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Wednesday, September 26, 2012

Birthing Stool

A birthing stool is a tool that can assit a midwife in managing labour. Birthing stools can be used in the second stage of labour to aid in delivery of the baby. We all love birthing stools because we found them highly effective; they are a great place to rest while still using gravity to aid in labour. There was a time when birth was treated as a natural process rather than a medical condition. Before 1800, women gave birth seated in birth chairs or on stools and were helped along by midwives. Then societal changes in attitudes toward women and the practice of medicine made birthing a province of the male-dominated medical profession.

A birthing stool is has been specifically designed for use during childbirth. It allows a woman to sit or squat while giving birth with support to help her if she begins to feel fatigued. Many advocates of natural birth support the use of a birthing stool, which may also be called a birth support stool or a birth stool. Such stools are available from companies which provide equipment to midwives, and they can also be handmade.

 

The concept of sitting or squatting during labour is ancient, and widely practiced in many cultures, and the use of the birthing stool is also quite old. There have been ancient art created to depict women squatting during birth. Artfully crafted birthing stools and chairs have been built to assist mothers. Until very recently, in Europe, particularly in Northern Europe, in Denmark, birthing stool was considered a family treasure, and was preserved in the family for generations. A bride brought to the new family the birth stool inherited from her mother, grandmother, and great grandmother.



The medieval birth stool was a horse-shoe or boomerang shaped slab of wood on legs, without a back and without arms. A woman could sit on it and move her pelvis freely. One of the birth companions sat behind her cradling against her body and moving with her. It was a familiar, comfortable posture since women were accustomed to sitting crouched on a low stool when milking a cow or goat and spinning or weaving.

A birthing stool is designed to bear up to a substantial amount of weight and pressure, and it is usually low to the ground so that a labouring mother can plant her feet firmly. Also, a birthing stool has a hole in the middle, which allow a midwife to monitor the progress of the labour and providing a space for the baby to slide through.

The birth stool were used in Egypt, Persia and India and also of lap-sitting. The latter was common in Africa, Europe and South America. In the early nineteenth century a German carpenter devised a birth stool with a back to it after his wife told other pregnant women in her neighborhood how easy it had been giving birth sitting between her husband’s thighs. As a result women called on him to attend them when they were in labor. He became very popular in the town, to such a degree that he constructed a birth stool to take his place.
First, the benefits of squatting include:
  • shortened second stage of labor (the pushing phase)
  • Reduced need for forceps during delivery
  • Reduced need for episiotomy
  • Shortens the depth of the birth canal
  • Increased pelvic diameter
Many women can use the birthing stool to squat. This is a very interesting history of birth stools. The full version of the article by Sheila Kitzinger is available by clicking here. The teaching film The BirthRite Experience, explains the use of the Birthing Seat in detail.

Tuesday, September 18, 2012

Smoking During Pregnancy

Smoking is a major public health problem. Smokers face an increased risk of lung cancer, other lung diseases, and cardiovascular and other disorders.  According to the World Health Organization (WHO), globally 1.1 billion people smoke. Each year tobacco causes some five million premature deaths.  If current smoking patterns continue, it will cause some 10 million deaths each year by 2020. Half the people that smoke today; that is about 650 million people will eventually be killed by tobacco. According to these figures, smoking will claim more lives than HIV, tuberculosis, motor vehicle accidents, suicide and homicide combined.

South Africa became one of the first countries in the world to ban smoking in public places in 2000 when it introduced its Tobacco Products Control Amendment Act. The act put a serious dent in the smoking culture in South Africa, as it prohibited smoking in restaurants, pubs, shopping centres and offices where there was no separate, enclosed smoking room. Having said all that, the smoking habits continue. According to the Tobacco Institute of Southern Africa, there were some 7.7 million tobacco users in South Africa last year (2011), lighting up some 27 billion cigarettes.
 
Maternal smoking during pregnancy remains a serious public health problem. Smoking is known to have an effect on babies before they are born. Cigarette smoke contains more than 2,500 chemicals. It is not known for certain which of these chemicals are harmful to the developing baby, but both nicotine and carbon monoxide play a role in causing adverse pregnancy outcomes. 
Nicotine, carbon monoxide and other chemicals in tobacco smoke are passed on to the baby through the placenta. Nicotine increases a baby's heart rate and breathing movements. Some of the chemicals passed to through the mother's blood are known to cause cancer.Women who smoke during pregnancy could be more likely to have a child with high-functioning autism, say researcher Professor Amy Kalkbrenner from the University of Wisconsin-Milwaukee. The dangers of smoking during pregnancy include premature birth, certain birth defects and infant death. Smoking makes it harder for a woman to get pregnant.

