that we had given birth at home.
What sort of care did you have postnatally?
Our midwife had scheduled to see us the following morning but was called to attend another birth and so our lovely doula came to check in on us. It was lovely to reminisce with her about the birth and have her reassure us regarding the breastfeeding. Our midwife did three more visits at home monitoring our baby for signs of jaundice (our son had jaundice) but thankfully that didn’t happen this time around as well as weight checks and postnatal self-care for me.
What has been the impact of having a homebirth for all of you?
Dean – “I know it’s cliché’ but I really went from being anti-homebirth (fearing the unknown) to homebirth advocate. I can’t recommend it enough! Inform yourself, do your own research and protect your process in whatever way works for you. It really helped to keep our plans to ourselves.”
Dawn –“ I can say that it has been profound and at the same time “normal”. Our baby was born here at home while our son played with his granny next door. We laboured in between preparing for an upcoming holiday away, laundry that needs doing and dishes that needed cleaning. Our life has just taken on a new sense of normal. I really appreciate not having visiting hours for my husband enforced on me and our newborn as they were in the hospital or possibly having our son not be able to spend time with us right after the birth of his sister. He has accepted her presence with ease and is loving and gentle towards her.
I am an even bigger advocate of midwifery and doula support for women. I see and feel the difference in myself as a mother and a woman at how you are treated through all of this makes you feel on the other side. We need birth support that is empowering and encouraging of our abilities.
I loved my homebirth!”
This past month we were lucky to catch up with Midwife Kathleen Van Heerden who managed to squeeze in time to answer our questions while supporting a bumper load of births over the busy September birthing season.
Kathleen owns and runs Kathleen’s Mother and Baby clinic, a “home away from home” birth centre based in Boksburg.
- Tell us a bit about yourself, your family life. How did you get into midwifery as a profession?
I am married to Braam van Heerden and I am the proud mother of three children – Benita (26), Sean (24) and Megan (20). I’m also grandma of two beautiful girls, Kate and Jamie.
I’ve lived in Boksburg for the past ten years. I studied nursing at University of Free State. After obtaining my degree I worked at Klerksdorp Provincial Hospital from 1990 until 1991 when I fell pregnant with my firstborn. I relocated to Witbank and started working at Witbank Provincial Hospital, maternity unit and that is where I really fell in love with midwifery and obtained my experience as an independent midwife.
I always knew that I wanted to be a professional nurse, but working in the maternity ward got me hooked on midwifery…I knew that this was my calling and that I wanted to be part of that special experience where a new mother gets to go through the natural birth process in a peaceful environment.
During 2001 I relocated to Pretoria and started working at Pretoria East Netcare Hospital, Maternity unit. We moved to the East Rand during 2005 and I started working at the Sunward Park Netcare Hospital, Maternity Unit. I started providing prenatal classes to expecting mothers as a service to the Hospital. A gynaecologist asked why I do not start my own prenatal classes from home….and that is where it all started. Two years on I was requested by the Hospital Management to join their team at the maternity unit to do midwifery deliveries. I accepted and continued as an independent midwife providing prenatal, midwifery, natural birth and postnatal services at the hospital. Two gynaecologists joined the hospital and informed management that should be midwives continue to provide services to the hospital, they would transfer to another facility.
I was already registered as an independent midwife, but then through God’s calling and grace started by own practice from home where I converted the apartment on our premises to a full homebirth clinic.
Ever since my practice has been growing from strength to strength with more expecting mothers opting for midwifery services due to the relationship that we build with our clients and the fact that we underwrite the natural birth process rather than opting for caesareans and unnecessary medical interventions.
- You are offering a home-away-from-home birth experience, tell us a bit more about how this works?
Once a client has expressed her wish to have a natural home birth, I will schedule an appointment with her to evaluate her and to inform her of the process of home-away-from-home birth. If she has not yet been for a scan, I refer for the first sonogram to a qualified sonographer as soon as possible. She will again be referred for a sonogram at 22 weeks and 32 weeks of pregnancy.
The client will see me throughout her pregnancy on a regular basis – during the first 28 weeks, she will consult with me every four weeks, thereafter every two weeks up to 36 weeks and thereafter weekly until her delivery.
My consulting rooms are in an established medical centre, whilst the birth takes place at my residence in an apartment which has been converted to a birth unit, consisting of two birth rooms, a living room where the extended family can await the arrival of the newborn baby and full bathroom. The birth unit is equipped with all necessary medical appliances, e.g. oxygen, suction equipment and emergency medication.
