It’s estimated that globally 80% of babies are born with the assistance of midwives. However, in South Africa there are still people who imagine that using a midwife is only for “new age” moms determined to have babies naturally at home without pain medication. And that’s just one of the misconceptions about midwives.
Myth 1: Midwives are less qualified to care for pregnant women and do deliveries than gynaecologists, obstetricians and qualified nurses.
In South Africa, most midwives are nurses. Midwifery is a second qualification, and is defined as “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum from pre-pregnancy, pregnancy, birth, postpartum and the early weeks of life”, says the Society of Midwives of South Africa (SOMSA).
Midwives’ education is regulated by the South African Nursing Council. Current qualifications include midwifery, general nursing, community nursing and psychiatry. The qualifications can be obtained through either a four-year degree or four-year diploma.
New qualifications are starting from 2020, with a Bachelor’s Degree in Nursing and Midwifery that licenses individuals to practise as a professional nurse and midwife. An Advanced Diploma in Midwifery can be pursued by general nurses to become a midwife, and a Postgraduate Diploma in Midwifery offers specialisation in midwifery. These qualifications allow them to be employed internationally, says SOMSA.
Myth 2: Midwives are only for elite moms who opt for personalised home births rather than hospital care.
In South Africa, most women give birth in public hospitals, and the birth attendants tending to the majority of them are midwives. “Midwives in South Africa are the front line caregivers and backbone in maternal and child health care,” says SOMSA. It’s only when complications arise that obstetricians are called in.
There are also midwives who work in private practice, either in private hospitals, where they work with an obstetrician and provide care during labour and birth, or independently, “seeing childbearing families in their homes or independent practices, and providing care throughout the continuum of childbirth”. Today many hospitals offer choices in childbirth, including natural, low-intervention childbirth, or higher intervention and medical intervention, and midwives can offer support in all these environments.
Some private facilities also offer “sensitive Caesarian sections”, where midwives can ensure a more family-friendly experience of the birth, says SOMSA. “Having a midwife who can advocate on behalf of a woman, her choices and birth plan is appropriate in all these settings.”
Myth 3: Midwives will not allow the use of pain medication in labour.
Midwives are likely to start with medication-free methods of pain management, supporting the natural process with the likes of relaxation techniques, showers, a hot tub, massage, switching positions and walking around.
While they are not permitted to prescribe pain medications (such as painkillers and epidurals), they can support women who request pain medications, at facilities where medications are available. “Women’s choices are likely to be respected by a competent and caring midwife,” says SOMSA.
Myth 4: You’re not as safe with a midwife as with an obstetrician.
For normal, healthy births, you can be just as safe, and midwives can give you much more time and attention than a busy obstetrician, who will be called in only at the moment of delivery or if there are complications, says SOMSA. If you’re at risk of complications (and perhaps have a pre-existing medical condition such as diabetes), you can be attended by a midwife in a hospital facility with access to an obstetrician and medical equipment, if these are needed.
“Should major complications arise, or should you require a Caesarian section, the midwife will remain a part of your care team, supporting you through the procedure and through the recovery period, and allow a more sensitive birth for the baby”, SOMSA says.
Myth 5: Midwives are focused only on the birth.
With their education, midwives are focused on a holistic experience in all aspects in pregnancy, from nutrition and exercise to emotional changes and the responsibilities of new parenthood.
It’s important to give birth in the way that makes you feel safe and supported. Whether you opt for the hospital route or a home birth, a midwife can help, “even just to defend your right to choose alternatives in care”, says SOMSA. But it’s a decision you need to make for yourself.
For information on midwives and midwifery, contact the Society of Midwives of SA http://www.midwivessociety.co.za.
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