Women who smoke during pregnancy are more likely than other women to have a miscarriage.
  • Smoking can cause problems with the placentaExternal Web Site Icon—the source of the baby's food and oxygen during pregnancy. For example, the placenta can separate from the womb too early, causing bleeding, which is dangerous to the mother and baby.
  • Smoking during pregnancy can cause a baby to be born too early or to have low birth weight—making it more likely the baby will be sick and have to stay in the hospital longer. A few babies may even die.
  • Smoking during and after pregnancy is a risk factor of Sudden Infant Death Syndrome (SIDS), deaths among babies of no immediately obvious cause.
  • Babies born to women who smoke are more likely to have certain birth defects, like a cleft lip or cleft palate.
  • Stillbirth.
In South Africa, less than 10% of women of European, Indian, and African descent smoke. However, an alarming 46% of women of Khoi women smoke and continue to smoke throughout pregnancy. Most women are aware that smoking is harmful, but do not understand the potential severity of the harm. Research done at Tygerberg Hospital in Cape Town found that smoking during pregnancy was associated with an 8% increase in pre-term delivery and a three-fold increase in abruption placentae - a complication during pregnancy in which the placenta (which feeds the unborn child) prematurely separates from the wall of the uterus. These two conditions are the most common causes of death in unborn and newborn babies.

Cape Town is experiencing a devastating level of methamphetamine use, with an estimated 7% of the adult population reporting the use of this drug. A study conducted among pregnant women attending an antenatal clinic at the Tygerberg Hospital in Cape Town has found that 10 percent of the mothers were abusing the drug methamphetamine or “tik” as it is known in Western Cape.
Most midwives would love to educate their patients about the risks of smoking during pregnancy. Most midwives are confident about discussing smoking during pregnancy with the women. In fact they would love to receiving training in smoking cessation counseling.
Source:

 

Foetal Alcohol Syndrome Features

South Africa is among the top three heaviest-drinking nations in the world, with the highest number of heavy drinkers and binge drinkers found in the Western Cape Province. The government estimates that alcohol abuse and its associated social and health consequences, including employee absenteeism, costs the South African exchequer over R1 billion annually. It is therefore, no wonder that so many pregnant women are drinking so much.

Foetal alcohol syndrome is growth, mental, and physical problems that may occur in a baby when a mother drinks alcohol during pregnancy. Foetal Alcohol Syndrome is a clinical diagnosis, which means that there is no blood, x ray or psychological test that can be performed to confirm the suspected diagnosis. The diagnosis is made based on the history of maternal alcohol use, and detailed physical examination for the characteristic major and minor birth defects and characteristic facial features.
Let’s not forget what the mother drinks the foetus drinks. The alcohol that the pregnant woman drinks goes directly to the developing baby at the same level of concentration. If mom's blood alcohol level is 0.2, so is the baby's. However, mom is much, much larger. Her mature liver acts to detoxify the alcohol. On the other hand, the fetus is incredibly smaller and the liver is not yet mature. Therefore, while mom might stay drunk for several hours, the developing fetus can stay drunk for three to four days.
Classic features of Foetal Alcohol Syndrome (FASD) include short stature, small head size, low birthweight and poor weight gain, microcephaly, and a characteristic pattern of facial features. These facial features in infants and children may include small eye openings measured from inner corner to outer corner, epicanthal folds small or short nose, low or flat nasal bridge, smooth or poorly developed philtrum the area of the upper lip above the colored part of the lip and below the nose), thin upper lip, and small chin. Some of these features are nonspecific, meaning they can occur in other conditions, or be appropriate for age, racial, or family background. Take a look at these pictures and we can be sure they will make you think about the effect of alcohol on our communities.
















Other major and minor birth defects that have been reported include cleft palate, congenital heart defects, strabismus, hearing loss, defects of the spine and joints, alteration of the hand creases, small fingernails, and toenails. Since FASD was first described in infants and children, the diagnosis is sometimes more difficult to recognize in older adolescents and adults. Short stature and microcephaly remain common features, but weight may normalize, and the individual may actually become overweight for his/her height. The chin and nose grow proportionately more than the middle part of the face and dental crowding may become a problem. The small eye openings and the appearance of the upper lip and philtrum may continue to be characteristic. Pubertal changes typically occur at the normal time. These pictures below shows a typical cleft palate and strabismus in children, which can be connerected by surgery. Strabismus surgery is on the extraocular muscles to correct the misalignment of the eyes.







Because of the physical problems such as cleft palate and others, newborns with FASD may have difficulties with feeding due to a poor suck, have irregular sleep-wake cycles, decreased or increased muscle tone, seizures or tremors. They also experience delays in achieving developmental milestones such as:
  • Rolling over
  • Crawling
  • Walking and talking may become apparent in infancy.
  • Growing and learning normally for his/her age
Behavior and learning difficulties typical in the preschool or early school years include poor attention span, hyperactivity, poor motor skills, and slow language development. Attention deficit-hyperactivity disorder is a common associated diagnosis. Learning disabilities or mental retardation may be diagnosed during this time. Arithmetic is often the most difficult subject for a child with FAS. During middle school and high school years the behavioral difficulties and learning difficulties can be significant. Memory problems, poor judgment, difficulties with daily living skills, difficulties with abstract reasoning skills, and poor social skills are often apparent by this time. It is important to note that animal and human studies have shown that neurologic and behavioral abnormalities can be present without characteristic facial features.

