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Sunday
Dec262010

South African Childbirth Resources?

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By Jill

 

I’ve noticed on the VBAC Facebook page that there are a lot of South African women looking for VBAC— and just plain VAGINAL— birth resources. It’s not surprising considering that the South African cesarean rate is 70% in private hospitals.

There are some fascinating older studies that look at health care disparities as a result of institutionalized racism in South Africa, including this 1998 study which concluded:

In fact, there is growing evidence that discrimination might also have a direct effect on the health and health care of different ‘racial’ groups, because poverty alone cannot explain the differences in health observed among different ‘racial’ groups. For example, there are clear differences in caesarean section rates between women from different ‘racial’ groups, irrespective of their socioeconomic and medical characteristics.  In fact, caesarean section rates provide an ideal opportunity for identifying bias in medical decision-making, because a variety of nonclinical factors, including ‘race’, have been found to influence the prevalence of caesarean sections at different health facilities and among different physicians.

A 2007 study examined the inhumane and abusive treatment of South African women in labor and concluded that the quality of state hospitals needs to improve:

In South Africa, the quality of care for women during childbirth could be improved: women are often left alone for long periods during childbirth, and in some instances women are shouted at, struck, or slapped. Staff are under stress due to lack of resources, and this demoralises the work force. However, women will not use a service they judge to be of poor quality, and choosing not to deliver in a health facility can compromise maternal and foetal outcomes.

 

Here’s what I’ve found. Please add to this list in the comments, even if it’s just your contact information as a midwife, doula, childbirth educator or vaginal birth friendly doctor.

MotherInstinct is a site run by a woman named Elsabé which appears to have mostly natural birth-type resources.

Birthing in Awareness is a list of links and services, including doctor and midwife recommendations, assembled by Rosalia.

Little Footprints Planet has a short list of birth and breastfeeding links.

 

As far as national or international organizations seeking to eliminate or reduce harmful childbirth practices from a human rights/social justice perspective in South Africa, there don’t seem to be many, especially in a country in which lack of access to medical care is an issue contributing to maternal mortality and preventing the spread of HIV/AIDS is top priority.

The cesarean surgery page on the Atlas of Birth site probably sums the polarized situation up best:

In nearly all countries rich women have a much higher percentage of caesarean births than poor women, so even if the national average seems adequate, poor women may still be unable to access this life-saving intervention. In some countries you find both excessively high rates amongst the rich women suggestive of over-intervention, alongside an unacceptable low rates – suggesting high unmet need – amongst the poorest women.

The United Nations Development Programme’s South Africa site lists eight Millennium Development Goals, one of which is MDG 5: Improve Maternal Health.

According to USAID, “South Africa has excellent maternal and child health policies. However, implementation is weak and South Africa is only one of a few countries in the world where under – 5 mortality is increasing.  Unless this situation changes, South Africa will not achieve millennium Development Goal number 4 or 5.”

 

Other resources:

South Africa’s Care.org Profile

South African Human Rights Commission 

 

 

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Reader Comments (3)

I started my own website on the topic of natural birth because this is something I'm really passionate about and I've found that many resources are specific to the American or British systems. My site is still new, but I'm am looking to include an evidence based resource on VBACs in South Africa, including a list of VBAC friendly providers. At the moment I am working on articles on how to improve your chances of having a natural birth in the first place, including my pregnancy diary (in it's 12 week) which documents my journey on making informed choices in childbirth. At the moment I'm working on an article on the best positions for labour, it's just illustrations that are taking extra time because I couldn't find photos or good illustrations of moms giving birth in any position other than lying down or semi-sitting.
With my first baby I had a natural, minimal intervention birth (6 hours at home, 6 hours at hospital, 4 pushes, only gas and air and a tiny tear) at one of our notorious private hospitals and even the nurses from the next shift came in to see how this miracle mom and baby were doing! I was seen as an extreme rarity! That's what got me first thinking about all this stuff....
I get so upset when I see such a high percentage of my mommy friends going through the usual induction, epidural, caesarean cycle without being informed about the choices they are making.

About state hospitals, I have a friend whose mother-in-law is one of the head matron at one of the better state hospitals (teaching hospital - referrals only), and another friend who is a doula who goes to state hospitals just to help and get experience, and another friend who runs a charity collecting baby gear for newborns since she found out that many of the babies went home naked, wrapped in their mother's clothing because they have nothing else.

So anyway, feel free to check out my website! I'd love to do some guest blogging, I think my friends are tired of hearing the rantings and ravings of their birth junkie friend! I'm also happy to do research in my own city (Pietermaritzburg, an hour's drive from Durban) for VBAC resources, and even in Durban as well. For one, I know that my midwife, the only private midwife in our city of over a million, does do VBACs at home and in hospital.

December 26, 2010 | Unregistered CommenterLeigh Jansen

Thank you for writing this, there really needs to be some dialogue on these issues. The gap between rich and poor is so evident in our healthcare system, to the detriment of the mom/baby dyad, on both ends of the spectrum. Anyone's welcome to contact me for inform of midwives/doulas in the Joburg area.

December 26, 2010 | Unregistered CommenterMilly

I have just started my own search in Pretoria, where I live. Since I'm from the Netherlands where home births (and thus vaginal delivery) are the number one choice I am quite shocked to learn about South Africa's c-section rate. And I am determined to only get one in case of a medical emergency. Please do note that I am posting the information I found here but that I have no hands-on experience with any of these service providers yet. I only now am starting to contact them since I'm still in early pregnancy.

So far I have found these midwives (Midwives Exclusive) in Pretoria who are pro natural birth: www.birth2baby.co.za. Contact Heather Pieterse <heather@midwives-exclusive.co.za> or call Yolandi 0123041818 or 0832836999. They work at the Active Birth Unit of Femina Clinic, 460 Belvedere Street, Arcadia, Pretoria.

Midwives Exclusive works with Gynaecologist & Obstetrician Dr. Paul Swart who is very pro natural birth but more pro evidence based obstetrics. His feeling is that natural birth should be handled by midwives who specialize in it whilst high risk complicated cases should involve a gynae. Tel. 0123284326, also at the Femina Clinic in Pretoria.

Other info I found:
Mariatha Yazbeck, Private Midwife specializing in natural births in the Pretoria area.
Cell: 0825763558.

For Johannesburg this Birth Centre seems to focus on natural birth:
Genesis Clinic (Birth Centre)
Location: 5 Northwold Drive, Corner of Jan Smuts, Saxonwold
http://www.genesisclinic.co.za/home.htm

January 6, 2011 | Unregistered CommenterMarjolein
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