Birthing Options

By Barbara Hanrahan – Midwife and Educator

Childbirth is not an illness. Neither does the birth of every baby have to be a medical procedure. Fit, healthy women can have the choice of being active and participative in the birth of their babies.

Most women already have a gynaecologist by the time they fall pregnant. The question is do you know what you want from your birth experience? This is a sensitive area as your gynae may work at a hospital with limited birth options. So the first step is really to find out what YOU want and which setting will best offer you the birth options you are looking for.

The current trend for the average healthy woman is swinging away from the high tech intervention and women are now exploring choices and alternatives about where (hospital, birth unit, home), with whom (gynaecologist, midwife) and how they might give birth to their babies. The main catalyst to change has been through education and the increasing availability and knowledge of birth options. To make choices – informed choices, one needs as much information and education as possible.

Once a woman finds out that she is pregnant she needs to start considering all her choices, research and explore her options. Establish a circle of support. Women need to take responsibility for their own health, explore their options, read widely and not feel intimidated to change their ideas or choices at any time.


Choosing the place of birth really determines the kind of birth choices you will have and who will be your caregiver.

  • A birth unit – this is a homely environment usually within a medical facility. A birth unit actively encourages partner and family participation – known as family centered maternity care. The setting is relaxed and intimate. It may include a bath / jacuzzi / small pool, double bed and homely furniture. The caregiver could be your gynae or a private midwife. You have the option of going home shortly after the birth or staying for a couple of nights for help and guidance through those early days with your new baby. Birth units in a medical facility will have access to theatre should the need arise for a caesarean section
  • A maternity ward – this means that you would give birth in labour ward and then move to the postnatal ward for your postpartum stay. The choice of hospital is usually determined by the doctor, who may have consulting rooms at that hospital. This is a traditional hospital setting
  • A homebirth – is usually attended by a pair of private midwives who will give you a lot of  guidance about what you need to prepare for the birth and what to expect on the day. You would attend regular antenatal checkups with these midwives. The midwives will arrange a back up doctor and hospital facilities in case of emergencies


  • Private midwives are qualified, registered with the SA Nursing Council, who work independently in a self employed capacity. Midwives view pregnancy and birth as normal biological events and have a back up doctor should the need for intervention or a caesarean birth arise
  • The doctor who looks after women in pregnancy is usually an obstetrician who has particularly specialised in the care of women who have a high risk in pregnancy
  • Besides the midwife or doctor, many women are choosing to have a doula / birth companion present with them during labour and birth. A doula is a lay woman who has trained as a companion who supports women and their families during labour and birth. The doula can also provide care and support at home after birth too

Your right

Your right is to change caregiver or hospital if you are not going to be accommodated or your choices not willingly met or if your views are not deemed important.

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