There is no treatment for FASD that will reverse or change the physical features or brain damage associated with maternal alcohol use during the pregnancy. Most of the birth defects associated with prenatal alcohol exposure are correctable with surgery. Children should have psychoeducational evaluation to help plan appropriate educational interventions. Common associated diagnoses such as attention deficit-hyperactivity disorder, depression, or anxiety should be recognized and treated appropriately.

Home remedies or treatment for FASD includes proper guidance, understanding, care, patience, and support to the child. The best Fetal Alcohol Syndrome treatment is our love. No one understands the FASD patient world than his or her family. The role of the  midwife is to build trust and confidence and to encourage the women they care for, to take control of their addictions, their futures and the health and well-being of themselves and  that of their unborn baby. Our roles are to tailor education for the women and their families setting goals and plans for the future through a coordinated, comprehensive and individual service. 

Although FASD occur in every population in which women drink during pregnancy, they are more widespread in schools where alcohol abuse is prevalent. Midwives and school nurses must communicate with each other. Educational programs must consider the origin of the problem and prepare children to function in the environments in which they will live as adults.

A major focus of education should be effective communication. Just as there is a wide range of IQ and achievement among those with FAS and FAE, so is there also great variability in communication skills. Students may have apparently normal language but other who are severely affected, there will be no verbal communication at all. The majority has some verbal ability, but their language skills often appear much greater than their actual ability to communicate effectively. A child with poor verbal skills may let a teacher know that she needs help by something as subtle as moving her paper aside or something as dramatic as tearing it. Recognizing such behaviours as communication and shaping them into appropriate language is an important part of a comprehensive program. That is where the role of nurse, midwife and teacher overlap; we are all in this together to help our future generation.
Midwives should aim to inspire women to take control of their lives, give up alcohol, eat healthily, and stabilise the pregnancy to improve outcomes. This is not easy; even the most motivated of women will struggle. However, by encouraging early and continuing antenatal care and by being readily available to talk to things might change and improve as times goes on. We should focus our attention on early identification, early intervention and support services and help these people to have a stable home environment.
Sources:
Encyclopedia of Medicine, 3rd ed. | 2006
South African Medical Journal
Britannica: http://www.britannica.com/EBchecked/topic/205469/fetal-alcohol-syndrome-FAS
Youtube: http://www.youtube.com/watch?v=6o3JLlNGZe0
AAPOS: http://www.aapos.org/terms/conditions/102
CDC: http://www.cdc.gov/Features/fasd/

Foetal Alcohol Syndrome


Foetal Alcohol Syndrome (FASD or FAS) is a serious health problem that tragically affects its victims and their families, but that is completely preventable condition. FASD came to public attention in the early 1970s and is now recognised as a major health problem. FASD is a problem that reaches all corners of the Earth – where there is a love affair with alcohol, there is FASD. Unfortunately, it is also a problem that is misunderstood, and often perpetuated by ignorance and denial.

Africa has the world’s highest proportion of binge drinkers. Africa has become a boom market for international brewers and distillers whose sales are often flagging in the wealthy world. Drinks companies want to keep up the momentum. SABMiller is investing up to $2.5-billion (U.S.) over the next five years to build and renovate breweries on the continent. Rival Diageo’s African sales have risen by an average 15 per cent in each of the last five years, and now account for 14 per cent of the group’s total.

