Birth in South Africa

The Privilege of Midwifery

The obstetricians at Vincent Pallotti hospital have decided to no longer provide a back-up service for my practice. Apart from the loss of the medical back-up as a professional midwife, the greater loss is to mothers and women who are not able to choose this private hospital for medical back-up when they have chosen me as a professional midwife. No reasons for this withdrawal have been stated in their letter of notification.

I am formulating a response which I will send to the Obstetrical team at Vincent Pallotti Hospital in due course. I understand various perspectives which I shall summarize below:

Women and Mothers:

Mieke before her birth, hoping for a Vaginal Birth after Caesarian

Many women are afraid of childbirth and the possible dangers it may present. These women are confident that to book with an obstetrician, and be promised the pain relief interventions such as an epidural, opiates, and/or other medical interventions, will meet their needs. Some women, though, intrinsically feel in the core of their bodies and souls, that to birth naturally is vitally important. To do this they need an attendant who can hold a safe space and is attuned to their physical, emotional and spiritual needs, someone who will both evaluate clinical progress while at the same time respond to the needs of a woman as her labour progresses to the actual birth. Birthing mothers need someone who knows their physiology well, who recognize nuanced changes in their bodies and who will monitor the unborn baby’s wellbeing. They also need someone who is quick off the mark, who will take charge when the situation demands, who can resuscitate a baby, who can safely transfer to hospital from home.

Kiran Ciel, a VBAC baby, was born naturally at the Vincent Pallotti

The Obstetrician

An obstetrician spends 13 years training to qualify first as a doctor then as a specialist obstetrician. The training occurs mostly in a tertiary level of care hospital where women with major complications of pregnancy are treated. Birth in these   facilities is a carefully orchestrated and monitored affair to prevent the deaths of mothers and babies with severe conditions such as diabetes, heart disease, hypertension, pre-eclampsia and eclampsia, multiple pregnancies.  The obstetricians become skilled surgeons and clinicians adept at preventing harm and saving lives. When an obstetrician leaves the public service and serves in the private sector this training may colour his perspective notwithstanding that he is mostly assisting normal healthy pregnant women from higher socio-economic levels. He is also personally at risk of being held liable and being sued for any mishap that may occur.

The Midwife

Me, the midwife, holding Rob and Karen Baker's newborn!

A midwife is called to her profession by passion and a love of caring for other people, particularly women and their babies, from before conception to after the birth of their babies. A midwife in South Africa trains as a nurse first before her year of training as a midwife. In countries such as the United Kingdom and New Zealand a midwife trains directly for 3-4 years. A Midwife specializes in normal physiological/healthy pregnancy and natural birth. She guides a pregnant woman through her pregnancy by paying attention to all aspects of a woman’s health and wellbeing. A midwife is not equipped to provide ongoing medical care when complications arise and therefore works hand in hand with a doctor or an obstetrician. This ensures the safety of both mother and baby.

I present below a portfolio of pictures of mothers who birthed at Vincent Pallotti Hospital in my care or had homebirths backed up by obstetricians at Vincent Pallotti Hospital.

Appeal to Vincent Pallotti Hospital

If you would like to help in my appeal to Vincent Pallotti hospital, go to the Facebook group “Restore Sister Littlejohn’s Privileges at Vincent Pallotti Hospital” and write a letter or contact me via the page.

7 thoughts on “The Privilege of Midwifery”

  1. Dear Stephen

    I read your comment a long time ago, shook my head and thought to myself I’m not going to waste my time replying as this guy probably needs a hug or something! It reminds me of the scene from Monty Python’s “The Life of Brian” where, ironically, the guy keeps interjecting “or woman”, every time the word “man” is uttered.