A home-away-from-home birth experience is a midwife led birth experience, which is ideal for healthy women with straightforward pregnancies who would like to give birth in a comfortable homely environment. As a qualified midwife, I provide support during the labour process to have a normal birth, with the option of hydrotherapy (water birth) or normal birth.
Women who choose to have a home-away-from home birth experience have fewer interventions during labour, which contributes to a faster recovery following the birth.
Should complications arise during the client’s pregnancy or delivery of the baby, I have two gynaecologists as back-up. I also have the ER24 ambulance service should the client have to be transported to the nearest medical facility.
After the baby is born and I am satisfied with the condition of both mother and baby, they can go home. Alternatively, I would advise that they remain until they are stable to ensure continues monitoring.
The client and baby will come for a postnatal check-up on day three and thereafter at two weeks and six weeks. During the client’s pregnancy and after birth I am 24 hours available for any advice and support.
- Tell us about any challenges you face as a midwife providing services, information and education on homebirth?
The biggest challenge with midwifery services is the ignorance of expecting mothers and their families on what the process entails and what services are offered. This is partly because of gynaecologists misinforming expecting mothers of the dangers associated with normal birth versa caesarean births and the misconception created by some gynaecologists that midwives are not fully qualified to perform home births.
A further challenge is to have gynaecologists and hospitals to serve as a back-up to midwives’ due to the fact that they regard independent midwives as a threat to their practice. It is a known fact that gynaecologist tend to lean more towards caesarean births as they can schedule them in advance. Midwives employed by Government hospitals also tend to show animosity towards independent midwives with their own practices.
There is still not enough information and education provided by health care practitioners on the alternative of home based births. Through referral of previous clients and their families as well as enlightened health care practitioners we are however fast overcoming this challenge.
When I started my practice almost all my clients did not have medical aid and therefor one of their main considerations was the financial implications of medical care at a hospital and associated costs of gynaecologists and paediatricians, compared to the cost of home births.
However, I would estimate that 30% of clients who come for consultation now have medical aid. A big challenge regarding medical aids remain the contribution they are paying midwives compared to other health care practitioners.
- What is the best part of homebirths for you?
If we look back at history, home births were the norm – that is until doctors and gynaecologists took over the role of midwives. This lead to an increasing number of women having their babies at hospitals. However, as awareness on the advantages and safety of home births increases, more women are willing to consider the option of having a home birth.
One of the biggest advantages of a homebirth is that the expecting mother can share the experience with family and friends.
A home birth affords the mother the freedom to move around, take a shower or a bath and enjoy the comfort of a home setting and a friendly environment compared to the clinical setting at a hospital or clinic.
The bond that forms between me as midwife and the expecting mother as well as the rest of her family, is something that is very precious to me. I have clients who still today send me pictures of babies I have delivered ten years ago as those babies grow into beautiful young children.
- What in your experience are some of the misperceptions around homebirth?
“Homebirths are dangerous”
There are many misconceptions about home births. I think the major misconception about home birth, is that it is dangerous. Some women have high-risk pregnancies and is such situation, a home birth may be unadvisable. But for most healthy women with normal pregnancies, home birth is an excellent option to avoid unnecessary interventions during the birth process.
Mortality rates are the same for home births as for low risk births performed in hospital. Add to this the reality that mortality rates for mother and baby are increasing in hospitals.
Standard care for midwives for emergencies includes pharmaceuticals, oxygen, IVs, equipment necessary to monitor and record vitals on both the mother and baby and other first aid equipment. To eliminate any risk, I have a back-up hospital and two gynaecologists in case of emergencies. I also have emergency medicines in the event of a medical emergency. With these backup options in place, home birth is a completely safe and secured method for expecting mothers.
“Hospitals are cleaner and a more sterile environment”
Germs are everywhere. The difference between a home birth clinic and hospital is, that the germs in my home birth unit, are ones you are regularly exposed to while hospital germs are unknown to your immune system and therefore a bigger threat.
“Your medical aid will not cover a home birth/ midwife”
Even though a home birth/ delivery by a midwife is usually much cheaper that a birth at a hospital or clinic, many women believe that a home birth or midwifery is not covered by medical aids.
