Alliance of African Midwives

My organization is called the Alliance of African Midwives. The African Alliance of Midwives is a nonprofit organization whose purpose it is to improve the health of women and children in Africa. My mission for the African Alliance of Midwives is to provide comprehensive, quality care to women in pregnancy, childbirth, and the postpartum that is safe, holistic, loving, and that honours the divine in all people.  

I believe that pregnancy and birth are normal states of being and normal life processes.  I believe all women should have access to care. Most pregnancies and births are normal, and the greatest safeguards in keeping them that way are education and non-intervention.   I believe that spending quality time with women in pregnancy in regular prenatal appointments and giving loving, thorough care are essential to positive birth outcomes in today’s society.  I truly trust birth and do not intervene in the birth process unless necessary, as experience has taught me that most births unfold beautifully without outside interventions.  

My vision for the world community is that women in the continent of Africa will have access to safe and loving midwifery care.  I want all women to believe in themselves and in their bodies.  I want women everywhere to know themselves intimately: spiritually, emotionally, and physically.  I want for women to rejoice in femininity, in pregnancy, in the miracle that we can create and give life!  I want for women everywhere to be self-confident and to get what they want for their births.  I want for all normal births to stay that way, to be free from intervention.  And I want for women who experience complications to receive loving and safe care that they understand.  I want for midwives to be educated and to provide safe and available care to all women who seek for us.

I believe that birth has real power to change the Africa and the world.  I believe that the world can change one birth, one mother, one baby, one family at a time.  I will do my part by striving to constantly walk with all midwives and organizations in this continent of mine to make it happen.

Midwifery Education in South Africa

Midwifery education in South Africa goes back to the early 1960's. During that period in order to become a midwife a person first had to qualify as a nurse and then subject themselves to a period of training as a midwife.There was a three year nursing diploma course offered followed by a one year course in midwifery.This format was the norm for many years. Young women were first trained as nurses and it was compulsory at the time to complete midwifery traiing even if your willl never work as in a midwife setting.

Midwiffery clearly was seen as second to nursing with the doctors being the mainstay of birthing, the control over what we do and cannot do.The nurses ran the antenatal clinics, dispensing medication and doing basic medical procedures normal deliveries.This freed the doctors up to attend to the more lucrative issues. Doctors were called for complicated or surgical intervention. The nurses were left overworked and underpaid for many years.

The above picture in South Africa is the norm, tired and overworked nurses and clinics that are too small and overcrowded, and severely understaffed. Sometimes there is just a screen between women giving birth. Every person can hear every coversation which is suppose to be private and confidentail but it is not. It a wonder that African women prefer to give birth at home with midwives and avoid the clinics and hospitals completely. In private hospitals, babies are generally delivered by doctors, not nurses,


The  nursing curriculim was changed in 1986 when the four-year course was implemented. So, since then the most prestigious route to become a nurse in South Africa is a four-year degree, offered by several universities and universities of technology and regulated by the Department of Higher Education.

The four year degree course was implemented in the United States because nurses are the only healthcare professional without a degree. The decision was made that all new nurse entries should be a degree. At the time 15 countries signed up. South Africa tried to be on board as well but unfortunately, our nurses graduate with a four year Diploma in general nursing, community health, psychiatry and midwife. The four-year degree courses (BCur, BA Cur, BSc Cur) are offered at most university in South Africa


The degree nurses do the same course at university level and both degree en diploma nurses are callled profesional nurses whereas everywhere in the world nurses are called registered nurses (RN).  Forty years ago the American Nurses Association (ANA) issued it's position paper making the bachelors degree in nursing (BSN) mandatory for entry into the profession. This is happening slowly allover the globe. All new nurses in England starting from 2013 will have to be degree educated. Diploma courses will be fased out slowly. Countries like Canada, Australia require a degree entry for all new nurse applicants.

The South African system of training has to be upgraded since the current training system and curriculum is inadequate.The results can be seen in the high HIV rates, maternal and infant death statistics.The way the training of nurses in the US is structured is completely different and geared to cope with the problems we encounter in todays world. South Africa needs to upgrade the criteria in it's nursing education. The nurse-midwives of South Africa especialy those in the public health system are overworked and understaffed. Nuses are the largest category of healthcare professionals. The training of nurses has been neglected and need change.