    So sorry for your bad experiences with your gynaecologist and midwife because Stephen, it seems clear that that is the issue you are actually grappling with! As a father of two, both water births, and having spent hours with Marianne in consultations and classes, frankly Stephen, I have to say you are taking liberties which degrade not only her work and but also her website. You somehow try to rationalise your stern use of the word “unacceptable” with the fact that you yourself used a midwife as though that somehow makes you less accountable for your damaging actions. I bet you anything your midwife wasn’t Marianne – am I correct? It would almost be insulting to Marianne to defend her ubiquitous love and care for each and every family member (not just the mother and father), alas I feel an obligation to other readers who might falsely give you credit for your whim.

    Sure, father’s need to be included but let’s get real here, who’s carrying the baby and eventually giving birth. As my uncle John B Keane used to tell me – you might as well be giving birth to a football as to a baby with the amount of labour involved. My advice to you Stephen is to do a little research before you attempt publically to make disparaging generalisations about a professional midwife with more than thirty years experience. Somehow you manage to confuse the very correct notion to “include men at every stage of pregnancy and birth” with the false belief that Marianne is somehow promoting something different. In a private email that viewpoint would be acceptable (though incorrect) but to post such a comment publically is irresponsible and counterproductive to the whole purpose of a Spiritual Birth – which by the way was sheer and utter magic, joy you can only dream about dreaming about.



  2. HI Stephen,
    I’ve been very fortunate to have worked with a variety of midwives including Marianne & totally concur with your observation of the fathers role during the pregnancy, birth & beyond. However it’s been my experience that Marianne is the exception to this practice & goes out of her way to make fathers realize the importance of their role in the couples pregnancy & birthing process. In my own observation of the cross culture of fathers I serve however – not all fathers are willing to participate to the extent that they could – And so I encourage you to inspire your peers to embrace the full role of “father” as it’s fathers like you that are the foundation of a wholesome family!

  3. Marianne, I support midwifery entirely and we have used a midwife for the birth of our first child. What I find unacceptable is your lack of reference to fathers as a perspective above. This exclusion is something I have experienced as a father both when attempting to support my wife at her gynaecologist and when consulting the midwife we chose. Until we begin to include men at every stage of pregnancy and birth, they will remain on the periphery of raising children and we should not expect to see major change in the participation of fathers in the lives of their children that so many complain about today. I am interested to hear your views on this. Thanks, Stephen.

    1. Dear Stephen

      Thank you for pointing this out to me. In fact I have the greatest respect and inclusive approach to fathers in my work and will write an article specifically for fathers, as applied to conception, birth and parenting. Both a woman and the man she is with need to be transparent and committed and take 100% responsibility for their part in the process. When women are well connected with themselves and their bodies they are more easily able to see their men as REAL people, not an ideal of masculinity and manhood. The same applies to men with their women! And of course when a couple are truly loving towards themselves and their partners, this love will extend to the children. Much love, Marianne

  4. What complete nonsense…….What we clearly need is a pregnancy wellness centre that takes couple through from healthy conception with proper lifestyle support, through a healthy pregnancy and on to a successful home birth or birth at a birthing centre, if we limit the risks to mothers by ensuring that they are super healthy when they get pregnant much of the need for high tech medically monitored labours will be moot. Birth does not belong in a hospital!!!!! Women need to get educated about lifestyle and health before getting pregnant, this should be the focus, if you have taken charge of your own wellbeing you will be in a more empowered space, if you are an empowered, healthy woman labour should not be a problem. The hospital is then the place for moms who have placenta previa or other really serious UNPREVENTABLE conditions.

  5. This is a very sad state of affairs. I know that you have been offering an excellent service, adhering to outcomes based medicine, and in line with all the latest research on what is optimal for the mother and baby. I hope it can be resolved soon.

  6. Wow! I don’t understand the reasoning. I’ve had 3 VBACs at Vincent Palotti and now, finally, an HBAC backed-up by Mowbray. I hope this will not influence other hospitals, including public ones, to follow. Where to go from there? ‘Underground’? Crazy!

What do you think?