For years, poor Africans were limited to home-brew sorghum or maize beer, sometimes made with dangerous ingredients such as battery acid to increase the potency. Commercial alcohol is now widely available in most African states and premium brands such as Johnny Walker whisky or Heineken beer are increasingly in reach of the average drinker.
Many South Africans are binge drinkers. South Africa has one of the biggest alcohol consumption rates in the world. South Africa’s Western Cape province, has the highest reported rate in the world. Foetal Alcohol Syndrome is very prevalent issue throughout South Africa wine-regions- the Western Cape where farm labourers were once paid in alcohol. A shocking 122 out of every 1 000 Grade 1 pupils in the Northern Cape town of De Aar have foetal alcohol syndrome - the highest incidence of the syndrome in one population anywhere in the world. And in the Western Cape, research shows that 88 out of every 1 000 Grade 1 pupils have the syndrome.
Cheap alcohol is common in South Africa, and the shebeen system doesn’t help.  Also, poverty is at the root of the problem.  The shebeen system is one of informal taverns dispensing alcohol because there’s lack of employment opportunities. So people open up shebeens trying to make a living. De Aar is a town in the Northern Cape Province has 95 shebeens in a population of 28,000. Alcohol abuse leads to unsafe sex and “many, many unplanned for and unwanted children,” and “no doubt” contributes to rising rates of fetal alcohol syndrome and HIV infection according to experts.
Denis Viljoen, a founder of the non-governmental organisation the Foundation for Alcohol Related Research (FARR), states, “Fetal alcohol spectrum disorder is the most common birth defect in South Africa, by far more common than Down syndrome and neural-tube defects combined.”The move is designed to cut one of the world's highest rates of Fetal Alcohol Syndrome.
FASD is a term that describes a range of disabilities (physical, social, mental/emotional) that may affect people whose birth mothers drank alcohol while they were pregnant. Alcohol use appears to be the most harmful during the first 3 months of pregnancy; however, drinking alcohol any time during pregnancy can be harmful. As mentioned, alcohol can damage a growing baby’s brain, organs and body. This damage can affect how the baby thinks, acts, looks and learns as a child and as an adult. Alcohol damage doesn't always show up before the child goes to school. And every pregnancy and every baby is different.
There is no cure for FASD and its effects last a lifetime. The World Health Organization recommends that pregnant women should avoid alcohol. The World Health Organization, for instance, says alcohol-related injuries such as road traffic accidents, burns, poisonings, falls and drownings making up more than a third of the burden of disease, all because of drinking. South Africa is considering introducing a law that bans retailers from selling alcohol to pregnant women. A large number of South Africans are misinformed about FASD and when we tell people that drinking just one or two glasses can harm their baby, they don't believe me.
Causes:
Alcohol is readily absorbed from the gastrointestinal tract into a pregnant woman's bloodstream and circulates to the foetus by crossing the placenta. Here it interferes with the ability of the fetus to receive sufficient oxygen and nourishment for normal cell development in the brain and other organs. The consumption of alcohol directly contributes to malnutrition because it contains no vitamins or minerals, and it uses up what the woman has for metabolism. The foetus is most vulnerable to various types of injuries depending on the stage of development in which alcohol is encountered. During the first eight weeks of pregnancy, organogenesis (the formation of organs) is taking place, which places the embryo at a higher risk of deformities when exposed to teratogens.
 Symptoms:
A baby with fetal alcohol syndrome may have the following symptoms:
• Poor growth while the baby is in the womb and after birth
• Decreased muscle tone and poor coordination
• Delayed development and problems in three or more major areas: thinking, speech, movement, or social skills.
• Heart defects such as ventricular septal defect (VSD) or atrial septal defect (ASD).
Problems with the face, including:
Narrow, small eyes with large epicanthal folds folds
Small head
Small upper jaw
Smooth groove in upper lip
Smooth and thin upper lip

What happens to children born with Fetal Alcohol Syndrome?
• Their brain is permanently damaged, so they have trouble following simple instructions or remembering things.
• They're small and don't grow normally.
• Their faces may look different, such as small eyes and thin lips.
• They're often colicky babies and hyperactive children.
• They might have trouble seeing, hearing or speaking.
• They might have heart or kidney trouble
The advice of midwives and nurses is likely to have the most powerful impact on pregnant women and help them to avoid the risks. It is essential that the advice given is up to date, consistent and evidence-based, alongside advice provided on other lifestyle choices such as drugs, smoking and nutrition. All health care providers at all levels should be trained to screen for, diagnose, prevent, and treat an alcohol-exposed pregnancy. Curriculum programs and materials tailored to meet the learning needs of these professionals should be developed and used. We need to better understand the many social and psychological processes that contribute to risky drinking and sexual activities in the environments in which these women live, and we must seek to delineate personal and societal interventions that are both acceptable and realizable.
TakeAway Theatre has been creating groundbreaking community theatre with South Africa’s leading Fetal Alcohol Syndrome (FAS)-related research and training organisation, the Foundation for Alcohol-Related Research (FARR), for the past four years.  Another non-profit organization works in communities in the North and Western Cape of South Africa and they partnered with SAB Ltd to address the issue of Foetal Alcohol Syndrome. Young girls and adult women are taught the risks of drinking alcohol when pregnant, while young boys and adult men are encouraged to support their future girlfriends/wives not to drink during pregnancy. An independent impact assessment found that 82% of those involved said that their knowledge of FAS and the dangers of alcohol abuse had increased.
“The future of our country…
Does not only lie within our mothers’ wombs…
But also in the supporting hands of many…
Mothers, Fathers, Families, Community Leaders...
And yours…because in the end it takes a village to raise a child”

African proverb
Sources:
National Council on Alcoholism and Drug Dependency -- www.ncadd.org
Fetal Alcohol Syndrome Family Resource Institute. www.fetalalcoholsyndrome.org
World Health Organization: http://www.who.int/bulletin/volumes/89/6/11-020611/en/

Sunday, September 16, 2012

Midwives in Gauteng

Midwives are integral to ensuring that we take quality care of our mothers and babies at all times. Midwives midwives are involved in every aspect of a pregnant woman's health, from pregnancy screening to post-delivery care and the provision of family planning and pap-smears to detect cervical cancer. Midwives are classified as nurses in South Africa so there are no figures on their numbers, Nurses and Midwives also comprise the largest group of health care providers in South Africa. Independent Midwives work in both public and private hospitals. In the past, midwives helped women give birth at home, but there are no longer enough of them for this to be possible.