Since the Direct Entry Midwifery Course was stopped in South Africa in 1981, we now are all nurses first. Some academics argue and brag that the Advance Midwifery Course is the way so if it is the way why not making it a direct entry course. Mothers should be attended by midwives not nurses who know little about childbirth support apart from technology. If this is not the case why are so many women giving birth in hospital alone, and why are there so many private hospitals controlled by men.

The problem is that nowadays home births in South Africa are not catered for by the state health service. The only registered professional service that offers this option is that of the Professional Midwives, registered by SANC and a Facebook page for students studying direct-entry midwifery in Johannesburg from other countries, these student practice on our women and return to their countries with degrees. Our women and resources were use to help foreigners advance but our own student and people do not get the opportunity to enrol in a direct entry midwifery program. We have to start the long road of becoming a nurse. It is a frightening thought!

Abortions in South Africa and midwives

I am a midwife. Midwives bring life into this world. They are doing great work and I am honoured to know many wonderful compassionate and caring midwives. Midwives provide care across the spectrum of a woman’s reproductive life–from well-woman care, to pap smears and yearly exams, to prenatal care, and the birthing process.

Abortions are a very sensitive issue in South Africa. It is angers people. For many years abortions were illegal and were only done in certain cases. With the change in Government abortions were legalized, as in terms of the new constitution they were deemed a right. Abortion was made legal in South Africa with the implementation of the Choice on Termination of Pregnancy Act of 1996. The Choice of Termination Act stipulated that registered midwives can perform abortions for women and immediately a program was initiated to train midwives around the country to provide abortion services. How disgusting! Prior to the Abortion law, abortion was understood to be a common crime. The law was after the person who performed the abortion not the pregnant woman.

Many religious groupings were against the legalization of abortion and many protest marches took place to the countries parliament. The government however resisted, and the law legalizing abortion was duly promulgated and passed. To add insult to injury midwives were forced against their will and their religious convictions to partake in abortions. South Africa is the only country in the world where midwives are expected to perform abortions. They trained these saviours of life to perform abortions; what a contradiction! Abortion is a gruesome business. From 6 weeks gestation after conception the foetus is clearly human. At 8 weeks, the foetus is 3 cm long and has limbs and facial features.

South Africa hospitals perform two types of abortions, surgical and medical abortions. In surgical abortions the vacuum extraction or dilatation and curettage (D & C) technique is used. The abortionist use sometimes a handheld specially designed syringed or hollow tube connected to an electrical pump to apply suction inside the cervix, removing the unborn foetus in the process, all in pieces. So it is understandable why nurses and doctors are revolting. Doctors and nurses see the pieces of the dismembered foetus as they come out. Worse of all, the nurses must scrap all the pieces together of the dismembered foetus to prevent infection and to make sure nothing is left behind. As a midwife for 25 yrs I am appalled that any health professional would want to be part of this "campaign of abortion."

In medical abortions the patient is given pills orally or vaginally to induce labour. Sometimes when the foetus is over 20 weeks, the baby is still alive and lives for a few hours. Nurses have to stand and watch a baby die and do nothing while the pregnant woman goes back to her normal life of promiscuity. No wonder so many of us want nothing to do with abortions. The ANC government did not take into account the feeling of the medical profession when they debated on this law.

Resultant from this particular law many midwives left the country; nurses found this law very contrary to their training and belief; anathema. Were the fact of the matter that a woman had a miscarriage or self induced abortion this would have been a different matter; to force nurses to abort women is enough to blow even the broadest of minds. There of course were numerous arguments in defense of the abortion act; the foremost being that it would help reduces maternal deaths. As it turned out it was the exact opposite, but rather an increase in the maternal death rate, coupled with severe trauma and depression. In a report published in the Pretoria News in 2004 it was estimated that 500 women died each year from legal abortions in South Africa compare with just 32 backstreet abortions. The Pretoria News surveyed 18 hospitals and each one admitted that pregnant women had died from legal abortions.

