A Cultural Pregnancy- Part 1

19 Jun

About 2.5 months ago… before Keena learned to walk, before we had that onslaught of sickness and before we went to Durban for a wedding… before aaaaall of that, I posted my upcoming blogs and had quite a few requests for this particular blog topic.

It’s taken me a while to put it together because of all the above mentioned circumstances… plus, I suddenly got very nervous about writing it! I grew up in America, lived in Australia for four years & have now resided in South Africa for five. I feel that I’ve experienced enough day to day life in these nations to speak about their culture… but I’m still somewhat afraid that I’ll say something that isn’t totally accurate and misrepresent one of these nations! I know that no one’s perfect but still, isn’t it better to hear it straight from the horse’s mouth? So… I’ve asked friends of mine living all over the world to answer a few questions for us to give us an idea of how their nation handles pregnancy and childbirth.

You’ll be amazed at how, in today’s day and age, with all the advanced technology, global social networking, international conferences and precise information we have that’s only one click away… two nations can take the same information and facts and translate them completely differently based on that nations values, health & insurance schemes, logic and priorities. Obviously I’m specifically referring to pregnancy and childbirth but you get the point.

As I started putting together the responses I received, it turned out to be quite lengthy so this is going to be a 3 part series.

I’m kicking it off with my experience here in South Africa. It’s kinda lengthy but interesting info. You must enjoy and stay tuned for more! 

Myself- An American married to a South African, living in South Africa (in case you haven’t read my “About Me”) I had a scheduled C-section performed by my gynecologist  in a hospital.

– What is considered a normal birth situation in your country?

Stastitically speaking, a C-section is the norm. South Africa has the highest C-section rate in the world at a whopping 60%. Many women choose to have a C-section long before their due date actually arrives and many of our doctors encourage this. All births are performed in a hospital by a gynaecologist.

– Is your gynaecologist automatically your obstetrician (baby doctor) as well?

Yes. Gynie’s do it all here- regular ‘women stuff’, pregnancy and births. I saw my baby doctor/gynie at every single appointment and he delivered my twins too. If you have a natural birth your gynie meets you at the hospital when you go into labor, unless they are out of town or busy with a C-section. Many doctors here like scheduling C-sections so they can plan their schedules more effiecently. A lot of women who have natural birth choose to use a midwife who is basically a birth-coach and does a few house visits after you’ve been discharged from hospital.

– How often did you have scans/ultrasounds during your pregnancy? Who performs them?

You typically have your first scan around 8/9 weeks and every 4 weeks after that if you have medical insurance. If you don’t have insurance people usually go for the 2 major scans, being the 10/12 week and 24 week scan. I had scans every four weeks (which is normal) and because I had twins, once I reached 30 weeks I had a scan every 2 weeks until I delivered. My gynie performed all the scans in his room at each visit.

– Are you encouraged or discouraged by your medical staff to receive an epidural or any other delivery drugs?

I would definitely say that you’re encouraged to have some sort of labor drug here. I obviously can’t speak from first hand experience but I do know that any of my friends who wanted to go without drugs had to really put their foot down with their doctor multiple times. It feels like the women who really try for a vaginal birth are seen as hardcore, even with most of them knowing that they’re going to take an epidural. The woman who go without drugs during a vaginal birth are seen to be SUPER-SUPER hardcore… and maybe a little crazy/ambitious:) 

– Are C-sections for emergency use only or can they be elective by you or your doctor?
Both. It is very common here to have elective C-sections. When you first go to the doctor you are asked if you’d like to have a vaginal birth or a C-section and many woman here choose to have a C-section. At least in my city, many of the gynies recommend you have a C-section regardless. This way you can be more prepared and they can plan their schedule better. Before I found out I was having twins, I had to switch doctors to one of the only pro-natural gynies in town to have a good shot at having a vaginal birth. Obviously none of that was relevant once I found out about the twins anyway. I’ve also noticed that regardless of the baby’s position or a woman’s hip size, if the baby is 4kg+ (8.8lbs) in your last few weeks of pregnancy, your doctor will almost definitely recommend you have a scheduled C-section.

