The Talk of the Umuzi: The Travelling Midwife

1. Talk at the Umuzi

I had the wonderful opportunity last week to assist Thokozile give birth to her baby girl in Kwazulunatal. Thokozile and her family live on their family homestead (Umuzi in Zulu) on the neighbouring farm. Tapsile is Thokozile’s mother and

often helps my mother in the house. After the work is done, they share tea and a chat about local affairs as women do. Tapsile’s older daughters sometimes work with the horses as well as around the farmyard.

2. Labour Preparation

I offered to accompany Thokozile during her labour and birth. We spent a wonderful afternoon together with the neighbouring pregnant women,  sharing and  preparing for the birth and a Zulu crash course for me. I demonstrated for Thokozile how to breathe deeply and explained the sensations  of labour, how important it is to stay calm and not be afraid.

The men were not part of this gathering. It was clear that pregnancy and birth belongs to the womenfolk in this extended family. I palpated each of the women’s abdomen’s and reflected my findings to them in broken Zulu. I listened to their baby’s heartbeats with my doptone. There were smiles of delight and many questions and answers.

The following day, Thokozilie’s sister ran to our house from their farm to tell me that labour had begun. I walked back to their home with my midwifery bag in a backpack, climbing through the fences en route.

3. The Birth

Thokozile was indeed in labour and it was progressing nicely. Thokozile’s sister Nosipho insisted that we transfer to the local Bruntville Clinic, 13km away. We piled into the back of the car and I continued to  massage her back and legs as we drove off to the clinic.

The Midwife in charge gave me permission to remain with Thokozile. I humbly and quietly familiarised myself with surrounding equipment and protocols. Thokozile, by now in deep transitional labour, preferred to lie on her side on the bed. She quietly used the breathing technique I had taught her.

Thokozile laboured beautifully, kneeling and lying on her side alternately. There were no commands to push, there was no shouting. There was  no unnecessary rupturing of membranes, no unnecessary vaginal examinations, no hand on the perineum (she would NOT allow me to touch!). Just silence, gentleness and trust.

All efforts emanated spontaneously from the mother and the baby was ‘born in the caul’. The baby lay on a soft cloth on the bed, before her mother reached forward to lift her into her arms. Thokozile was overwhelmed with relief and wonder. I did not touch mother or baby.  I covered them with a sheet to keep them warm. They were not separated.  the newborn baby girl found her mother’s breast within ten minutes of the birth. 

The placenta popped out after a quick push from Thokozile – the perfect example of physiological birth.

It is true that, as Michel Odent says, we need to stop ‘thinking’ and allow the primal brain to release the powerful hormones that drive natural labour and birth. For this to happen we need to understand the basic needs of a woman in labour: silence, calm, warmth, safety.

5. Breastfeeding

Breastfeeding was the natural response of both the baby and the mother, as skin to skin contact continued. The baby searched for the nipple and the mother responded instinctively and helped the baby latch. Breastfeeding is encouraged in the Zulu culture. Thokozile’s mother (Tapsile) herself breastfed her four children for several years each.

Thokozile and I spent the rest of the night sleeping inbetween feeds at the clinic in the postnatal room ( I slept on the bed alongside). My Mum thankfully arrived at 08h00 to take us home and after some shopping for supplies, we squeezed into the front of the cab. Soon we settled Mum and baby into bed at the Buthelezi family homestead.

6. The First Grandchild

Afterwards, it was lovely watching grandmother Tapsile connect with her new granddaughter, and sharing the experience with her other daughters and grandchildren. What a privilege to be part of this family’s journey. Needless to say, Thokozile is very proud that she had her own personal midwife and she is the talk of the community.