In countries such as Australia, midwifery-led care is the primary medium of care for expecting women. 

Quality medical care is imperative in a woman’s pregnancy journey. When done right, pregnancy and childbirth can be an empowering experience and can happen with minimal complications and expenses. 

According to Port Elizabeth midwife Juanita Mackenzie, midwife-led care is making sense for a lot of women with low-risk pregnancies. 

Midwives attend to pregnancies that are low-risk and healthy, whereas gynaecologist deals with high-risk ones. When a woman’s pregnancy is healthy, they can see a private midwife who can hold their hand throughout their journey. 

According to Juanita “a lot of women just don’t realise using a midwife is  a viable and safe option for them.” 

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More women are starting to do the research to look at what alternative birthing options they have.

Aloe Tree House birthing centre in PE believes that women can be empowered when they have the necessary information “on what good health entails.” 

“In midwife-led care, the emphasis is on normality, continuity of care, and being cared for by a known, trusted midwife during labour” the World Health Organisation says. The mother-midwife relationship is important, and a healthy one leads to a positive pregnancy and birthing experience. 

Juanita says that “evidence tells us that holistic midwife and doula led care results in good birth outcomes.”

Women that birth with a midwife are reported to: 

  • Have a lower need for medical intervention during labour 
  • Experience less postpartum depression
  • Establish quicker and easier breastfeeding relationships
  • Higher rates of mother-child bonding 

Cost of birthing in South Africa

In 2019, 26.2% of births in SA were via C-section, and the majority of these were elective. This means that women are choosing to use this method of birthing over vaginal births.

Historically, C-sections were performed in circumstances where a vaginal birth would prove to be impossible or hard. 

According to Business Insider, women on comprehensive medical aids are reported to have less C-section rates than those on hospital covers. The Council for Medical Schemes accredits this to their socio-economic status, which usually means they are more informed about their options. 

“This is unfortunately because of the way our current medical model works here in SA, which is driven mainly by financial gain and doesn’t hold the patient’s best interests,” Juanita says.  

In the same article, it is reported that 77% of all medical-aid births are via C-sections and can cost anything up to R42 000 per birth. 

In a birthing centre, a woman can spend up to R12 000 for the birth, and an average of R500 for an antenatal appointment. 

A gynae visit can cost up to R1200

Even if a woman may choose home birth, which is more costly than a birthing centre, it still works out cheaper than a gynae-led pregnancy and birth. A home may require a birthing pool, and a doula might be necessary, although not a prerequisite. 

What is a doula

According to Juanita, doulas are “trained supporters who advocate for women and provide physical and emotional support during labour and delivery and after birth.” Midwives do offer the same support but are also qualified health professionals, which doulas are not. 

Most doulas offer packages that range between R3,000-R5,000 and include pre and post-natal visits, birthing, and breastfeeding support.



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