– Is breastfeeding or bottle feeding the norm?

I think this is 50/50 here. Breastfeeding is most definitely recommended even if only for a few weeks, but it’s not pushed ridiculously to the point where you’re shunned if you don’t do so. When you deliver, a nurse comes to you and asks if you want to bottle or breastfeed and it’s labeled on your babies chart. It is slightly uncommon to find women who have breastfed up to a year or more. I think a lot of this has to do with the stress of cultural norms as it’s completely unacceptable to breastfeed in public and there are very few feeding rooms in public places. When some of my friends wanted to go to the mall with their family while they were breast feeding, they have had to sit on a public toilet to feed their baby! I wouldn’t want to keep going if I had to do that either! I never publicly breastfed cause I had to basically take off my whole shirt as I was feeding 2 babies at once which… isn’t really appropriate in any nation… except maybe Europe. Hooter Hiders or Hide-n-Feeds as we call them, have just come to our city in the last 2-3 years and are becoming very popular, but still… I don’t think I’ve ever seen a woman using one in public. I think this is sad. But you need the full picture to understand.  South Africa is a VERY diverse nation & in some of the people groups here breastfeeding is very normal… so normal that whole boobs are whipped out in church or at the super market or wherever they happen to be. So like all things, I think many have gone to the opposite extreme. 

– What is the size of an average family?

Two kids seems to be the norm. Anything more than that and people think you have a big family. Total strangers will stop to ooh and aww over the twins and comment on how lucky I am that I “got it all done in one shot”- two kids, one pregnancy. When Husband and I say we actually love kids and that we are going to have more they’re super shocked and give us the “you’re flippin’ crazy” face.

– Are SAHM’s a luxury or a norm?

Most definitely a luxury… huge luxury.

– Is it normal to have help with you baby? (ie. full time maid, nanny, mother helping for a bit)

Yes, totally normal. South Africa is a culture of domestic help. As long as I’ve lived here we’ve had a maid who comes twice a week and cleans my house from top to bottom and does all the laundry. Many families get a full time maid when they have a child who doubles up as a nanny, regardless of whether the mother is going back to work or not. (And when I say ‘many families’ I mean your average middle class family, not only extremely wealthy people.) Once you have a second child it’s almost assumed that you’ll have a full time nanny/maid. Many people here were shocked to find out that I chose not to have a nanny but to rather take care of the girls myself. Many families also have a small living quarters off the side of their house where their nanny can live. In the case of these families, the nanny/maid is usually sent on a cooking course so she can help with the cooking especially at night or help as a night nurse depending on your arrangement with her.  

– Any other interesting facts about your birthing nation in regards to pregnancy and child birth?

When I first moved here I was completely shocked and upset at how high C-section rates were. I blamed doctors for being too busy to wait for labor and not skilled enough to deal with the complications that can arise. After being here for a while… I’ve totally changed my tune. Never once in the five years that I’ve lived here have I known a friend or heard of a friend-of-a-friend or anyone for that matter, who has given birth and ended up with a still born, brain damaged or handicapped child from vaginal childbirth complications. NEVER ONCE. I’m sure it does happen but it’s rare. So before you get your panties in a wad (like I did) about our C-section rate, understand that our doctors are conservative and want our babies to come out alive and healthy at all costs. If there even looks like a possible risk, they often don’t chance it and I don’t think you can fault them for that. Plus, who cares if they want to schedule C-sections? At least then you are assured that the doctor you’ve spent 9 months building a relationship with will be there for your delivery. They might even be a little more calm and collected than if it was an emergency, or if they’ve missed their best friends wedding cause your baby decided to make an entrance into the world.

Well folks, that’s me. That’s my experience of being pregnant in South Africa. Now you know…


One Response to “A Cultural Pregnancy- Part 1”

  1. Chris and April June 20, 2011 at 9:06 pm #

    I can't believe you get so many ultrasounds! That is awesome. I'm sure it was cool to see how the girls were progressing so often!

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