Rules regarding home births/ midwifery expenses vary from medical aid to medical aid. However, that does not mean that your medical aid does not cover home births. As mentioned earlier I am experiencing that more and more clients who have medical aid cover are utilising the services of a midwife.
“Home births are messy”
When you opt for a home birth at my home birthing facility, you can be rest assured that you are in a clean, safe environment. The mother gives birth over chux pads, which are very large, disposable diaper-like squares to protect the bedding. The clean-up is minimal and the responsibility of the midwife. All clinical waste is removed and discarded in terms of health regulations.
“Postnatal care is expensive”
The kind of care you receive from a midwife is quite different from what you will receive from a General Practitioner or Gynaecologist. Instead of the 48 hour stay in hospital, your care with a qualified independent midwife is more frequent and more detailed. You will have postnatal visits at three days after birth, three weeks after birth and six weeks after the birth. During this period, I am also available 24 hours per day for any support and advice regarding breastfeeding, care of the mother and baby, etc.
“Only Hippie-mothers give birth at home birth clinics”
There is still a misconception that home births are very ‘alternative’ with most women opting for it being categorised as hippies or new-aged. The home birth experience I provide is according to professional nursing standards and does not necessarily entail water births. Although there is this option, most mothers opt for a normal natural birth.
“You must have a very high pain tolerance to deliver at home”
Normal labor at a hospital or clinic and labor at a home-birth clinic, requires the same amount of pain tolerance. The benefit of home births is however that you are in a comfortable environment, where you can take a bath prior to the delivery, you can walk around, and you have the support of family and friends who are there with you throughout the delivery process. Being able to relax in a calming environment, both during and after labor, is a wonderful way to experience the birth process.
Pain relief options are available, although you cannot have an epidural because it is a medical procedure that requires an anaesthetist. However, research shows that women who birth at home clinics need less pain relief than women who birth in hospital as they are more relaxed.
- Any highlights of homebirths you’ve attended that you care to share?
Every home birth is an exceptional and unique experience. However, the relationship that I build with a client will vary according to the personality of the client. Some women are easier to bond with, and become much more than just a client.
Another highlight for me is having the family of the expecting parents present at the home birth clinic. The mother is surrounded by familiar faces and the support and encouragement of family and friends are a big benefit to home birthing.
- What are your hopes and dreams for birth in SA?
I think my biggest hope and dream is that the public at large should be better informed and educated about home births. This will reduce or eliminate the misconceptions, as mentioned above, to a large extent.
I believe that women should have a choice on the kind of natal care that they receive and that they should not be forced to undergo caesarean sections, just because it is convenient for the gynaecologist to schedule the birth for a certain date and time – or just because the mother’s delivery is prolonged.
I believe that should more women opt for home births and the number of hospital births are reduced, the number of caesarean sections will reduce, which will have a direct impact on the mortality rate of mothers and babies. I further strongly believe that through choosing a home birth, the mother (and father) is more relaxed and the recovery period is reduced. There is greater bonding between both parents with the baby which reduces the possibility of post-natal depression associated with a traumatic delivery.
More relaxed environment = better bonding = more successful breastfeeding = healthier babies = happy Mommies….
Should you wish to make contact with Kathleen, you will find her at….
Kathleen’s Mother and baby clinic
221 Rondebult road, Boksburg
Home birth unit :
4 Gordonroad, Morganridge, Boksburg
Via Facebook messenger : https://www.facebook.com/KathleensMotherAndBabyClinic/
WhatsApp 0829289841; or
email : email@example.com
This month we spoke to Bloemfontein based midwife, Yolande Maritz.
Tell us a bit about yourself, your family life. How did you get into midwifery as a profession?
I am a mother of 2 beautiful daughters – born naturally, breastfed and home-schooled! I’ve lived in Bloemfontein since 2010. I married my first love in 1997 while I was in my 3rd year, studying Nursing.
I simply L.O.V.E.D midwifery from the very first day I was introduced to birth. Being a student in those years I knew I wanted to do this (Labour and Birth) different – as instinct convinced me. I wanted my mommies active in labour, in control and off their backs. Hospital protocol took charge and I hoped that “one day” I can make a difference. I would volunteer to take my fellow students’ working weekends in order to be in the labour ward. I had so many opportunities during this time by managing twin-births, breech-births, complicated -births, all by the guidance of the passionate Sr Nwgenya! In my final year I received the Gold Merit award for the best Midwife-student in 1998. I was over the moon….and hooked to Midwifery. I simply knew Nursing was a calling, but MIDWIFERY was my calling!
