Wednesday, November 9, 2011

Maternal health in the Eastern Cape

She rests her hand on her protruding belly as she looks at the small, light blue building in front of her. She lifts her hand to knock on the door but hesitates. The memories from her last three labours come back to her in a mixture of bright lights, shouting strangers and pain. Most of all, she remembers not feeling safe. A stubborn determination enters her eyes as she knocks on the door: she does not want her fourth pregnancy to be the same. Zethu Mqopi* was one of the first rural women brave enough to enter Karen Clarke’s Busfare Babies Birth House in Hamburg. “At the birth house we are trying to comfort you so that you can forget about all the bad things that happened during the first baby,” Mqopi says. She now works with Clarke giving other women the option to enjoy giving birth. “Birth can be a beautiful thing,” explains Clarke, a qualified midwife, “not just something you have to get through to have a baby.” For just over a year the birth house has served rural women from Hamburg and the surrounding areas. Clarke provides a safe and supportive place for these women to have their babies free of charge. “Hospitals don’t realise that the environment they are creating is actually counterproductive for birth,” she says. Clarke believes it is better for both the mother and baby to have a natural and home birth provided there are no complications during the pregnancy. “We’ve neutralised the maternal instinct,” she explains. Clarke bases her methods on the natural way the body reacts during child birth. “There are two major hormones in birth- adrenaline and oxytocin,” she says. Adrenaline (which allows us to act in times of danger) stops the release of oxytocin. “Oxytocin is the hormone that makes many things happen,” she explains. “It’s the hormone that makes breast milk be produced; it’s the hormone that makes contractions happen for the baby to be born.” A mother needs to be able to relax and feel safe so that she produces less adrenaline. The two most important things to leave out during the birthing process are light and language. “Instead you have the opposite, you have bright light and someone shouting at you which means a woman can’t give birth,” says Clarke. In a hospital, the baby is generally taken away from the mother, cleaned and put in an incubator: all of which Clarke feels is unnatural and unnecessary. “Try to imagine a new born of a gorilla mother – and if you try take her baby away from her, what her reaction would be,” she says. “It’s not a natural thing to just let someone take your baby but if you go to most hospitals, most women don’t question it.” Clarke argues that even premature babies do not need an incubator. “You keep them on you like a kangaroo and they grow much quicker because they feed on their mother’s warmth,” she says. “It’s much more normal for a baby to be in that kind of environment than a heated box.” Eastern Cape hospitals, especially, are not an inviting environment for expectant mothers. A Human Rights Watch report released a few months ago alerted the public to the terrible treatment experienced by women in these facilities. Many women, like Mqopi, who come to Clarke are afraid to repeat the experiences they have had in these hospitals – experiences of pain and fear. Clarke maintains that a natural home birth need not be painful. It should be relaxed and as natural as possible. “Studies have been done that say the more civilised a country the more pain is experienced during child birth,” says Clarke. In our modern culture the idea of home births, and Clarke’s birth house, may sound backward. However, the birth house, and what it stands for, asks a telling question of the Eastern Cape’s health system: is it better to be human or humane? “I always joke that I can climb into bed with anyone,” Clarke smiles. “During labour I climb into bed with the women because that’s what the women want – someone to lie with them, not going anywhere, not fiddling about and when neither of us can sleep it’s time to have a baby.” For more information about the Busfare Babies Birth House please visit or contact Clarke on 0827763622. *Name has been changed

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