Khanyisa and husband Sabelo were surprised today by how safe and pleasant it was to give birth to Khanyisa’s second child at home, after finding out that the birth unit where they had booked to give birth was full! A homebirth is safe for a healthy mum and much more comfortable and private, with minimal intervention and maximum support. Elona quietly graced us with her sweet presence, while the earth continued to turn and life proceeded normally around us. Sabelo, Khanyisa and I welcomed Elona gently and I left the new family alone to acquaint themselves with each other. Sabelo was delighted at Elona’s alert responsive behaviour, sucking her fingers, gazing at him with adoring expression and licking her lips. She weighed in at 3200gms. Mother and baby have gone to her mother’s home to fulfill Xhosa customs and Sabelo will prepare their own home for his wife and child’s return after the baby’s umbilical cord detaches. I was honoured and grateful to be present.
On the other hand, a hospital is the best place to be when a pregnant woman suffers a complication of pregnancy or birth. Last week, ‘Sarah’ (not her real name) developed Gestational Proteinuric Hypertension (GPH) and was referred to an obstetrician for further care at 35 weeks of pregnancy. Sarah had set her heart on giving birth undisturbed at home in the presence of a midwife. While her liver functions were normal, her kidney functions were NOT normal, her blood pressure was labile and proteinuria was almost solid. The baby was born by caesarian section yesterday and is healthy. The mother is recovering slowly. This mother is clearly safer in a hospital setting, cared for by specialists with surgical and intensive care facilities at hand.
The safety of homebirth depends on assessing mothers with good risk selection factors, an easily accessible transport system and well trained midwives. In Holland, students choose whether they wish to train as nurses, or as midwives. And once they are trained as midwives, they choose again whether they wish to work as homebirth or hospital midwives. So the training is thorough and applicable to their chosen vocation. This system seems to work well. Women need to be educated and nurtured with regard to their health, none more so than in South Africa. A one-on-one domiciliary midwifery service is a means to this end.