My first daughter was born very quick (2 hour labour) and I had the opportunity to “catch” her myself. That day in 1999 the actual midwife inside me was born too. I was no student no more, but a midwife…. with a calling.
Unfortunately, I had to leave the Government environment for the Private Sector. Here I couldn’t find a post in the labour-ward and settled for Theatre. I was a scrub sister for 6 years, seeing a lot and assisting with mostly C/Sections, ENT and Plastic surgery. My heart longed for the Maternity ward. And then it happened! I relocated to Middelburg in Mpumalanga and was accommodated in the Labour ward. My dear UM gave me a lot of scope to follow my heart and I took the lead in the night-shifts. I was in my element, although I felt I wanted to do even more. A lot needed to change……..Birth needed to change!
The need to start to support the community was high and I took hands with Hospice. In my off-duty days I would do bed-baths and reading to the terminal ill patients in their homes. I would support the families during the time of death and my first home birth client got hold of one of my business-cards. She was a rape victim and did not see her way birthing in the Government setting, and funds to go private was out of reach.
My first Home Birth happened May 2009…..led by the Holy Spirit. I was overwhelmed by the calmness of the environment, the courage of the birthing mother and the alertness of her newborn baby. Home Birth was my calling! I would do nothing else……….
UFS offered me a position as a Clinical Facilitator for their 4th year midwifery students. I was excited, because I was hoping to create the same enthusiasm in my midwifery-students as I was feeling. You & Me Independent Midwife Practice also started in 2010 and quickly grew to a very busy busy practice. I had no more time to meet the students, due to the high demand of Home and Water Births in the Free State, Northern Cape and Lesotho.
Being an independent midwife is not always easy and definitely not glamorous. It’s simply VERY hard work, dedication and further studies. In 2012 I had the opportunity to study Advanced Midwifery and Neonatology at UFS, together with Nursing Management and Education through UNISA. If I wasn’t supporting a mommy in birth, I was studying. Day and night. Sleep is a luxury for midwives.
In February 2016 I realised the environment, we as midwives function in, can be a very intimidating place. We need tools to protect ourselves in this litigation era. I prayed a lot that the Lord would guide me to help other midwives and doctors who face the same challenges. EasyOBS.com was born and is officially launched for all midwives, doctors, birthing centres, hospitals and home birth practices. EasyOBS.com is an Obstetric Management System….making obstetrics easier!
You offer homebirths/birth centre births, what is it that attracts your clients to this sort of service?
Most of my clients are vulnerable in a lot of ways. Some are very young, most don’t have a medical aid, some have the need for ‘healing” births after very traumatic hospital experiences and others are simply birth-educated and know what they want.
Being able to offer Homebirths and Water births in my own Birth Centre is a privilege I wish every person who is pregnant could experience. Mothers are longing for intimacy. They want to feel that they “can do this”. They want a voice. They want birthing-space without intimidation, without people take control over their bodies, birth and babies. They also need someone to trust in situations when things might go wrong. They mostly don’t need rules, but only guidance when asked for.
I always tell my clients “I am your cheerleader….. Your instinct will guide you”. I will remind them they are strong when they forget at 9cm dilatation!
Mothers want a safe-haven when nobody else believes in birth.
What is the best part of homebirths for you?
I don’t like rules and routine. Homebirths give me and my clients’ freedom. Freedom to believe, freedom to move, freedom to do and just simply be!
Homebirths have far better outcomes (I have experienced in the 2 000 births I have attended to) than hospital births. I believe it is because we don’t interfere with nature. We allow mothers to birth their off-spring. Midwives don’t “deliver” babies.
We trust labour, births, mothers and babies. O yes, some babies have a lot of tricks! Some mothers change personality during labour, but that’s all ok.
Homebirth gives the mother a platform to be human.
- What are the challenges for midwives such as yourself offering homebirths?
You will find that the challenge of a back-up doctor is the same for all midwives throughout of South Africa. I have convinced myself it is nothing personal. It’s the doctor’s misperception about midwifery as a profession. Doctors don’t know what midwives really do. They don’t know our scope of practice. They don’t know our specialised skills. They tend to forget we are there to take their hands, not their jobs.
We are living in a litigation climate, whether we work under hospital protocol or in a homebirth setting. People want to sue, because they can. We as midwives need to keep our profession alive by keeping our skills up. We need to maintain our expertise by educating ourselves internationally, national and through life-long learning. We need to protect ourselves, our practices and our profession.
