Karabo Mokoena
3 minute read
4 May 2021
2:12 pm

The impact of negligence on midwifery in SA

Karabo Mokoena

As midwifery-led care grows in South Africa, so are the anxieties linked to a public case of midwifery negligence.

Midwifery-led care has led to the successful births of many children around the world. Picture: iStock

A Carte Blanche episode titled Midwife Misery continued an investigation into a midwife’s negligence leading to the death of many newborns. 

Yolande Maritz is a private Pretoria midwife who continues to practice midwifery through her organisation You & Me Birth whose social media accounts are no longer active, although she is still practising. The first episode aired in October 2020 and the second in April 2021. 

Maritz’s case is being investigated by the South African Nursing Council (SANC), although she was issued a licence to practice in 2021.  

Increased anxiety from parents

Independent midwife Ruwaida Moola is experiencing the aftermath of this episode. Moola’s clients are worried about choosing midwifery-led care. 

She is concerned that the negligence of one midwife is instilling fear and anxiety among women. “This has destroyed the faith that many had in the natural process and the beautiful profession of midwifery,” Moola says. 

ALSO READ: Expecting moms considering home births: What you need to know

The show aired two days before one of her clients gave birth. She was 39 weeks and six days pregnant when she watched the show. The episode shared Chiedza Murecha’s story. Murecha’s baby did not have a heartbeat at 43 weeks gestation. Murecha says Maritz said: “Oh Chiedza, I don’t know why God is doing this to you, your baby has no heartbeat.” Murecha reports that Maritz told her it was normal to give birth at 43 or 44 weeks of gestation. 

The fear of losing the baby overwhelmed this couple so much that the mom developed some pain on Monday and went to Moola’s offices. The couple insisted that she was giving birth, although the chart showed no contractions and an internal scan indicated that her cervix was closed. 

The couple insisted on an induction, which led to a C-section because the baby was not ready to be born. 

How many more expecting moms watched that episode and became doubtful of their midwives? 

Malpractice in midwifery 

The World Health Organisation has set a requirement that every practicing midwife needs to work in conjunction with a gynaecologist during pregnancy. It is a prerequisite for a woman to see a gynaecologist at 28 and 36 weeks. 

Access to information 

“More and more women are choosing the midwifery-led route,” midwife Nonhlanhla Lengana says. She adds that some midwives approach midwifery differently. Some can easily deviate from a set method which is bad practice. 

The challenge is that not all mothers to be have information about what midwives can and cannot offer. 

Moola and Lengana offer some key information regarding midwifery-led care to empower moms when choosing this route of maternal care. 

  • Midwives specialise in low-risk pregnancies only. If the mother shows any signs of high blood pressure or foetal abnormalities, the midwife needs to refer them to a gynaecologist. 
  • Midwives, if trained, may perform a basic ultrasound. However, these are not to detect foetal abnormalities, unless she has specific qualifications for this.  
  • All clients are advised to see a foetal specialist, sonographer or obstetrician at 12, 20, 28 and 36 weeks.
  • Midwifery births can take place at the client’s home, a birth home, a hospital or active birth unit.
  • Intervention, induction, assisted births and vaginal births after a Caesarian section (VBAC) should not be done at a home birth or home birth unit. This is bad practice for midwives. 
  • Choose a midwife who follows safe midwifery practices and is a part of a larger peer group review like the Private Practising Midwives Alliance (PPMA). 

Trust your instinct. If you feel something is wrong and your midwife is not reassuring you, then seek a second opinion. If financially this is not possible, then do some online research and ask online communities. You are not the first person going through that experience and could get some life-saving advice.