Melomed Tokai – Charlene Yared West

Ruwa was nervous at our first meeting. Soft-spoken, she asked about my role as a doula for her birth. I walked with her in pregnancy and birth and when she went into labour, I met her at the hospital. Her birth changed everything. She was shown how powerful her birthing body was and that she could do anything. Here is her story of the birth of her son…

My name is Ruwarashe and I am 21-years-old and I come from Zimbabwe. I’m currently studying at UCT. I became pregnant in September 2018. Pregnancy was going to be a hard journey for me, as I didn’t understand anything about birth and even worse, I was a long way from home where I had friends and family to guide and support me. In Cape Town, I have little support. So many people recommended I get a doula, especially since I felt quite isolated in Cape Town without my family near.

Choosing a doula for me was so important, because I needed someone compassionate and soft and when I went onto Charlene’s website, I knew she was the doula who would understand my fear and confusion of becoming a mother. ( I hadn’t even met her in person yet, but I just knew.)

I remember I wasn’t sure if I was going to have anyone close to me at my birth, because my family and fiancé stayed so far away… And I had so many fears of becoming a new Student mom. Charlene reminded me that she was going to be there for me – and that I would be ok, no matter what turn it took. She said this at our first meeting.

Charlene engaged with me every week reminding me to trust the process of the journey I was on, offering me her kind support along the way. I was at school from 8am to 5pm everyday and I was at school until I was 9 months pregnant.

She also made sure we were able to meet close by to where I lived, as I did not have a car. She did this without hesitation – and it was so kind of her. When I felt low, I would message her and we would chat and she would encourage me to keep my faith and to be strong.
I think what especially helped were the Relax Into Birth visualisation tracks. Listening to them regularly helped me realise that birth wasn’t just an event, it was a process – a beautiful process… Finally I was learning to trust the process – and trusting myself to do it! I felt strong enough to birth my baby boy. The strength seemed to come from within me. A deep knowing.

The Relax Into Birth classes made me realise I wasn’t just doing a duty a woman is required to do; no! My body was giving life to a soul, another human being. Although it was about birth, it also somehow helped me establish what type of mom I was going to be to my little boy.

When I finally went into labour, the emotional support for me and my fiancé was tremendous! She always made sure I was as comfortable as I could be in those circumstances. When it was time for me to deliver, I remember I was very tired – and our doula Charlene never once wavered, always trying ways to help energise me and encourage me to bring my son down to earth.

During my visits to the doctor, I was told we had to schedule an induction, because they didn’t want me going over my due date, which was the 26th of May. I wasn’t so sure I wanted an induction considering the potential complications. It was really not what I wanted.

In my 39th week, I went for cervix check to prepare for my induction. I was notified that soon I was going to be in labour – and that it was likely I would not need an induction. On Thursday 23 May, my waters broke as I was going to bed. I remember I kept my calm. I took an Uber with my fiance who had arrived from Zimbabwe, even though my contractions hadn’t kicked in properly yet. I didn’t want to stay at home after that because I didn’t want to be under pressure to rush to the hospital when it became necessary. I didn’t want something dramatic! Charlene did join us at the hospital when my contractions got regular and intense. She was there the whole time and I held onto her. She created such a calming environment in such a tense situation. I remember I had moved 1 cm in 4 hours and all I wanted was an epidural. I asked the nurses for an epidural, but was refused by them, saying it was too early to administer. In the face of that, my doula encouraged me to keep going and to stay strong as I was birthing my angel.

We used other forms of natural pain relief. We used the shower and we counted together and breathed together and finally at 7 am they decided to insert a dose of prostaglandin gel to help my cervix open. Once that was given to me, five minutes later I was standing to go poo in the toilet and another five minutes later I was walking myself to the tub in the delivery room. During that walk I definitely felt my baby was coming! I got into the tub for a few minutes and notified both my fiancé and Charlene that the baby was indeed coming.

The delivery room not prepared by the hospital staff (as they didn’t expect me to push so soon), they quickly put me on the bed, and there was my baby crowning! They quickly set up the room as I involuntarily pushed him out. A few pushes and I had birthed my baby.