IN SOUTH AFRICA INDEPENDENT MIDWIVES OFFER:
Antenatal and Postnatal Care
Home birth
Waterbirth
Hospital Birth
Birth in Birth Centre
Caesarian section attendance
Ntombi Mchunu ,
Little Arrivals Private Midwife Services
Address: Linkwood Hospital 24 12th Avenue Linksfield West,
 Orange Grove, Gauteng 2192
Tel: (07) 2949 6058
Fax: (08) 6504 1808
http://www.littlearrivals.co.za

Home Visiting Midwife
Address: Roodepoort, Gauteng 1724
Tel: 071 6367692
lgvanderw@gmail.com

Hettie Grove: Carmi Clinic: Springs

RN, RCN, RM, BACurEdAdmin, advanced midwife, IBCLC, Internationally certified childbirth educator, Happiest kid on the block educator, Evergreen parent facilitator. PR 8806926
TeL 011 815 2129
083 492 5861
Childbirth education, postnatal classes, well baby clinic, home phototherapy, lactation education & consultation 492 5861



Sunday, September 9, 2012

Birth & Midwifery Groups Western Cape

There are two main options open to a pregnant woman when having a baby in Cape Town: midwife or ginaecologist. Whichever the woman choose, the midwife or gynaecologist will remain the person in charge of her care throughout the pregnancy and will be present at the birth so there is very reassuring continuity of care. Here are some contacts for private midwives. Please feel free to add to the list and give your recommendations. Most of the private hospitals in Cape Town offer antenatal classes which  must be paid.

Central
Cape TownBirthworks
Karen Clark
Registered nurse & midwife
PR No. 0092444
We hire birth pools, birth stools, Tens machines & birth balls nationwide
(021) 785-5670 / 082 776 3622 / www.birthworks.co.za 
Mouille Point
Thula Baby Centre
Heather Wood
Registered nurse & midwife
PR No. 0192031
Antenatal preparation classes, well baby clinic, home visits
(021) 434-2614 / 072 548 8506
Sea Point
Bella-Mia
Tania Wener
Perinatal instructor ICEA
PR No.
Birth preparation, nutrition, postnatal rehab, pelvic floor strengthening, core
083 408 8868
info@bellamiax.co.za 
Gardens
Ruth Katzman

BSc Physiotherapy, IBCLC
PR No. 7222742
Physiotherapy for breastfeeding problems, hiring of Tens machine, pelvic floor rehabilitation
082 864 8232

Pinelands Joann Lugt Childbirth Education
Joann Lugt
Registered nurse & midwife
PR No. 0880000032395
Antenatal classes, baby sign language workshops, postnatal visits
(021) 531-5422 / 084 879 8511

Northern suburbs
Milnerton Be Prepared For Life
Devorah Gruss
Registered nurse & midwife
PR No. 8804559
Childbirth education classes for couples
(021) 552-5872 / 083 463 8114

Milnerton
Sr Lyns Baby Clinic at Milnerton Medi-Clinic
Lyn Smit
Registered nurse and midwife
PR No. 0016985
Well baby clinic offering immunisations, breastfeeding, weight & observation of newborns
(021) 529-9195 / (021) 552-8126

MilnertonThe Lactation Consultancy
Jean Ridler
RN, RM, international board certified lactation consultant
PR No. 8809068
Breastfeeding classes for parents-to-be, home consultations for breastfeeding problems, breastpump hire
(021) 556-9162 / 082 668 1082

Milnerton
Paula Pedersen
Qualified labour doula
PR No.
Certified childbirth companion for all births (home, hospital, water, vbac), breastfeeding support
083 334 2253 / www.paula.co.za / paula@paula.co.za

TableviewTenfold Baby Clinic
Jackie Butler

BCur Hons, registered midwife
PR No. 0880000056170
Antenatal classes, well baby clinic, breastfeeding support, immunisations, postnatal home visits
(021) 557-6066 / 082 297 2742

Table View Robin Buck Physiotherapy
Angela Buck

BSc Physio
PR No. 0159263
Treatment of engorged breasts, cracked nipples, breastfeeding advice & infant massage
084 981 0232

Sunningdale
Blaauwberg Hospital
Delene Cloete
Registered nurse
PR No. 0880000018082
Antenatal classes
(021) 556-8027 / 072 470 0435

Sunningdale Storks Nest Netcare Blaauwberg Hospital
Barbara Chambers
Registered nurse & midwife
PR No. 0880000003379
Antenatal classes, breastfeeding advice, well baby clinic, immunisations, milestones & development
(021) 554-9388/9

Melkbos
Marcha Izatt
RN, RM, RPN
PR No. 0880000087580
Postnatal care, breastfeeding counselling, home phototherapy
078 138 2040

PanoramaPanorama Breastfeeding Clinic
Justine Geiger

BSc Nursing, RN, RM, RCHN
PR No. 8853088
Antenatal classes, breastfeeding advisors, all baby & child immunisations till preschool
(021) 939-9720 / (021) 930-8397 / after hours helpline 083 703 7711

