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!