Midwives in South Africa

Midwives in South Africa are nurses who focus on the care of pregnant women and the delivery of babies. Midwives have the ability to work independently in cases of healthy pregnancies and problem-free deliveries; however, they can refer patients to gynaecologists or obstetricians when complications are diagnosed. The majority of pregnant women in South Africa use the public healthcare system, and most of this care is provided by midwives. The first registered nurse-midwife in the world was Sister Louisa Jane Barrett, who received training in Kimberley, South Africa, in 1891. There is almost no documentation as to who attended to births in South Africa prior to commencement of Dutch colonisation in 1652. From 1652, midwives could function independently and were certified and licensed. Between 1948 and 1991, the apartheid system of racial segregation in South Africa influenced the way that nursing training was structured and organised. In the 1960s, most women in South Africa delivered in hospitals as it was believed that this was the best place for birth. Additionally, hospitals in both the public and private sector did not support independent midwives by allowing them to use their facilities. Midwives then assumed the positions of 'obstetric nurses', where they would work in healthcare facilities under the guidance of obstetricians. In 1994, the National Health System implemented a primary healthcare approach to improve access to healthcare services by disadvantaged communities. Along with the other United Nations member states, in 2000, South Africa committed to help achieve a set of world development goals for 2015 called the Millennium Development Goals. South Africa did not achieve the Millennium Goals for maternal health. In the subsequent years, different policies and programmes have been implemented to improve maternal care and child mortality. A new, integrated inter-professional training model is also being attempted by health practitioners to improve outcomes in maternal care.