My birth experience at a public hospital in South Africa

A lot of people couldn’t believe it when I said I was going to give birth to Andrew naturally. A few more expressed even more shock when I told them I was going to have him at the National Hospital in Bloemfontein, which is a public hospital in South Africa.

The choice to have Andrew using the government system originally stemmed from not being on medical aid. A private hospital charges R50,000 for you to have a baby there without medical aid and a water birth with a private doctor costs R9,200. While we could have taken out a loan and done either of these options, we chose not to.  You see, Mark and I are earning enough to get by with, but paying back a loan is definitely not an option right now. I am so glad we chose to work with our government system, it has made me feel more connected with the country I am living in.

Andrew Letley | www.AuthenticallyAsh.com
Andrew Letley – eyes open and staring at the world.

The Clinic Visits

Waiting in line for 4 to 6 hours for the clinic check-ups made me realize how difficult it would be for low-level workers to make the decision between going to a clinic or working through their health problems. In some cases the low-level worker would loose out on money (if they are paid per hour) just for taking a day off to visit the clinic. In other cases they would have to use one of their sick days (or family responsibility days) to go to the clinic.

Ashleigh Letley - 36 weeks pregnant with Andrew Letley | www.AuthenticallyAsh.com
Ashleigh Letley – 36 weeks pregnant with Andrew Letley

I went to a small clinic in Langenhoven Park for all my check-ups. They have 2 nurses, a pharmacist and a counselor.  There is only a doctor on Thursdays. I experienced a few days where the pharmacist and one of the nurses were on leave, so the remaining nurse had to handle the pharmacy and the administration too! Those were slow days where we could wait in line for over 6 hours.

What I found remarkable is that the people never complained. Everybody would sit in the queue and chat or zone out. There was a day where an African woman started the day by singing a hymn and saying a prayer. I didn’t understand because she spoke Sesotho, but I could tell what was happening. Then there was another day where we had quite a comedian in the queue. I also couldn’t understand because she was speaking Sesotho, but she made everyone laugh. Her actions where animated and she was lively and bubbly.

The clinic I went to worked as follows (when there is only one nurse on duty):

  • People where checked in.
  • Those coming to collect medication were helped first.
  • Elders (those over 80) were helped next.
  • Children under 6 were helped third
  • All the left-overs from the previous day were then helped.
  • Finally all the new people were seen to in the order of their arrival.

The counselor would do HIV testing and TB screening of each adult patient before the patient saw the nurse.

If the pharmacist was there, then she would help those collecting medicine while the nurse saw the patients. If there were two nurses on duty then one would handle the elders and children while the other handled all the adults in the queue.

Besides for appearing under staffed and over worked, I was amazed at how well the clinic is run.

Labour Starts

On the 8th of April, at about 4pm I felt a cramp, the sort of cramp I hadn’t felt before. I told Mark about it, and we agreed to watch and see what would happen. I felt the cramp two more times within an hour, but not again. We took it as a warning sign to be on alert for the next few days, expecting that I would go into labour sometime in the next week to two weeks.

At 1am on the 9th of April 2015, I got out of bed to let our English Cocker Spaniel, Zoey, outside. As I got to the living room door I felt wet. My first thought was “I have either lost bladder control or my water has broken.”

I went to the toilet and emptied my bladder. As I stood up, I felt another small gush. That is when I woke Mark up.

I wasn’t having any cramps yet. So I went on the internet to check if I should go to the hospital or wait until contractions started. All the websites said that if your water breaks you should go to the hospital within 24 hours, because there is a possibility of getting an infection.

Calmly, Mark and I packed the car. We dropped Zoey-dog off at my in-law’s house and headed to the National Hospital here in Bloemfontein. We arrived there at about 2am.

My experience at a public hospital in South Africa

Admission

Through the emergency door we walked, following the green line on the floor to the maternity ward. A man asked us for a smoke along the way, neither of us smoke so we couldn’t assist him. He appeared to be there for the free TV and warmth in the waiting area as he didn’t seem distraught or in any pain. He did confirm that we were heading the right way.

The green line lead us straight to the nurses station, where there was also a single doctor on duty. I explained that I think my water broke, but I don’t have any contractions. They took me through to the examination room, but first I had to give them a urine sample.

