The Talk of the Kraal: The Travelling Midwife

I had the wonderful opportunity last week to assist Thokozile give birth to her baby girl in Kwazulunatal. Thokozile and her family live on the neighbouring farm to my mother’s farm and are thus her neighbours. Tapsile is Thokozile’s mother and helps my mother clean the house. Tapsile’s daughters often assist at horse-feeding time as well as around the farmyard.

I offered to help Thokozile at her birth and spent a wonderful afternoon with Thokozile, her siblings and the neighbouring pregnant women teaching a birth preparation class for them and a Zulu crash course for me. I taught Thokozile how to breathe deeply and explained the mechanism of the sensations of labour, how important it is to stay calm and relaxed.

The men were not part of this gathering and it was clear that pregnancy and birth belongs to the womenfolk in this culture. I palpated each of the women’s abdomen’s and reflected my findings to them in broken Zulu. I listened to their baby’s heartbeats with my doptone. There were smiles of delight and many questions and answers. The following day, Thokozilie’s sister ran to our house from their farm to tell me that labour had begun. I walked back to their home with my midwifery bag in a backpack, climbing through the fences en route.

Thokozile was indeed in labour and was progressing nicely. Despite the cellphone signal being poor and difficulty in finding transport, Thokozile’s sister Nosipho, insisted that we transfer to the local Bruntville Clinic, 13km away. I piled into the back of the car with Thokozile, massaging her back and legs and we trundled off to the clinic. The Midwife in charge gave permission for me to continue assisting Thokozile and I gratefully acquainted myself with surrounding equipment and protocols. Thokozile, by now in deep transition of labour, preferred to lie on her side on the bed and used the breathing technique I had taught her in silence.

Thokozile laboured beautifully, kneeling and lying on her side alternately. There were no exhortations from me to push, no unnecessary rupturing of membranes, no hand on the perineum (she would NOT allow me to touch!).

All efforts emanated spontaneously from the mother and the baby was ‘born in the caul’ and lay on a soft cloth on the bed, before her mother reached forward to lift her into her arms. Thokozile was overwhelmed and I did not touch mother or baby other than to cover them with a sheet and keep them warm. They were not separated, the newborn baby girl found her mother’s breast within ten minutes of the birth and the placenta popped out after a groan and short expulsive effort from Thokozile – the perfect example of physiological birth. It is true that, as Michel Odent says, we need to stop thinking (neocortical activity) and allow the primal brain to release the powerful hormones and neurochemicals that drive natural labour and birth. Breastfeeding was the natural response of both the baby and the mother, as skin to skin contact elicited searching responses of the baby and loving responses of the mother. Breastfeeding is also accepted and witnessed frequently in the Zulu culture. Thokozile’s mother (Tapsile) herself breastfed her four children for several years each.

Thokozile and I spent the rest of the night sleeping inbetween feeds at the clinic in the postnatal room ( I slept on the bed alongside). My Mum thankfully arrived at 08h00 to take us home and after some shopping for supplies, we squeezed into the front of the bakkie and settled in back at the Buthelezi family kraal. It was lovely watching Tapsile connect with her new granddaughter, sharing the experience with her other daughters and grandchildren. What a privilege to be part of this family’s journey and needless to say, Thokozile is very proud that she had her own personal midwife and I am the talk of the kraal.