There are so many decisions to make when you’re pregnant, one of them being where to have your baby. Factors that might play into your choice include your location, whether your pregnancy is high or low risk, and your financial situation or medical aid options. These days the Covid-19 pandemic is also a consideration and you’ll need to find out what measures your chosen option requires you to follow and whether those fit in with your birth plan.
Government hospital
If you can’t afford private care and don’t have medical aid, birthing for free at a government hospital is one of your options. Labouring mothers are usually kept together in a maternity ward and then moved into a private room for the actual birth. Government hospitals support natural birth, and have the facilities and expertise to conduct a C-section if necessary or to deal with emergencies in the mother or baby. Mothers who have high-risk pregnancies will have their antenatal appointments at a hospital.
Midwife obstetric unit
A midwife obstetric unit (MOU) is also a government facility, run by qualified midwives. Women who have a low-risk pregnancy and are able to deliver their baby naturally, can birth for free at an MOU. These units also offer antenatal care for expecting mothers. They are equipped to deal with basic emergencies, and will transfer patients to a government hospital if more serious care is required. Mothers have to use the MOU that’s closest to where they live.
Obstetrician at a private hospital
Women with medical aid often chose to see a private obstetrician during their pregnancy. An obstetrician is a gynaecologist who has specialised in caring for women during pregnancy, birth and the period after birth. These obstetricians usually have birthing rights at a few private hospitals and you may have the option to chose which one you’d like to have your baby at. You can have a natural birth or C-section with an obstetrician, although, in South Africa, many obstetricians encourage C-sections.
Birth centres
Birth centres or birth units are run by midwives in private practice. You can have a natural birth at one of these centres provided your pregnancy has been classified as a low-risk, uncomplicated pregnancy. You can also visit these centres for your antenatal appointments and classes. Some of these centres have birth baths where you can have a water birth. They usually encourage the use of a doula who will support you and your birth partner emotionally and with natural pain-relief methods. These centres are equipped to deal with minor emergencies and will transfer their patients to a private obstetrician or a private or government hospital in the case of a more severe emergency.
Private midwife
A private midwife will take care of you during your pregnancy and birth. With a private midwife you may have the option of birthing at a birth centre or a private hospital, where she has birthing rights. Some midwives are willing to attend home births. Private midwives work with one or more private obstetricians who will have to see you once or twice during your pregnancy to confirm that it’s low-risk. If there’s an emergency during your birth, your midwife will transfer you into the care of an obstetrician and if needed, a private hospital.
Homebirth
Some women prefer to have their babies in the comfort of their own home. Many are considering this option more seriously as a result of the strict Covid-19 regulations that have been implemented at many hospitals. At home, you’re free to move around during your labour and may even decide to labour and birth in the bath or a hired birthing pool. A midwife can attend your homebirth to care for mom and baby. You may also want to hire a doula to support you emotionally and physically during the labour and birth. In a few cases, women chose to give birth at home without any support from a healthcare practitioner. It’s a good idea to know what your back-up options are if you do experience an emergency during a home birth.