My birth taught me to trust my body and trust my baby. I have never felt as strong or as empowered as I did in those first days. I was blessed to have such a positive, empowered birthing.

I’m about to share the the latest statistics from 2017 for the Birth Options Midwifery team – and they are unbelievably good!

The team is comprised of Glynnis Garrod, Susan Lees, Angela Wakeford and Bernice Jehring Down.

Birth Options Independent midwives can attend both home and hospital births at Vincent Pallotti and Melomed Tokai with gynae/ obstetrician backup at those allocated hospitals. Ayla Nowell of Birthing Naturally, another wonderful independent midwife, has back up support from Vincent Pallotti and Constantiaberg Mediclinic. So women have the option of birthing at home with the support of Independent Midwives (with gynae back up support in case of emergency) as well as to birth at these allocated hospitals under the care of an independent midwife (with gynae back up support in case of emergency). We also have traditional midwives in Cape Town, who use various government hospitals for back up support. It pays to know your options and that you have choices available to you!

It says a lot about these doctors at those hospitals (Vincent Pallotti and Melomed Tokai) and their view on promoting a natural approach to birth, where caesareans are only called for when necessary. This is a rare breed of doctor in South Africa and should be taken into account when choosing your care provider/back up gynae.

Independent midwives specialise in normal, low risk pregnancies and birth and will do all within their capacity to help you have the most positive birth experience, whether that is a natural, vaginal birth or a necessary Caesarean in the end.

Without an independent midwife, you will have hospital midwives attend to you in private hospitals. Hospital midwives change shift, so you might have multiple midwives for the duration of your labour and birth time. Hospital midwives are also not allowed to deliver babies, (but sometimes they do as a baby may come quickly!:-)) as that role falls to your obstetrician, who is called to come in when you are near being fully dilated. Many hospital midwives are underappreciated for their hard work and loving care of mothers in labour, and burn out can be a very real challenge facing all birth workers.

My wish is for women in South Africa to start seeing independent midwifery care and doula care for Pregnancy and birth to be the norm, so that we can also lower our exorbitant rate of 90% caesareans in the private sector… Of which most were likely not necessary… and, to choose their doctors and hospitals more carefully too. You only have your one birth, so make choices that will facilitate a good birth experience without regret in the end.

So, without much ado, here are the fabulous stats from Birth Options.

Birth Options Midwifery Team Statistics 01/01/17 – 31/12/17

Total number of clients: 147
Total no Caesarian Section 21/147 = 14%
Number of clients who labored with the Team = 136
Spontaneous Vaginal Birth 115/136 = 84.5%
Kiwi Ventuse Delivery 4/136 = 3%
Emergency Caesarian Section 16/136 = 12 %
VBAC 7/10 = 70 %
Primigravida (first birth) 55/136 = 40 %
Waterbirth 15/136 = 11% (many more labored in water)
Epidural12/136 = 9%
Episiotomy 14/136 = 10%
Induction of Labour 15/136 = 11 %
PPH 500-1000ml 9/136 = 6.5% (post partum haemorrhage)
PPH over 1000 ml 3/136 = 2 % (from a retained placenta)
Third degree Tear 1/136 = 0.7 %
Neonatal Unit Admission at Birth: 2/136 = 1.5 % (1x 34 weeks, 1x signs of sepsis)
Births @ Life Vincent Pallotti 73/136 = 53.5%
Births @ Melomed Tokai 29/136 = 21 %
Home Births 34/136 = 25 %
Transfer to hospital from home birth 3/34 = 9 %
7 births not with the team – care taken over by back up Obstetrician: X3 persistent Breech Position after 37 weeks for elective c/s, 1x 37week early labour with breech position, 1x 31week premature labour breech position, 1x previous Caesarian Section, Term, SROM with meconium, unfavorable cervix, baby weighed 4.6 kg, X1 transfer from homebirth in labour for c/s ( CPD) to Christian Barnard Hospital – care handed over to Gynae as we don’t have an SLA there ( prior arrangement )