The toilet was clean, and in better condition than the ones during our camping trip last year October (where I opted to go in the bush over using the toilets). The hospital toilet didn’t have a seat, but it was clean and it could flush.

The bathroom light was not working so I had to leave the toilet stall door slightly open to get light from the passage (note: take a torch with if you go to a public hospital). There also wasn’t any toilet paper. I found out later that the government only provides two rolls per toilet per day and when it is done it is done. Thankfully I had brought my own toilet paper with.

Mark wasn’t allowed to be in the examination room while they did the vaginal exam, but as soon as they put the heart monitor on my stomach to listen to the babies heart beat he joined me. The beat was less than 140, which the nurses said means it is a boy 90% of the time. Apparently girls have a faster heartbeat.

The nurses confirmed my water had broken and they showed me to a bed.

The First Ward

The first ward I was in, is where they put all the ladies who are waiting to go into active labour. Active labour is when you are more than 4cm dilated. At my admission I was 1cm dilated.

Mark wasn’t allowed to spend the night with me, as they only allow partners to be present once active labour starts, or after 7:30am. So, he went home to sleep, although he told me later that he hadn’t been able to sleep.

I got cosy and tried to sleep, but couldn’t. The ward had 6 beds in it. The bulbs in the lights above each bed didn’t work, so the only light was the one from the corridor. This bed did have a warm blanket and a pillow on it, as well as clean sheets.

Around 5am, when the nurses turned on the lights to do the morning checkup routine, I posted to Facebook using my phone to let everyone know I was in labour, in hospital. I also said I wouldn’t be online again until after I had given birth. During all this time, I didn’t have any contractions.

The Contractions

At about 8am I had my first contraction. It was noticeably a contraction, but not unbearable. The first 3-4 were spaced 40 minutes apart, then it went down to 20min apart and finally by 11am they were 5 minutes apart and painful.

How could I describe it in a way a man would understand? It was like my stomach was trying to clench itself into a fist. All the muscles pulled tight, and held themselves that way for 30-40 seconds at a time. It was not a sharp pain, but rather a drawn-out pain, like when you are doing crunches and have to hold yourself at 45-degrees for 30 seconds… and you are unfit! Now imagine that happening every 3-5 minutes for 2 hours.

The second ward

The Hospital Arm-Bands for baby Andrew. | www.AuthenticallyAsh.com
The Hospital Arm-Bands for baby Andrew. | www.AuthenticallyAsh.com


At 6cm dilated I was moved to the second ward. It had 4 beds in it, but the only other occupant was moved to the delivery room soon after I entered the ward, so despite 4 beds, I had the room to myself. There were no pillows or blankets on the beds, but there were clean sheets and mattresses.

Mark was by my side the whole time from here on.

The contractions where now 2-3 minutes apart. I had, naturally, lost track of time. Mark was timing the contractions for me, it gave him something to do besides holding my hand.

Gravity is the best friend of a woman having natural birth without any pain killers. I was sitting on a chair for the contractions and standing between them. I could feel my little boy’s head pushing down with each contraction. My body naturally got to a point where it wanted to push with each contraction, in fact I couldn’t stop my body from trying to push him out.

So how does it feel? Not as bad as I expected! It was painful, but not unbearable.  Passing a kidney stone was much worse.  I was comparing the pain and discomfort I felt from my Kidney Stone experience to the birth pain the whole time, and waiting for the birth pain to overtake that of the Kidney Stone, but it never did.  Apparently the brain releases natural pain killers and hormones to help a woman cope with the pain.

Please don’t get me wrong, I was in pain, and if I was a stronger person, I might have broken Mark’s hand during some of the bigger contractions. It definitely helps to have something to grip onto, ideally a metal pole or somebody’s hand.

There was an African doctor who reminded me of a black version of Buddha in looks. He was very friendly and quite a jolly bloke. Although the nurses did most of the work, he would check up on me from time to time as he was the supervising doctor.

The Delivery Room

When I got to 10cm dilated I was moved to the delivery room. Lying on my back, feet up and legs open. There were nurses handling the whole procedure, and as I got ready to push the baby out, my contractions suddenly got less intense. No idea what happened. It is though the baby got stage fright.