By keeping our mothers and babies safe, time will convince doctors the world needs midwives more than ever!
What in your experience are some of the misperceptions around homebirth?
People tend to think homebirth is weird, because of the media. Births usually happen with a whole lot of drama either at home (with the first contraction) or on the backseat of a taxi (with the rupture of membranes) in most movies. All the “actors” are screaming, sweating and panicking in the birth scene.
Most men don’t want drama and choose their wives to birth in a hospital, because that’s the norm in modern society. Men tend to think that THEY need to take charge of every situation in order to be a good support. Couples love to tell the horror-stories of birth to expecting couples. Why, I really don’t know! Pregnant people are bombarded by a lot of terrifying stories (and usually lies) about birth, but never do they ask about the beauty of home birth, because they simply don’t read birth educational articles. People don’t want to be classified as weird and choose to “hush” if they have decided to follow their gut and go for home birth.
Any highlights of home births you’ve attended that you care to share?
I simply love kids to be present at homebirths. They lighten up the environment and bring a special kind of presence to the birth room.
My last birth was a HBAC and Kiana (4yr old) was present. She got into the birth tub with her labouring mother for “support”. Everything was in the birth tub with mom and Kiana – Gabby the floating doll, the toy-fishes, the plastic farm animals and her mirror! Kiana would rub her mother’s arm with every contraction, encouraging her to “be strong”! Kiana would drink the half of her mom’s Energade and offer mom a sip when she decided it was needed. When mom reached the transition stage and couldn’t get comfortable in any position, Kiana took her mirror and held it to her mother’s face. They both looked into the mirror and Kiana proclaimed very load “Mom! You are doing this for me. I need a friend you know!” Mom smiled and I smiled, capturing these moments in silence engraving it in my heart. When pushing time came Kiana refused to get out of the tub. She was there to stay throughout – with her mirror and encouragement , supporting her mom with the arrival of her new sister, Nika
What are your hopes and dreams for birth in SA?
My hopes and dreams for births in SA, is to have more midwife-led births centres. I really hope and pray that midwives will rise and make the difference that only Midwives can make. Midwives are born not made in educational centres.
The world and especially SA need midwives more than ever. We need a stronger generation – it starts with birth.
How we are born -DOES INDEED MATTER!
This month we spoke to Samantha Squire-Howe, mother, birth photographer and doula. And also the 2015 Midwifery and Birth Conference official photographer. Based in the Southern Peninsula of Cape Town, she runs Twinkle Star Photography – her passion for her work is evident in her photographs.
Tell us about yourself and the birth work that you do.
My name is Sam Squire-Howe and I am a professional Birth Photographer (Twinkle Star Photography). I am based in Cape Town and travel to births in all the surrounding areas. I attend both hospital and home births, natural births and c-sections. I am currently busy certifying as a Mama Bamba doula as well, which I am so enjoying. I feel being fully equipped both emotionally and mentally to be present at a birth, is so important. I am hugely passionate about discreetly documenting this incredibly profound experience. Witnessing the moment someone becomes a parent, is beyond a privilege for me. I have seen through my work, what a gift it is for parents to have these precious memories captured. Birth is such an intense experience. Often it goes by in what feels like a flash and a lot of the details get lost in a blur. I have also found when birth doesn’t go exactly to plan, that those images are a valuable tool in the healing process for a mom. My own birth experience really taught me that at the end of the day, sometimes your birth doesn’t go according to one’s picture or plan. Sometimes it is hard to let go of the way we wanted it. Seeing beautiful images of the story, just the way it unfolded is incredibly healing.
How do you feel about capturing home births?
Although I completely love being present at all types of birth, I must admit being present at and capturing home births is definitely my absolute best! I am so pro-home birth and really wish I had made that choice with my own birth. It is wonderful documenting birth in such normal, natural surroundings – completely unmedicated. I love that the mood of each home birth is so unique to each family and couple.
How did you get involved in home births?
As soon as I specialised in Birth Photography, I began documenting home births. In fact, the first ever birth I photographed was a home birth. To me home birth is just the most natural thing. I had already read up and researched so much about birthing at home while pregnant with my daughter, 10 years ago. Quite a few of my friends have chosen to birth at home, so it has been very familiar to me.
Are there any challenges to photographing a home birth?
