Approximately 10% (5 million) of the women in South Africa who can afford medical aid give birth in private hospitals and of these 80% will undergo a caesarian section. The other 20% of white women will have epidurals, inductions, vacuum and forceps deliveries, be induced with prostaglandins, or augmented with pitocin for no good medical reason. They will have
episiotomies, be separated from their babies after birth, and subsequently struggle to breastfeed. Perhaps less than 3% of women will give birth spontaneously, without trauma to her or her infant. Most of these women experience their births as traumatic. Therefore 97% of white babies in South Africa experience birth as traumatic. The birth is rushed and ‘pushing’ is forced, babies are pulled out not ‘born’. The baby is born to bright lights, an unfamiliar person, and examined before being given to the mother. The umbilical cord is clamped and cut immediately, the baby’s skin is routinely scrubbed down by the hospital midwives with a rough dry towel.
What worries me about these behaviours is that they appear to be torturous to the baby as almost all babies scream during these procedures. Kindness does not seem to be the order of the day. These are the first lessons white babies are learning in South Africa: How to dominate and subjugate another human being by using power, technology, money and knowledge.
Of the 60 million people inhabiting South Africa, only 10% are white, most of whom can afford to pay installments on a medical fund that will allow admission at a private hospital. Of the 48 million black people in the country, only 7,9% can afford medical aid coverage. Most black women give birth in understaffed public hospitals that do not have adequate equipment, or facilities. Black women and babies diegiving birth in South Africa. White women rarely die. Black women give birth in open wards with no privacy, are not allowed to have a support person or family member with them, give birth in training institutions. Sometimes there may be as many as 20 people around a patient’s bed discussing the case. Women’s needs are ignored, they are prohibited from walking around by staff, forced to lie on their backs to give birth, shouted at and bullied by staff to ‘push’ the baby out. They often do not eat for days as there is no food served. Babies are also treated roughly after the birth, the cord is clamped and cut sometimes before the baby’s shoulder is born. Mother and baby are then left abandoned on the bed while available staff tend to other births and emergencies. When a mother is discharged the next day from hospital with her baby she may travel or walk for hours before she arrives home. What are the first lessons black babies learn from their birth experience in South Africa?
Black babies are learning that they and their mothers are bullied and co-erced, abandoned and neglected, that they have meagre resources and that they are not really wanted. What does this engender in non-white or black children? Perhaps underlying feelings of worthlessness, helplessness and rage? Perhaps the need for revenge later in life?
We would do well to introduce compassion in our South African national maternity care services by training our midwifery students and obstetricians in the real skills of ‘Being with Women’ in labour, of delaying clamping and cutting the cord, of maintaining the maternal-infant dyad after birth, of allowing upright positions for birth, of facilitating spontaneous expulsion of the baby from the womb.
Is it possible to teach a young adult to be humane and to treat others with kindness if he was not treated with kindness himself when he was born?