Eventually the doctor helped me push the baby out by massaging my stomach. Although massaging isn’t the right word, it was more like he was kneading dough on my stomach.

Andrew was placed on my chest at 13:15 on Thursday the 9th of April 2015. He was all sticky and crying and I was in a state of disbelief. How on earth did he fit in my little body? If you had told me a stork had dropped him in my arms it would have been more believable to me. I mean, I knew he had come out of me, logically, but it was so overwhelming I couldn’t comprehend it emotionally.

He was 51cm long and weighed 3.1kg.

My first instinct was that Mark needed to hold him and I had to focus on getting the placenta out. I knew it wasn’t over yet. The time it took for the nurses to take him away from me seemed forever. All I wanted to do was get this whole process finished, then I would love him and cuddle him.

Complications with the placenta

That is when the complications really started. My cervix closed before the placenta came out. I had a visit from the doctor again to inspect the situation, and a new white doctor was also around. He seemed younger, possibly busy doing his Zuma years (the 2 years all doctors have to do with state hospitals after graduation). In the end it was decided that they would remove the placenta in the operating theatre.

Andrew Letley in the Incubator, first photograph. | www.AuthenticallyAsh.com
Andrew Letley in the Incubator, first photograph.

Andrew had been taken to the incubator and I made Mark go with him. I was okay being alone from here, but I couldn’t bear losing Andrew and I had heard stories of babies being taken from hospitals, and not only public hospitals!

I was taken to the operating theater. There was a nice black guy moving the bed around. Quite a flirt too. I can’t remember what he said, but it made me laugh.

I was in a preparation room for a while, it had heaters in it, but I didn’t know why until afterwards. Then I went into the operating theater.

There was a student doctor in there that the doctors kept asking questions. There were also two new doctors I hadn’t seen before and the two I was familiar with. I was told that I might lose blood and they asked if I had any problems receiving blood from a donor. I signed a consent form and the last thing I remember was being told to keep my eyes open as long as possible with the gas mask over my face.

When I woke up, I was back in the preparation room and feeling extremely cold. The flirty porter took me back to the ward after I had warmed up a bit. He was talking about boxing with another guy in the elevator. Something about a match that he couldn’t miss.

Back to the Ward

Ashleigh and Andrew after birth. | www.AuthenticallyAsh.com
Ashleigh and Andrew after birth.

I was moved back to the first ward again, by now all the women had babies with them, excluding one lady who was new. The other 4 had c-sections. Mark came to see me. He had called his parents to stay with Andrew, until I could hold him again.

It wasn’t long before a nurse checked up on me and Andrew was brought to me. It still didn’t feel real, but it was amazing.

I had lost a lot of blood, and I was given 1 unit, which I had to wait 5 hours for. If I was above the weight limit I would donate blood after this experience. Please consider becoming a regular donor if you are able to. I should have had 2 units of blood, but they could only give me one due to the shortage.

This time I didn’t have a pillow on the bed in the ward. Mark brought me mine from the car. The pillows are cleaned between each patient, and there are not enough pillows considering the patient turnover rate.

Andrew spent the night in the bed with me and I was checked by the doctors the next morning again.

Eventually, I was discharged at midday and we went home.

Overall thoughts about my experience with the public hospital in South Africa

The doctors and nurses are amazing! The people who are working there are doing so well with the old facilities and the lack of supplies. As I said on my Facebook status, it is as though 5-star hotel staff are working at a cheap roadside motel. I really wish that our government would support them more.

I also noticed how there are certain people who take out their frustrations with the limited facilities on the nurses and doctors. Most of those people who take it out on the doctors and nurses are white people. They also seem to take it out more on the black staff than the white staff.

There was a white man whose wife was giving birth, and while I only passed them in the passage a few times, I didn’t hear a single positive word come from him the whole time. It made me so grateful to have a husband like Mark, he is such a patient and caring person.

If you are at a public hospital, treat the staff with respect. 95% of the time they are doing the best they can. You will be amazed at how much better the experience will be just by chatting nicely and saying thank you.

Also, remember the torch, your own pillows, a warm blanket and toilet paper!

Have you had an experience with a public hospital in South Africa? Please tell me about it in a comment below!

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