The only real challenge is a technical one and that is that often, one is photographing in very low light – compared to say a hospital situation. I often find myself shooting in what feels like the pitch dark. This is lovely for the birthing mom, but you really need to know your way around your camera and how to make the most of the little bit of light that is available! I pride myself in capturing these sacred moments without disturbing the scene at all. I don’t use flash for this reason. Not disturbing the atmosphere at all is of paramount importance to me.
Tell us something that has stood out for you in the work that you do.
Shew, this is a hard one. There are so many things. I think the most incredible thing for has been the response to my images. In today’s society birth has become so unknown to us as women. Gone are the days of the past where by the time we gave birth for the first time, we would have already attended many births of the women around us – our mothers, aunts, sisters and friends would have shared this experience with us, in a circle of woman. Birth would have been so familiar and natural and real. Now the doors are closed and birth has become something hidden and taboo. As we all know, a picture speaks a thousand words. Birth Photography has a very noble task today. This is one of the ways we can normalise birth again. Make it something familiar to woman. Something not to be feared. I feel so strongly about this. Women are hungry to be reminded of the power and beauty of what it is to birth a child. I love being a part of this revolution.
What are the challenges/misconceptions you’ve encountered about birth photography?
I think the biggest challenge (especially here in South Africa) is that most people don’t understand what Birth Photography really is. Everyone seems to just picture that crowning shot. You know!? But it is so not about that. It is about having one of the most important days in your life discreetly, beautifully and authentically captured. It is about the story of the birth – the labour, the moments of the birth and the first few hours of your baby’s life. The other misconception, I find, is that people don’t realise how in the background one is as the photographer. So often my clients will comment how amazing it was, that most of the time, they were not even aware I was there. To me in my role as photographer, that is an art and the biggest compliment.
You’ve been selected as the Cape Town Midwifery and Birth conference ‘s official photographer this year, what are you hoping to gain from this collaboration?
For me, I so enjoy hanging out with fellow birth junkies! It feels like I am with my tribe. Plus, I have always loved capturing woman in my photography. So I love documenting these kinds of events – the passion and beauty of these dedicated, warm, wonderful people. So passionate about empowered birth. So passionate about birth education and supporting women’s choices. I can’t think of anything better. Last year, I wasn’t able to be at this event and I so loved seeing the photographs and getting a glimpse of what I had missed. I also loved watching all the talks on YouTube. I got so much out of it. So the photographs and videos make this event accessible, even to those unable to be there on the weekend.
For more info on Sam and to see her work, please visit her website www.twinklestar.co.za
It is never easy to pindown an on-call home birth midwife but this month we managed to interview Sandy Standish, an independent midwife practicing in Cape Town.
How long have you been offering home birth services for?
I had my first own home birth in 1987 which sparked the passion. I started private midwifery in 1993 with Joy McPherson.
What are the reasons mothers come to you (or other midwives) for a home birth?
Mothers come to me mostly to experience a natural birth with as little intervention as possible. They want to have medical support without being disempowered. Home births also allow the privacy to birth however you feel works for you whether it is dancing wildly or meditating quietly, the space is yours to do what you like with. So birth is a much more private affair and is unique to each mother’s own expression of it..
What are the challenges you face as a midwife offering home birth?
The challenges as a home birth midwife is, always, about the backup and attitudes towards home birth. There is a degree of risk involved due to the limitations around medical support in an out of a hospital setting. Therefore, there is resistance and concern around obstetric backup. It is also the responsibility of the midwife to be aware of her limitations and move sooner rather than later if there is a concern around outcomes.
How did you get involved in home birth? Can you tell us about the first home birth you attended? What stood out for you?
Joy had only worked in hospital and she had the first home birth client and was stressed out so wanted me to be there as support and that is how we started having 2 midwives at a birth as was not the norm before that. I remember it was a typical cape winter night with rain and all.But we were happily ensconced in a warm home and praying we didn’t have to go anywhere. The birth went well.
For more info on Sandy and the services she offers (which include placenta encapsulation, childbirth preparation classes as well as private midwifery services) visit her website Birthing Naturally.
This month we chatted to Vanessa Hartman.
She is a doula, a yoga teacher, antenatal educator, a soul connection facilitator and co-founder of Honoured Birth.
Tell us about yourself and the birth work that you do.
