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Resource centre - Pregnancy and Birthing

Birthing Options : Birthing Places
by Lana Peterson


Active birthing units (ABU)

ABU's have been established to fill the need of pregnant women, to have a comfortable, homely setting with the safety of a hospital environment at their disposal. Here women are also encouraged to labour actively and use natural methods of pain relief. She is often attended to by a midwife from the ABU or she may choose to bring in her own independent midwife for her labour & birth. ABU's are designed with the comfort of the mother and her partner in mind, so in most cases these rooms have a double bed, birthing bath, labour balls, cd player, etc. Rooming- in of the mother, father & baby is encouraged. In the event of any complications that could arise, obstetric assistance is available on the same premises.

Candidates for ABU's need to be low-risk pregnancies.

Private hospitals

Private hospitals accommodate women with low to high risk pregnancies. In this setting women can be attended to by their OB/gyn (who is licensed to practice at that specific hospital) or independent midwife (as long as the back-up OB/gyn practices from that facility as well) Second to the public sector, most women deliver their babies in private hospitals for various reasons ranging from the need for reassurance that they are in a facility that can offer immediate obstetric assistance in the event of an emergency, to the need for privacy and avoidance of being subjected to “staff-in-training” .

It should be noted that S.A's private sector has an alarmingly high caesarean section rate (btwn 70-90%) Whatever the reason for this imbalance, women should be made aware, that when choosing to deliver at a private hospital, they're more likely to have a medically managed birth.

Public maternity hospitals

Most government hospitals have implemented the “better birth initiative” whereby women are encouraged to bring along labour support persons, have an active birth (labouring and birthing in positions conducive to best health practices) and not be restricted to nourishment and so on.

Statistics also show that the caesarean section rate in the public sector is significantly lower than those in
the private sector – 20% (state) vs. between 70-90% (private) as is the use of pharmacological pain relief.

Because of the large volumes of patients utilising the public sector, you can expect longer waiting times and in some instances less time being attended to by the relevant staff.


A birth at home can be an immensely empowering experience and women who choose this option do so for reason varying from wanting to avoid a repeat of a previous bad hospital experience, wanting to have complete autonomy during labour and birth, the safe & familiar setting of home, to the feeling of being uninhibited and unrestricted.

There is still a lot of misconception regarding the safety of homebirths and which women are suitable candidates for homebirths. Worldwide research has shown that homebirths done by skilled practitioners with good obstetric backing
on “low-risk” pregnant women, have as safe and in some cases, safer outcomes. You will need to find an independent midwife to offer you this service and she will help you arrange the services of a back-up obstetrician in either the public or private sector as a precautionary measure should any complications arise during your pregnancy or labour. High-risk pregnancies should not be attempted in a homebirth setting.

Lana is a qualified Doula at Lalilu Doula Care. She can be contacted on 021 703 4291 or 073 514 9754. She can be emailed at