So you have gathered all your information and decided to birth with a midwife!
Your first step is to book for your first consultation:
This consultation is usually done at around 14 – 16 weeks after you’ve had your initial sonar which is usually done around 12 weeks. (see prenatal screening tests)
When you book for this first visit you’ll be asked to complete a medical history form as well as the personal information. We’ll also be asking you to bring in any sonar reports and blood results you may have from your doctor or the sonographer who did your initial sonar.
If you are further along in your pregnancy when you make your choice it is also ok as long as we still have space available. Our last bookings are usually made around 32 weeks.
As we are a practice of 4-5 midwives in our practice it’s a good idea to have a look at the profiles on the website and decide which midwife looks like the one who would fit best with you. You may also have heard of one of us through a friend or family member whose birthed with us previously.
If you’re still undecided you can always meet one of the midwives and then if you’re not 100% sure you can book to meet another at the next consultation until you find your match.
Note: The midwives only take on a certain amount of births per month and can book up quite far in advance so don’t spend too long trying to decide. Midwives also take leave from time to time so this would also be taken into account when choosing your match.
Your first consultation is usually booked for an hour as much time is spent getting to know one another; history taking, healthy education, information being only some of the discussion points. Come with your questions!
We are a woman and family centered practice so welcome your children or other family members if you’d like them to attend the consults with you.
A full antenatal checkup will be done which includes:
- Checking your urine
- Doing your vitals – Bp, Pulse, Temperature
- Doing a general physical check
- Palpating and taking a measurement of the height of your uterus
- Listening to baby’s heart beat
If you haven’t already had your antenatal blood screening we would either draw blood for this or send you to the lab for these tests.
According to SA Maternal Guidelines as well as international pregnancy guidelines, only 2 sonars are required during pregnancy.
At our practice we encourage our clients to have 3 sonars during pregnancy:
10 – 12 weeks, 18-22 weeks and again at 36 weeks.
If we are concerned about anything during the pregnancy such as baby growing too slowly or too fast or foetal movement we will refer you for additional sonars.
You are also welcome to go for further sonars if you choose.
Sonars are either done with a radiographer specializing in pregnancy sonars or with the obstetrician who is back up. Whilst there are some midwives offering sonars we have chosen not to as we are not trained or legally permitted to do diagnostic sonars in SA at this stage.
Your consultations will be every 4 weeks until 30 weeks.
2 weekly until 36 weeks and then weekly until you give birth.
Consultations are usually around 30-45 minutes and spent really getting to know you, answering your questions, assisting with health advice and support with pregnancy niggles as well as doing the full antenatal medical checkup. A large portion is also spent discussing the birth wishes and plans.
Download your Prenatal Testing and Screening Table for easy reference.
The back up plan:
Because we provide care to low-risk, healthy women, we make use of a back-up system. Thus, should any complications arise during pregnancy or birth, we may need to refer to a gynaecologist or hospital. If you have the funds or have a medical aid you can use one of the private obstetricians whom we work with and are willing to provide back-up support (you’ll need to see the back-up gynaecologist 1 – 2 times during your pregnancy). If you don’t have the funds for a Caesarean section or further care at a private hospital, you would be referred to the Steve Biko Academic Hospital or Tshwane for further management with whom we have a good working relationship.
For safety sake and in order to adhere to our midwifery scope of practice we are quite specific about the women we take on as clients.
Certain medical risk factors in pregnancy require the care of an obstetrician. You can let us know if you have concerns and we can help you determine if our practice would provide you with the care that you need.
However, apart from these medical aspects, we also know that obtaining the good natural birth outcomes we strive for are based on selecting those women who truly are committed to their pregnancy and birth experiences, and are willing to make the necessary changes needed to obtain their goals.
Over the past 21 years we have maintained a low intervention rate (15-20 % c/section rate and 80-85% normal birth rate), of which we are extremely proud.
When it choosing the birth venue there are 3 different options available when birthing with a midwife:
- Femina Netcare Hospital in Arcadia has a lovely midwife unit where we do many of our births. Midwives Exclusive and completely separate from the hospital’s labour ward and is managed solely by Midwives Exclusive
- Wilgers Hospital, Life Hospital in Pretoria East where we have birthing rights. This is in the labour ward setting but they do have a nice bath available for water birth for those who choose.
- Midwives Exclusive’s Birth House, a cozy little house in Rietondale. The Birth House is not a clinic or hospital, but a guest house that we’ve set up for very special, home-like births. It was specifically chosen for its location, which is within 4 minutes’ drive from both Steve Biko Academic Hospital and Femina Hospital. Certain medical aids are contracted into this facility and will cover the majority of the fees.
- Homebirth – If you don’t live too far away and have a suitable home-environment, you can also give birth in the comfort of your own home.
After birth we do post-birth visits to you and your baby, either in hospital or at your home. We do on average 3-5 visits after the birth to check that you are healing, assist you with breastfeeding, check for jaundice, provide support and education on caring for your baby, debrief after your birth, etc. We’ll also assist with immunization, registration and referral for newborn screening as well. At 6 weeks post birth we offer a full mom and baby check up with our clinic sister at the practice.
If you’re on a medical aid it’s important you contact them to see what portion of our fees they will
cover. Whilst your medical aid will cover a portion/all of the fees we do not work directly with most medical aids so you would have to pay us first* and then claim back from them.
Most medical aids cover anything between 50-70% of our fees. The hospital fees are usually covered 100%.
*A few medical aids will cover 100% of your birth if you decide to rather use the Birth House opposed to the hospital.
We follow a holistic approach to ensure that you and your baby really receive all the care you need throughout pregnancy, birth and the postnatal period. Other services we offer at Midwives Exclusive include:
- Antenatal classes and natural birth workshops
- Breastfeeding support groups and consultations
- Pregnancy yoga/dance and mom and baby yoga
- Post birth workshops: birth debriefing, starting of solids, infant stimulation
- CPR/Choking workshops for parents, childminders, grandparents
- Well baby check ups and full 6 week mom and baby check ups after birth
- And many more support services….