My name is Vanessa and I am a natural birth passionista. I am a doula, a yoga teacher, an antenatal educator and a soul connection facilitator. In January 2015, together with my friend and colleague, I opened a little studio in Noordhoek called “Honoured Birth,” a space where women can celebrate their pregnancies and where expecting parents are invited to ask questions and obtain necessary information in order make informed decisions. It is a place to meet like-minded people and to find support and nurturing on all levels.
What drives you to do this work?
The look on a mother and father’s face when they are holding their baby for the first time, the overflowing love that radiates from each and every cell of their bodies is nothing other than true and divine bliss. It takes my breath away and fills my heart with immense honour and gratitude. It does not matter how or where they gave birth, at home, at hospital or through a c/s, it is that moment that again and again reminds me that the birth of a baby will always be a miracle.
How do you feel about home birth?
I believe that if the pregnancy has been without complications the best place to give birth is where the mother (and the father) feel the safest. For me personally that would always be at home. Many people don’t know enough about home birth and the safety of giving birth at home with a midwife so we need to help parents learn about this possibility so that it may become an option for them.
Are there any misperceptions about home birth that you would like to dispel?
Oh there are many. One of the main ones that I hear a lot is when people talking about their feelings on home birth say: “I am just not that ‘airy-fairy-hippi-type‘!“
Sometimes it frustrates me so much that, largely as a result of the media, birth is perceived a fearful and medical event that needs to be controlled so that those who choose home birth are easily labeled as “airy-fairy”. But birth can be the most beautiful and empowering moment of a woman’s (and a man’s) life that will unfold in its own unique and wonderful way. To me there is nothing airy-fairy-hippie-typeish about that.
What is it about home birth that you enjoy?
I love the calm and warm atmosphere, the loving, undivided attention and support of the midwife and everybody involved. Experiencing this respect and honouring of the process of birth as well as the mother moving with confidence in her own environment makes my heart jump with joy.
How did you get involved in home births?
Becoming a doula opened the home birth doors for me and changed my life completely – even though the first 10 births I attended were all hospital births, many in public sector hospitals and MOU’s. After only seeing hospital births my first home birth changed my life – again. Looking back over the past 4 years of being a doula and on what I have learned makes me strongly believe that “peace on earth begins with birth” and I am on a mission to reduce the almost 80% c/s rate in this country by supporting parents in the decision-making process and providing them with all the information they need.
Tell us something that has stood out for you in the work that you do.
This could become a very long answer as there are so many things that I could name. That’s why I should rather keep it very short and only name one thing: It is life changing!
What would you advise all pregnant mothers?
Start educating yourself as early as possible. Don’t wait for 34 weeks to do antenatal classes. Start early so that you have enough time to gather all the information you need to make informed decisions. It is your body, your baby and your birth so never feel that you have to stop asking questions. Choose your support system wisely and make sure that they support and honour your decisions and wishes.
And VERY importantly, don’t listen to any “horror” stories of other people’s births. Protect yourself from stories like a friend-of-a-friend-of-a-friend-had-to-have-an-emergancy-cesear-…..- and kindly ask people around you to only tell you positive and empowering stories, as these are the stories that will support you and your decision-making process and keep you free from the unneeded and unnecessary seeds of fear.
To contact Vanessa, or for more information on the work she and her partner offer:
click here to like them on Facebook
I recently sat down for coffee with local Cape Town Midwife Lydia Du Toit who is a “no fuss-no frills” down to earth midwife who loves attending homebirths.
When did you first start offering homebirths?
9 years ago – after attending as the back-up midwife at a homebirth ….It’s such a stark contrast to hospital births – I even chose to birth my own to daughters at home with a midwife!
What is it about homebirths that you enjoy?
Labour and birth at home is so simple, no unnecessary interventions, the mothers seem more relaxed in their own environment and that make them better able to manage their labour having loved ones around to support them and a skilled midwife to attend them.
What would you say to women who are thinking of having a homebirth?
Granted, it’s not for everyone but do your research! The evidence is definitely in favour of homebirth as a safe option for mothers with low-risk pregnancies.
Are there any changes you’d like to see in the current practices around homebirth?
I would like to see more hospitals and doctors providing obstetric back-up for homebirths. I would also encourage obstetricians to come and attend/observe a birth at home –I’m sure it will change a lot of misconception that exists around homebirth out there.
You can reach Lydia at her Consulting rooms on 021 696 8571 or on her cellphone at 083 457 5270 or email her on firstname.lastname@example.org