A Registered Midwife in South Africa is someone with a diploma or degree in nursing. Nurse midwives work in public hospitals or clinics while others work in private hospitals as obstetrics nurses not as midwives because all births are in the hands of obstetricians. It is so sad that when deciding whether to go public or private, a pregnant woman need to weigh up what she want out of the birthing experience, as well as what you can afford and if their medical aid cover will absorb the costs of going private.
In South Africa, there seems to be a demand for a less technological medicalised birth. There is an increase in women who express a preference for a birth with a private midwife. In South Africa the trend back towards delivering with a private midwife is relatively recent and the field of private practicing (independent) midwives a growing one. Midwives offer the same care as any obstetrician or general practitioner who delivers babies.
It was not so long ago when the previous government forced all private midwives out of practice. Before 1976 all black women gave birth at home in the comfort of a midwife. Unfortunately some people still frown when I tell them to plan to have their baby born naturally and at home. It would be nice if natural home birth becomes the normality, like it used to be before medicalization of birth and the takeover of birth by men. Natural birth makes you think and I don’t think many people want to think. We have to unlearn to what was normal before and to do this will take time, determination and lots of education.
As mentioned most mothers prefer to be with a private midwife, than giving birth with an obstetrician/gynecologist. The problem is there are not enough of them. We are facing a dilemma of hospital births with an expert such as an obstetrician/gynecologist or overworked, and underpaid, nurse midwives in South Africa in poor resourced facilities. We wish for more nurses to go into private practice and support the thousands of South African women, black or white who demand good care and in the comfort of their homes.
There are no statistics available of the number of babies delivered by private midwives and no register exists of the names and numbers of private midwives available. These private midwives need to be registered with the South African Nursing Council every year as a professional Midwife. She also needs to be registered as a Private Nurse Practitioner with a practice number.
A nurse practitioner in South Africa is a nurse who has been trained in general nursing and midwifery and who has additional skills gained from additional course work. These nurses are usually experienced in a certain field in which they practice. They must be registered with the Board of Healthcare Funders of SA as a Practitioner or Agency and pay a fee after which they will be given a practice number which must appear on all your stationary. This is recommended but not obligatory.
Their address:P O Box 2324, Parklands 2121 Telephone: 011 880 8900
Indemnity insurance, although not compulsory, is a basic essential for any practitioner. The most cost effective and efficient insurance available in South Africa at present is that afforded to members of DENOSA and HOSPERSA. In addition one can take out additional insurance cover through DENOSA should you be practicing in a high-risk area such as home deliveries? Indemnity insurance is also available to members of the Occupational Health Nurses through the organisation.
HOSPERSA:P O Box 12266 Queens wood 0121 Telephone 012 333 6252
DENOSA:P O Box 1280, Pretoria 0001 Telephone: 012 343 2315
Licensing to prescribe and store medications are available on a limited basis through the Department of Health but there is a delay at present, while midwives planning to do home deliveries are required to register with the Local Authority for a permit. Current legislation, s38A, does not apply to nurses working in the private sector. Should South Africa consider state funding for home births as an alternative to hospital-based delivery? Midwifery services should be fully funded by the government of South Africa. This might be the answer to our overcrowded understaffed maternity units and high maternal mortality rates.
A midwife typically meets an expectant mother early in her pregnancy and sees her regularly throughout. Once labour begins, the midwife often goes to the home of the mother-to-be to check whether active labour is in progress or can also meet her patient at the hospital. The midwife attends the woman continuously during labour and delivery at the hospital. Barring any complications, the new mother can then choose to stay in the hospital or go home with her baby within hours of the birth. The midwife visits the mother and baby at home on days one, three and five and sees them at a clinic two, four and six weeks after birth. This is what birth should be like, not be controlled by surgeons, they should only take care of complications during chilbirth.