The law in question should definitely be revised since it is subject to abuse, being used as a contraceptive when it is in fact the ending of an innocent life. I don’t think we will have a change in the abortion law unless we have a change in government. The constitutional court has eight members and they are all pro-choice, all appointed by the present government.

Traditional Birth Attendant is derogatory term

Midwives have been around since the dawn of man. All those involved in the birthing process were called midwives. African midwives are no different, having been around since the dawn of man on earth. The western world however decided, in its wisdom, to change the definition of what a midwife is. They changed the name of the traditional African midwife to that of Traditional Birth Attendant; how derogatory can one get. What effectively has happened is that another country in the world has labeled the work of African midwives with the term "attendant."

The World Health Organization (WHO) has formed a definition with this name. The WHO defines a "traditional birth attendant (TBA) as a person who assists the mother at childbirth and who initially acquired her skills delivering babies by herself or by working with other birth attendants. Also TBAs are usually old and experienced women who see their assignments primarily as contributing their skill for the good of the community." Strangely, in the United States these same traditional midwives are called “lay midwives.” This raises the question as to why African midwives are called by demeaning names. Why is the name midwife solely claimed by the western world? To my mind this mindset illustrates a lack of awareness as to what is happening in Africa and also shows that there is no awareness in the west that Africans are indeed intelligent. The western world should give Africa its due and thereby instill confidence in the African midwife.

The traditional birth attendant is a woman who does not meet the international definition of a midwife. They are nothing in the eyes of the educated world. The WHO strongly advocates for "skilled care at every birth" to reduce the high maternal deaths in thw world. The WHO defines a skilled attendant as "an accredited health professional – such as a midwife, doctor or nurse – who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns."

Why is there this discrimination? My grandmother was one of these so called "birth attendants," yet, she could do anything when it came to the birthing process. This includes the delivery of a breech, twins, any complication during birth. How many skilled midwives or specialists today can do this type of complicated birth without technology? Are these skilled attendants really skilled? And where are the skilled attendants when the so-called traditional birth attendants provide the majority of primary maternity care in many developing countries. 

International Day of the Midwife

Happy Midwives day to all the midwives who give families the true midwifery model of care. We must keep this wonderful tradition alive! Today is a day of celebration and recognition for the work that we as midwives do.

Today is a very important day in the midwifery calendar – it is International Day of the Midwife. The International Day of the Midwife was  first elebrated on May 5, 1991, and has since been observed in many nations around the world. The idea of having a day to recognize and honour midwives came out of the 1987 International Confederation of Midwives conference in the Netherlands. There are many celebrations being held in support of midwifery throughout the world. It is a great opportunity for fundraising, raising awareness and raising the profile of midwifery through media releases and news coverage.

The term “midwife” originated in England between the 1250-1300′s. It is translated from the words “mid” meaning “with” and “wif” meaning “woman," so it literally means “with woman." A midwife is someone who supports a woman to birth a baby. The role of the midwife is more than just birth support, it involves antenatal education and assessment, labour care, birth care and postnatal care. There is also a responsibility to advocate for women and corporately work together to rectify injustices and unsatisfactory conditions and outcomes for birthing women in different communities around the world. It is for this reason that the Internanational Confederation of Midwives (ICM) fought for this day.

ICM has encouraged midwifery groups around the world to “take to the streets” and organise a walk in their local communities to highlight global midwifery issues. ICM’s ongoing theme, that started in 2008, is: “The world needs midwives now more than ever." ICM called on the midwives of the world to attend the triennial ICM Congress to be held in Durban, South Africa in June 2011. The ICM also called on associations to organize 5 kilometer walks in cities and towns across the world on International Midwives Day, May 5. On June 18 when the midwives of the world gather for the ICM Congress, they will complete the walk into the city of Durban in celebration of their commitment to improving maternal and newborn health globally. This is the first time in the ICM's history that the Congress is being held in Africa. This is an opportunity for ICM to bring visibility to midwives.

So congratulations to all midwives for the amazing, important, life changing, world changing job you do.  I wish you all a wonderful day. The world need midwives now more than ever. Let us all celebrate this wonderful day.