By Adeela Kasoojee
Pregnancy and childbirth are experiences that are unique to each person. Most women are overwhelmed by the wealth of information available on the subject and search engines abound with birth stories – good, bad and some that are downright scary.
I began researching a more natural approach to birth with the confirmation of my second pregnancy. The first time around – I lacked experience (go figure!) and the confidence to make decisions and choices. I chose the safest options – birthing in a private hospital with an experienced OBGYN and doing exactly as I was told by the nurses that checked up on me every hour or so in my private suite. It wasn’t a bad experience. I felt safe, ensconced in the little room, surrounded by people I loved. What I didn’t know was that being cooped up in that small space was not conducive to active labour. I laboured for close onto 20 hours without dilation, as a result. My labour was long and tiring after a pregnancy characterised by colds and flu and frequent bouts of bronchitis, sinusitis and even an episode of pneumonia.
This time was going to be different.
I was determined to, at the very least, attempt to birth this baby naturally and vaginally after a caesarean birth five years prior. I knew the risks and the contra-indications. I also knew that a natural, vaginal birth was possible. I had experienced an emergency caesarean and I hoped to be able to birth as Allah (SWT) intended this time around. I was strong and healthy and my pregnancy was going well, Alhamdulillah. Upon enquiring about the possibility of a vaginal delivery (after my previous caesarean) prior to my first appointment with my obstetrician – I was advised that he would not support my decision to attempt to birth naturally (the medical term is “Vaginal Birth After Caesar – VBAC). He believed, as many Obstetrician Gynaecologists do, that the risks outweighed the benefits and the possibility of my previous wound scar rupturing was a factor that loomed large in his recommendations. The fact that the VBAC was possible and that I was healthy and my pregnancy fit the medical definition of “normal” did not even feature in his diagnosis. I decided there and then that it was time for a change despite his expertise.
I began researching birthing options available in South Africa and while the idea of giving birth in the comfort of one’s own home appealed immensely, I also bore my own medical history in mind. A home birth, as appealing as it seemed, is not advisable after a caesarean birth. Whilst I intended to birth naturally – there was no foretelling what would actually happen until the actual birthing experience itself. I did not want to take too great a chance as well and risk baby’s life as well as my own. I had to be circumspect about my choices.
In my online forays – I came across Genesis Clinic Private Maternity Hospital. Touted as a natural birthing facility – it boasts an impressive team of midwives, obstetrician gynaecologists, anaesthetists and doulas. The facility itself is beautiful, tastefully decorated and located in close proximity to tranquil Zoo Lake in the northern Johannesburg suburb of Saxonwold. It was definitely an option to consider – a medical facility that felt like a home.
I perused their webpage (www.genesisclinic.co.za) and selected my private midwife from the list of practitioners available and the reviews of midwives posted in online forums. According to most of the reviews, Nthombi Mchunu of “Little Arrivals” was praised for her good bedside manner, in addition to her relaxed attitude and efficiency in delivering babies. I was sold on the mention of a ‘relaxed attitude’ towards childbirth and labour. I had to avoid the frenetic rush that characterised my first birthing experience at all costs. To elucidate, I was stressed and wrought up for days (post-birth) as a result of the constant rush with my first-born. A relaxed midwife would mean less stress for me. My hunch proved correct in the end.
My appointments with Sister Nthombi took place at Genesis in any one of the little consulting rooms provided for this purpose. She was laidback and chatty as well as thorough and I found myself sharing much of my life experience and birthing plans with her. My family could sit in on the consultations and the opportunity of hearing our little baby’s heartbeat on the Doppler for the very first was an awesome experience.
Since I was healthy and experiencing a normal pregnancy – Sister Nthombi advised that I could possibly deliver naturally but that I needed to consult with an OBGYN who would provide back-up in the event that I required an emergency caesarean. The OBGYN she recommended was Dr Donald Maasdorp whom I saw at 20 weeks and then again at 36 weeks when he cleared me for a “trial by labour” meaning that I would be supported for a natural vaginal delivery as long as labour progressed naturally. Sister Nthombi and Dr Maasdorp also advised that Genesis had limited rooming facilities and did not have a neonatal ICU unit. All patients who could not be accommodated at Genesis and all medical emergencies would be accommodated at Netcare Linksfield Hospital in the Linksfield/Orange Grove area. This particular factor was laboured over and over again by all the staff at Genesis.
I found my consultations with both my OBGYN and my midwife to be detailed and explanatory. All my questions were answered and my fears assuaged. All concerns were addressed and there was clarity and understanding. All in all, both medical professionals were empathetic and kind. What more could one ask for?
Turns out that a Doula is the cherry on top of any birthing experience.
So what is a Doula?
According to www.bellybelly.com.au, a popular Australian pregnancy website- “the word ‘doula’ (pronounced ‘doo-la’) is a Greek word meaning ‘woman servant or caregiver’. More recently, it refers to someone who offers emotional and physical support to a woman and her partner before, during and after childbirth. A doula (also known as a birth attendant) believes in ‘mothering the mother’, enabling a woman to have the most satisfying experience that she can, from pregnancy and into motherhood. This type of support allows the whole family to relax and enjoy the experience too.
DONA (Doulas of North America) explains how doulas fit into the birth team: “Women have complex needs during childbirth. In addition to the safety of modern obstetrical care, and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualised care based on their circumstances and preferences. The role of the birth doula encompasses the non-clinical aspects of care during childbirth.”
The webpage goes on to explain that “Doulas are trained and experienced in childbirth and are usually mothers themselves although there are Doulas who do not have children. They usually have a good knowledge and awareness of female physiology, but a doula does not support the mother in a medical role – that is the job of the midwife or doctor. She works on keeping birth normal and empowering, and should the birth become complicated and require medical assistance, a doula will still remain by your side and help in any way she can. She will not make the decisions for those she supports, but she assists them through the decision making process and provides balanced information so the couple can make their own choices.”
“The Promise Of A Doula
1. You cannot hurt my feelings in labour 2. I won’t lie to you in labour 3. I will do everything in my power so you do not suffer 4. I will help you to feel safe 5. I cannot speak for you; but I will make sure that you have a voice and I will make sure you are heard”
Genesis, being the top-notch natural birthing facility that it is – has doulas employed full time, working shifts.
After booking my (king-sized!) bed in a private birthing unit complete with a birthing pool and private garden, I opted to do a little more research on the role of a doula and was pleasantly surprised. A webpage called “Women Offering Mothers Birth Support – http://www.wombs.org.za has all information on natural child options as well as the hire of doulas in South Africa.
Initially, I didn’t have much luck in locating someone suitable but the persistence of a doula in CT paid off. She, very kindly, managed (by word of mouth) to put me in contact with a doula named Zenzile Fezeka Goba (Nana Wethu on Facebook) and we arranged a meeting to discuss my expectations and her role in my labour. We resonated completely from the very first meeting. Zee, as she is known to friends and family, provided the support and care necessary for a beautiful birthing experience.
When I eventually went into labour at around 40 weeks – she arrived at my home at 23h00 with her rebozos, loads of lovely massage oils and a sunny disposition. We laboured until 12h00 the next day and then made our way to Genesis where I was then given until 19h00 to dilate and deliver vaginally. This did not happen and as Allah willed it – another caesarean was on the cards but my pregnancy, labour and eventual birthing experience was awesome, nonetheless. My baby roomed in with me. She was latched within the golden hour and we enjoyed the tranquil facility for 3 days. My family was allowed to stay with me and Halaal meals were provided whilst we all bonded with our new addition.
Given the opportunity – I would definitely have another baby at Genesis and do everything as naturally as possible, all over again!