Panorama Panorama Antenatal Classes
Danelia Kok

Reg midwife, comm health, nursing education & admin
PR No. 0880000118532
We offer Afrikaans and English antenatal classes at Panorama Medi-Clinic
(021) 938-2153

Goodwood Storks Nest Clinic
Ronel Nortje
Registered nurse & midwife
PR No. 0880000161764
Antenatal classes, well baby clinic, breastfeeding support, vaccinations, baby massage
(021) 590-4196/1

Bellville Jeanne Roux / Tucker Physiotherapy
Jeanne Roux
Registered midwife
PR No. 0880000093416
Antenatal & postnatal education, exercise, delivery & back care
(021) 957-6283 / (021) 948-1553

Bellville Birth, Baby & Beyond
Rosemary Gauld
Registered nurse & midwife, internationally certified childbirth educator, international board certified lactation consultant
PR No. 8812608
Antenatal classes, breastfeeding private home consultations
(021) 910-0606 / 082 372 3348

Bellville
Sr Jenny’s Pregnancy Centre
Jenny Visser
RN, RM
PR No. 0024252
Antenatal classes, home & hospital births, postnatal & breastfeeding support
(021) 919-9000 / 082 508 5842

Durbanville Baby and U
Merle Townsend
Registered nurse & midwife, internationally certified childbirth educator
PR No. 0080010078921
Antenatal classes – childbirth education – relaxed and informative classes
(021) 976-5740 / 072 266 8864

Durbanville
Durbanville Family Care Centre Breastfeeding Clinic
Jessica Commaille
RN, RM
PR No. 0880000157139
Fun childbirth education for moms and dads, well baby clinic, immunisations
(021) 975-3634 / 073 235 2869

Durbanville All About Babies
Darol Wilmot
RN, RM, ICCE, CIMI
PR No. 8809747
Antenatal classes, all follow-up help birth – 6 years including feeding & immunisations
083 335 4653

Durbanville Magical Mums Clinic
Riana Stander
Registered nurse & midwife
PR No. 8847398
Antenatal classes, well baby clinic, breastfeeding consultant
(021) 976-6477 / 082 771 4253

Durbanville
Proselect Mother & Baby Clinic
Rika Hoffman
Registered nurse & midwife
PR No. 0217743
Infant massage, immunisations, breastfeeding consultant, antenatal classes, family planning
(021) 979-1970 / 082 575 3918

Welgedacht
Welmed Breastfeeding Clinic
Suzette Viljoen & Alma Strever
RN, RM, BACur admin, comm health
PR No. 883870401
Antenatal classes, breastfeeding advice & weighing of baby, immunisations, baby massage, phototherapy
(021) 913-7024 / 082 674 1077

Kuils RiverStorks Nest
Christine Swart RN, RM, RCHN, RPN, CNP
PR No.
Childbirth education, well baby clinic, breastfeeding, diabetes clinic, immunisations
(021) 900-6250
Brackenfell
Susan de Wet

BCur, RN, RM, IAIM
PR No. 0880000226963
Presenting condensed antenatal classes (1 day) & specialising in multiple pregnancies
082 785 7770 / susandw@mweb.co.za

Brackenfell
Clicks Pharmacy Fairbridge
Silke Schmidt-Dumont
BCur
PR No. 8841810
Well baby clinic, breastfeeding advice, immunisations, family planning
(021) 981-1144

Malmesbury
Natalie Hanekom Privaat Baba Kliniek
Natalie Hanekom
Registered nurse and midwife
PR No. 0880000129186
Voorgeboorte klasse, fetalehart monitering, weeg van babas, immunisasies, borsvoedingskliniek, babamassering ens
(022) 487-2567 / 082 714 3276

Malmesbury
Mediese Sentrum
Jeannine Bruwer

GV, GVV, GGV, PGS
PR No. 1582607
Immunisasie kliniek & weeg van babas
(022) 482-4589

Piketberg
Sujalet
Suzanne Burger

Geveg verpleeg in verloskunde, algemene, psigiatrisie en vermeenskapverpleeging
PR No. 880013013
Voorgeborrte klasse en nageboorte hulp, wat bosvoeding insluit en immunisering
076 703 2803

SaldanhaBaby Basics
Julia Slabber

BSocSc Nursing
PR No. 0880008806187
Antenatal exercise & education classes
(022) 714-1427
Southern suburbs
Claremont Kingsbury Hospital
Pauleen Nelson
Registered nurse & midwife, international board certified lactation consultant
PR No. 0880000066389
Breastfeeding education and support, antenatal & postnatal private home consultations
(021) 696-5791 / 084 082 9104 
Claremont
Cindy Homewood
Registered nurse & midwife
PR No. 0880000098302
Breastfeeding counselling, infant & child nutrition advice, home visits
082 960 5940

Claremont
Lady Buxton Clinic
Registered nurse & midwives
PR No.
Mon – Fri: 9am – 12 noon / Tues: 2:30 – 5:30pm
Support and advice to parents on babyhood & childhood, immunisations, family planning
(021) 674-3110

