How does it work if you want a midwife?

Hi There!

Are there any of these type clinics that are midwife led in Cape Town? That are on the same standard as genesis or femina?

If not, what are the rules in medi clinic hospitals on having your own midwive or doula with you during birth? Or isn't it something midwifes would even consider?

Hi there,

Sorry I only saw this now. I have worked with the midwives at midwives-exclusive very often before (I'm a doula & give HypnoBirthing classes).

They are great!! I can really recommend them, if fact, I'm preggies now and using them for this baby's birth.

They offer 3 birth place options, the Active birth unit at Femina clinic (its run by midw-exc.), birth at the Midw-exc birth house which is very close to Femina in case of an emergency, and home births.

Ps, how far along are you? I'm around 16 weeks...

I wrote to Heather @ Midwives-exclusive and this was her response:

Midwives are hightly trained and skilled to assist with natural birth whilst Gynae's at highly trained and skilled at doing high tech interventive birth. There are some gynae's who don't want to work with midwives but generally the feeling is pretty positive. Over the years I have fostered some really good relationships with excellend gynaes who are very pro and supportive of women birthing naturally with a midwife.

If you are considered low risk i.e.no major health risks or serious pregnancy complications then you would be a candidate for midwife led care.
We do work hand in hand with some of the best Gynae's in Pretoria (I've worked along side them in a team for the past 15 years).

How it works is:
You see one of us back up Gynaes for the 12 week sonar (Dr Paul Swart, Dr Sultana Sulliman or Dr MC van Aard)
At this stage you inform them you'd like to follow the midwife route and we referred you to them.
At 16 weeks you see the midwife for your first consultation - this consult takes around 45 minutes and includes a full history taking etc
At 20-22w you have another sonar (Fetal assessment sonar) either with the gynae or with the Fetal assessment specialist (who is also a gynae who specializes only in sonars) (Dr Nerine du Plessis or Dr Somo Pillay - both at Femina)
From 24 - 26 w onwards you follow up with the midwife through the rest of your pregnancy.
If we pick up a problem or are concerned about anything we simply contact the back up gynae who you've seen and refer you back to them for assessment.

Sonars are only done 2 - 3 times during the pregnancy and there is no medical reason why you should need more than those sonars. If however you do prefer to have more sonars you can see our sonographer at the practice who does lovely sonars and really takes her time.

The birth:
When you go into labour you contact your midwife who by that stage you'll know really well and hopefully trust completely. She'll support and guide you as to when you need to go to Femina's birth unit. Once you've decided when the right time to go in is she will meet you there and support you throughout the labour and birth.
As you get ready to give birth a 2nd midwife will come in for support.
There are always 2 skilled medical people at a birth.

We only call the gynae in if it becomes necessary for a c/section or instrument birth. (there is a 15 % chance of this).
As we have worked well for many years with our back up gynaes they are really comfortable working within the midwife led care team.

I would highly recommend you come in, see the birth unit at Femina and also meet up with one of the midwives working at my practice. We offer free information sessions to women who are looking at their various options for birth. If you'd like to do this please phone Yolandi 0123293865 to set up a time that suites you.

* * * * *

I found this very informative and she answered all of my questions.
Thought someone else might find it useful too.

There are gynaes who work with midwives, you've just got to search for them.

In my limited experience, the ones who do work with midwives either have a like-minded philosophical approach to pregnancy/ child-birth, ie that its a natural process not a medical condition to be 'treated' unless there are complications...
or... they quite enjoy being a backup because then they get to handle the more difficult/ challenging cases.

You can imagine that there's not a lot in it for the back-up gynae/ob... they are basically on 'call' with no guarantee that their services will be needed. and this probably explains why so many wont do it. (im not sure I'd give up my time with no quarantee I'd be needed/paid)
Also, theres a certain amount of trust required to be a midwife backup... the doctor has to be comfortable that the midwives they work with will make a good call if/when medical intervention is required. My back-up gynae works with only very specific midwives, probably for this reason.

All that said, hiring a private midwife if you're planning for a natural delivery is a great option. You build up a good relationship prior to delivery, when you arrive at the hospital (or when they come to your home) you have continuous care until and after) delivery). Hospital midwives may leave you alone, disappear/swop off-duty when shifts change... and your doctor may only arrive for the last bit (and if they're away, you may have their back-up doctor who you may not know at all). I believe that much of the 'relative' ease of both of my babies birth's is a lot due to the support and care from my midwife team. If you'd like the best possible chance of a natural delivery, i really feel that a private mid-wife is the way to go.

there, thats my 2c

Thanks JeanineK!
Ill give Femina a call and find out from them

Hi,

Your average Gynea generally don't work with midwives. Whatever the reason might be....

However, birth centres usually have gyneas that work with them that WILL support the midwives and are happy to 'just do the scans'. The midwives will have a list of ones that work with them specifically

I was at my GP today to do the confirmation blood work. I asked her about Gynea vs Midwives. Her advice was that OB/Gyn's are not working along with midwives anymore beacuse of legal obligations. Ob/Gyn wont take responsibilty to help if you've only ever been to a midwife because of these legal issues...apperently the same with 'the guys who do the sonar' (sorry dont know the technical term).

She is married to a Ob/Gyn so I dont know how much is trying to make sure her husband has work or if its really so....

Anyone have any experience regarding this?

I am so confused now...