Birth in the Western Cape – my perspective 

(adapted from a talk given at The Midwifery and Birth Conference 2013)

Having the presence to be present during labour.
 Having the presence to be present during labour. Photo Credit: Mother Health International. http://www.motherhealth.org

                      https://soundcloud.com/drgauri/nurses-song  – starting the day with a prayer. 

The Western Cape – home to about 10% of South Africa’s population. Between 1999 and 2007 the amount of live births increased from 70 000 to 99 000. About 5% of maternal deaths in South Africa are from the Western Cape. Most deaths are caused by non-pregnancy related illness like HIV and next hypertensive disorders in pregnancy. But I am not going to dwell on statistics of mortality. Although it is sobering to always remember that pregnancy carries risks and moms can die!

DIVERSITY

I want to give you a flavour of my experience in the PUBLIC sector of Birth in the Western Cape – full of diversity and discrepancy – first some practical insight of the structure of birth in the Western Cape.

Public – you sit in a waiting room half a day to be one of about 60 mothers seen by 2 doctors. (Numbers vary and increase at different hospitals.) You have an ultrasound – if you are lucky – only when it is indicated.

Private – you make your appointment, pay at least R500, have an ultrasound at EVERY appointment indicated or not and you wait a little. But you actually have about the same amount of time with your gynae.

Private midwives – you have your appointment, pay less, and have far more time with your midwife where you discuss deep subjects – your own birth perhaps, your home situation, stressors and how you are really feeling and coping.

Describing the delivery is also a similar exercise.

HUGE DIVERSITY.

Which make talking about birth in the Western Cape open to several different angles.

I would like to give a very raw flavour of what birth in the western cape has been for me in my last few years in medicine.

A young girl – it was her 18th birthday. It was also Valentines day. She was wheeled in on an ambulance stretcher with her baby almost crowning. She was small and wearing a mini skirt and had been out with her boyfriend at the waterfront. Her baby girl was born quickly and she breastfed. Then we found out she did not want to keep the baby. Her boyfriend told us that 9 months ago she was raped. She believed her pregnant belly was a cyst, as she said she was told by her doctor. Therefore she had NO antenatal care. Her baby went up to the nursery, to prepare for adoption, and she went to the gynae ward.

Read more here: http://drgaurilowe.com/blog/birth-in-the-western-cape

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