Plumstead Birth Options
Kate Christie

BSc Nursing
PR No. 8840873
Independent midwives, home & hospital births, antenatal care, antenatal classes, postnatal care, breastfeeding advice
(021) 761-9623 / 082 785 3877

Plumstead Birth Options
Glynnis Garrod
Prof nurse & midwife
PR No. 8846502
Midwifery practice including home and hospital births, antenatal classes and postnatal care
(021) 761-9623 / 082 894 5934

Plumstead Incredible Babies Clinic
Ceredwin Thomsen
Registered nurse & midwife & community health science
Well baby clinic, parenting support, breastfeeding weighing, immunisations, nutrition, home visits
083 303 5552 / (021) 761-9623

Rondebosch Well Mother & Child Clinic
Louise Naude
Registered nurse & midwife
PR No. 8826277
Well baby clinic, breastfeeding care, immunisations, weighing, developmental screening, maternal support
(021) 689-6930 / 082 829 9788

Constantia Constantia Antenatal & Baby Clinic
Lynne Heydenrych

BSc Nursing & midwifery, internationally certified childbirth educator, international board certified lactation consultant
PR No. 8814422
Internationally certified childbirth educator specialising in antenatal classes, breastfeeding baby clinic
(021) 715-2539w / (021) 715-2262h / 082 425 1151 
Constantia
Kathryn Sutton
BSc Nursing, lactation consultant
PR No. 8813779
Breastfeeding consultations & home visits, well baby clinic
082 728 6629
Constantia
Healthwise
Suzanne Leighton
Aromatherapy, reflexology, reiki, yoga
PR No. 1060000216224
Baby & pregnancy massage, postnatal depression & bi-polar disorder
(021) 794-2738

Kenilworth Perfectly Pregnant
Jill Mathew
Registered nurse & midwife
PR No. 8809224
Preparing for childbirth & parenting courses, paediatric CPR, antenatal & postnatal exercises
(021) 683-1404w / (021) 671-5294h / 072 329 0281

Tokai McLeod & Orpen-Lyall Physiotherapy
Wendy Orpen-Lyall

BSc Physiotherapy
PR No. 0087483
Women’s health physiotherapy (pregnancy aches and pains and incontinence)
(021) 713-3766

Marina da Gama Midwives Inc
Sandy Standish

CPN, registered midwife
PR No. 8814368
Antenatal and postnatal care, home and hospital deliveries
083 653 7794 / (021) 788-7199

Fish Hoek Carol’s Clinic
Carol Martin
Registered nurse, midwife, childbirth educator
PR No.
Antenatal & postnatal education & support, family planning, breastfeeding support
(021) 782-2124
084 989 0055

Fish Hoek
Labours of Love
Jennifer Skillen

BSc D.Phil, NCT childbirth educator
PR No.
Preparing for a natural birth in a high tech society
(021) 788-7867

Noordhoek
Noordhoek Baby Clinic
Sarah Philbrick

RGN,RM, BScHons
PR No. 0880000114561
Antenatal classes, breastfeeding support, baby care & advice, immunisations, postnatal home visits, weighing
083 437 7358
 
 Southern suburbs
Southern suburbs
Sue Lees
Registered nurse & midwife
PR No. 8818096
Antenatal care, home & hospital births, postnatal care
(021) 788-5997

Southern suburbs
Lalilu Doula Care
Lana Petersen
PR No.
Childbirth companion for home, hospital and vbac, support at home
(021) 703-4291 / 073 514 9754 / lalilu@sybaweb.co.za

Southern suburbsTums2Tots
Kerry Pienaar

Doula / Mom
PR No.
Doula – labour, birth, breastfeeding assistance, postnatal care, labour & birth kits
(021) 785-3694 / 082 475 7776
Boland
Stellenbosch
Swanger Familie Konsultasie
Leana Habeck

BCur, RN,RM,RPN,CHN,dip peri ed, UNICEF breastfeeding counsellor
PR No. 0880000026174
Antenatal classes for couples and singles, Afrikaans or English, breastfeeding support
(021) 855-4657 / 083 415 4657

Paarl
Paarl Medi-Clinic
Annelise Nel

BACur
PR No. 0880000087815
Antenatal classes, breastfeeding clinic, well baby clinic, massage consultant
(021) 807-8129 / 807-8130

Paarl
Mariana Symington

BACur
PR No. 8824460
Well baby clinic with immunisations, all midwifery services, antenatal classes
082 807 5887 / (021) 872-5106

WorcesterWorcester Medi-Clinic
Heidi Jonker
Registered nurse & midwife
PR No.
Antenatal & postnatal classes, well baby clinic, immunisations
(023) 348-1500 / (023) 348-1570

RobertsonMulti-Med Kliniek
Karien Orton

BCur Hons midwifery & neonatal
PR No. 8850186
Voorgeboorte klasse, gesonde baba kliniek, tuis bevallings, water geboortes
(023) 626-2022 / 082 334 3474

