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The beginning of my birth story happened in Portugal during the height of Covid19 in 2021. We had been living in a small fishing village called Ericeira for a few months during Covid to escape the chilly season where we had previously lived in the Netherlands. My partner and I had been together for six years and were pretty content with our relationship. We had worked hard on communication and building a happy life together – towards our dream of living near the sea and being able to work from anywhere in the world. Unmarried, but in love and committed.
At the end of what seemed like a roller-coaster year of lockdowns, isolation, cabin fever and missing our friends and family, we found out I was pregnant. It was unplanned and a bit of a shock at first. I remember sitting on the bed after the test came back positive and crying while my partner paced up and down asking “So what do we do?”.
Once we had calmed down and realized we were in a great position to have a baby, we called our family back in South Africa and shared the exciting news. Then reality hit…How did the medical aid system work in Portugal? Could I give birth in a state hospital? Where would I give birth? Where would I find a good English speaking OBGYN? Or did I want a home birth? It was so overwhelming.
Even after registering for state healthcare and visiting a lovely OBGYN who spoke perfect English, we made the decision to go back to South Africa. Although we loved the rocky seaside cliffs of Portugal, and we had made plenty of friends, having a newborn without family support seemed daunting. Surrounding ourselves with expats in both the Netherlands and Portugal, we had seen first-hand how important family support was for new families. And with it costing over R15 000 a flight back and forth from SA to Europe, it was just not an option to have family over often.
Me at 13 weeks pregnant in Ericeira, Portugal
At 24 weeks pregnant, we sold our furniture, sub-let our apartment, got our mandatory PCR-tests and booked one of the very few flights to back South Africa, Cape Town. Luckily, I had kept my SA medical aid in case of an emergency when I would visit frequently (if you don’t know this by now, medical aids will not cover your maternity care if you have been with them for less than 10 months or even a year). I cannot stress the importance of medical aid and gap cover enough. The average costs from pregnancy to birth in a private hospital ranges from R30 000 to R50 000 (depending on C-section or vaginal birth) for uncomplicated births. Add another R16,000 to the hospital bill – per day (IFC).
I had already found a wonderful doula when I was living in Portugal for my return to Cape Town. Now this is the most important point I’d like to make in the whole story…find a birth team who you can trust, confide in and get resources from based on your ideals and values. You know your body better than anyone else and you need to surround yourself with people who respect your wishes and intuition. My doula was the starting point on my journey of finding the most incredible prenatal and postnatal support I could ever hope for. In her words “Choose carefully. Be fussy. Because there is a provider out there that is just right for you”. (*Mama Bamba has a great directory of qualified doulas in South Africa).
Like I said previously, finding a doula is a great first step in surrounding yourself with the best care providers FOR YOU. My doula had access to a network of other doulas, midwives, and other care providers at her fingertips. So, when I asked her questions like, “Which doctors are pro-natural” or “Which hospitals allow for the partner to sleep over”, she could ask her network and get great recommendations for me. She also helped me if I was worried about my baby in my womb. “Is it normal if my baby…”, type of questions which you will be familiar with if you’ve already been pregnant or if you are expecting”.
Other than being a great source of knowledge, my doula was there for me emotionally and helped me feel prepared for labour. She asked me how I wanted to give birth (more on what to include in your birth plan to follow), how I wanted the atmosphere to feel in the maternity suit, how I wanted to be touched, spoken to and supported. And when the day arrived, she followed all my wishes as well as making sure the other care providers knew my preferences (my labour was so fast I never got to put up the fairly lights, set up the diffuser or play my birth playlist, but as you go into labour, you’ll work out that no plan is set in stone).
Find list of Doulas in the Western Cape here: http://homebirth.org.za/directory/doulas/doulas-western-cape/
Find list of doulas in Gauteng here: http://homebirth.org.za/directory/doulas/doulas-gauteng/
Find list of KZN doulas here: http://homebirth.org.za/directory/doulas/doulas-kwazulu-natal/
Originally, I wanted to have a midwife led home birth as I’ve read countless arguments for the benefits of a labouring woman to feel safe and secure while birthing in their own space. Midwives also have extensive experience with many types of ‘natural’ or unmedicated vaginal births and are less likely to push for interventions like inductions and C-sections. Sadly, it is very difficult to have a home birth with a midwife in South Africa under private healthcare as very few OBGYN’s are willing to back midwives due to the obstetrics professions strict legal and insurance protocols and the perceived risk of home births.
However, on my journey I did reach out to a midwife who also ran a prenatal class called by Birth Options called Relax into Birth. I highly recommend this class for expecting moms who live in Cape Town and want to feel confident delivering vaginally and without medical intervention (although it would be great for any type of pregnancy). Here I learnt about the myriad of pain relief techniques both medical and natural (breathing, massage, water). I also learnt about the stages of labour, what to expect and what the first 24 hours after having a baby entails (breastfeeding, bathing, babies needs etc.).
Make sure you find a great pre and postnatal class that covers all birthing methods and has an in-depth section on the actual labour itself so that you feel empowered.
Find list of Midwives in the Western Cape here: http://homebirth.org.za/directory/midwives/midwives-western-cape/
Find list of Midwives in Gauteng here: http://homebirth.org.za/directory/midwives/midwives-gauteng/
Find list of KZN Midwives here: http://homebirth.org.za/directory/midwives/midwives-kwazulu-natal/
Fortunately, and uncommonly, I was able to find an OBGYN who was very ‘pro-natural’ (unmedicated vaginal birth). I had asked my doula to ask her network of midwives which doctors were most likely to deliver vaginally as the C-section rate in our hospitals is through the roof at above 70%. The previous doctor I had seen was referred to as ‘Ceaser’ and the hospital he worked at ‘Ceasers Palace’. So, I quickly moved over to a medical professional who would respect my desire to avoid a C-section at all cost (although I have nothing against women who choose this, but this was not what I wanted).
There are a few red flags that I’ve noted when women I know have wanted a vaginal birth but have been pushed into a C-section by their doctor:
*Internal examinations are not necessary while pregnant and should be avoided as they have been linked to an increased risk of vaginal infection or possibly result in the premature rupture of membranes.
Once I found my perfect birthing team I felt at ease, empowered and fully supported. I knew my body and mind were powerful and capable of birthing and I was not afraid of the pain many women elaborate on and terrify you with. Through my birthing classes, conversations with my doula and listening to positive birth stories, I was able to frame birth as a profound experience that will change my life for the better. I would finally meet the love of my life (sorry hubby but you know this is true).
