Sensitive Midwifery - Issue 44 - October 2019

Birth Sensitive Midwifery writer Kelly Norwood-Young provides a snapshot of birth trends in South Africa today, and how these might influence the future of natural birth and midwifery in the country. The future of natural birth in South Africa C onsidering the current situation regarding C-section rates, litigation and indemnity insurance, doctors practising defensive medicine, and financial constraints that restrict women’s birthing choices, it is easy to feel despondent about the future of natural birth in South Africa. However, before we panic or throw up our hands in despair, we must remember firstly, that there have always been midwives who have risen to meet the needs of women (and their own need to live out their birthing beliefs), and secondly, that they have an important role to play as the keepers of natural birth. The influence of obstetrics Of course, the medical model of birth continues to a ff ect birth and midwifery today. In the private sector, C-sections are skyrocketing: one recent 2019 report revealed that 74% of babies born to members of Discovery medical scheme are delivered via C-section – numbers which are supported by the Council for Medical Schemes’ recent annual report, which shows that in 2017, about six out of 10 mothers had C-sections in private hospitals. In the public sector, C-section rates are lower (one in four mothers undergo the procedure) but are still climbing high above the rate of 10–15% recommended by the World Health Organization. While there are numerous factors at play, National Department of Health’s deputy director general for communicable and noncommunicable diseases, Yogan Pillay, has admitted that many doctors are simply scared of delivering babies Continued on page 21 20 eSensitive Midwifery Magazine Issue 44