VredendalMiracle Babies Kliniek
Estelle Bornman

BCur, midwife, OHS
PR No. 88000177636
Antenatal classes, postnatal care & support, breastfeeding care & support
084 548 6841 / (027) 213-5323
Helderberg
Somerset WestIrene Bouquin Childbirth Parenting Course
Irene Bourquin
Registered nurse & midwife, ICCE, ICPNE
PR No. 0880008801878
Childbirth & parenting classes for teens, single mums, couples and grandparents
(021) 852-3040

Somerset West The Cape Midwife
Natasha Stadler
Registered midwife & nursing sister
PR No. 0202584
Qualified personal care for you and your family, pregnancy, birth, early parenting
082 538 7707
Stellenbosch
Swanger Familie Konsultasie 
Leana Habeck
BCur, RN,RM,RPN,CHN,dip peri ed, UNICEF breastfeeding counsellor
PR No. 0880000026174
Antenatal classes for couples and singles, Afrikaans or English, breastfeeding support
(021) 855-4657 / 083 415 4657

Stellenberg Helping Hands at Stellenberg Pharmacy
Elaine van Zyl
RN, midwife, community health
PR No.
Breastfeeding advice, weighing, immunisations, postnatal advice
083 225 8880
Southern Cape
Hermanus – OnrusrivierAnita’s Mom and Baby Clinic
Anita Rust
Dip general & obstet, BCur, primary health care
PR No. 0880000168394
Prenatal education, lactation consultation, well women clinic, baby vaccination, screening
(028) 316-1717 / 082 929 4460

Hermanus & StandfordMarie’s Antenatal Care
Marie du Plessis
Registered nurse & midwife, psychiatry
PR No.
Antenatal classes
082 821 7144 / (028) 313-8138 / (028) 341-0643

Riversdal
Riversdal Gesonde Baba Kliniek
Rina Kapp

Geredestreerde verpleegkundige
PR No. 8830711
Voorgeboorte klasse
082 921 4415 / (028) 713-2500

George
George Medi-Clinic
Registered nurses of labour ward
PR No.
Antenatal classes Mondays at 18h00, postnatal groups every second Thursday at 10h00 at the baby clinic
(044) 803-2312 
George
Elon Clinic
Maureen BarnardRegistered nurse & midwife, community health, operating theatre science, primary clinical care, nursing of patients with diabetes
PR No. 8829357
Well baby clinic, immunisations, lactation consultant, diabetes educator
(044) 874-6769 / 082 494
For those who cant afford care visit the government clinics: http://www.westerncape.gov.za/eng/directories/facilities/6439

 

Breastfeeding is hard

Breastfeeding is beautiful and natural. But breastfeeding is hard, and it hurts. Yes it is hard and it is not a picnic. It is not always “natural.” Initiating breastfeeding is often painful. Cracked and bleeding nipples are every bit as unpleasant as it sounds. Many women will tell you there babies latched poorly, they bled, had cracked nipples, got mastitis not once but three times. Some of them are in pain during breastfeeding, breasts are swollen, making them miserable. For many new moms the experience was not comfortable or natural or easy at all.

There are times they want to give up. One problem is that many of new mom or even nursing staff have never seen a nursing mother and baby or grew up in a breastfeeding culture. This can make it difficult to learn the art and techniques associated with good nursing techniques like the proper latch and breastfeeding positions. By using good positioning with breastfeeding you can help avoid nipple pain and other breastfeeding problems.

If you feel I've missed important links for lactation experts, have a more up-to-date link for any of them or find any other problem, please find the following links:
La Leche League International (LLLI) www.lalecheleague.org/
Lamaze International  www.lamaze-childbirth.com/
Int’l Society for Research in Human Milk & Lactation nutrition.hhdev.psu.edu/ISRHML/MW4/noframes/default.htm

For more basic practical breastfeeding information, I highly recommend that you check out Dr. Jack Newman's articles which are great resources to help you know more about breastfeeding. Also be sure to check out "Gee Whiz" Lactation Facts for some surprising facts about breasfeeding. Breastfeeding is a learned behavior. It is not instinctual on the part of the mother and although a baby has the instinct to suckle, latching on properly and actually getting milk requires practice. A new mother and a new baby may get frustrated very quickly when things do not proceed smoothly. This is a comprehensive site regarding Breastfeeding, Birthing Centres, Breastfeeding Consultants, Midwives


Addtional breastfedding articles and links:
Fenugreek
Reglan
Reverse Pressure Softening

I found this article very interesting and worth sharing. It is so sad that breast feeding is looked at as almost impossible before even trying. Our bodies were made for this!

www.thealphaparent.com/2012/06/news...

How Weaning Happens
http://astore.amazon.com/peacefparent-20/detail/0912500549

Breastfeeding Older Children
http://astore.amazon.com/peacefparent-20/detail/1853439398

Adventures in Tandem Nursing
http://astore.amazon.com/peacefparent-20/detail/0912500972