Birth options and what they cost in South Africa

Posted on October 16th, 2019

Congratulations you’re pregnant! The next step is to plan your prenatal care and birth plan. Midwife Pippa Hime looks at the different options for care and birth in South Africa, including what it would cost you.

Birth options available in SA

Giving birth to your baby is a life-changing experience. Every new mother deserves the best possible care during pregnancy, in preparation for birth and the delivery itself. Considering where you would like to receive care during your pregnancy and birth is important. Many factors can affect your choice including your budget, location and options available. So do take the time to carefully consider what is important to you and explore your birthing options .

ALSO SEE: Top medical aid options if you are planning a family

These are the birth options available to South African mothers:

MOU (Midwife Obstetric Unit)

A MOU is a government facility run by trained midwives. If you have an uncomplicated pregnancy and are able to have a normal vaginal birth, this facility is an option. Here you will attend antenatal (pregnancy) checkups every 4 weeks leading up to your due date. If any complications arise during your pregnancy, or you are unable to deliver vaginally, you will be referred to the closest hospital. Your birth will be midwife lead and you will be discharged from the facility anything from between 6 and 8 to 24 hours after the birth.

Advantages:

  • There are no costs involved.
  • You are given midwife based care and will be well supported during a normal vaginal delivery.

Disadvantages:

  • If any complications arise during labour, you will need to be transferred to another unit.
  • You do not have a choice as to which MOU you can attend. You will need to go to the facility closest to where you live.

How much will it cost?

Free. It is covered under the Department of Health.

Government hospital

If any complications arise during your pregnancy, and you don’t have medical aid or can’t afford a private facility, you may be referred to deliver in a government hospital. These complications could include high blood pressure, your age or previous obstetric complications. In a hospital, medical expertise and emergency equipment are on hand should you need it. A C-section will only be performed if a vaginal birth is deemed to be to high risk for either you or the baby.

ALSO SEE: 11 reasons your gynae might insist that you have a C-section

Advantages:

  • There is specialised medical care available should you need it.
  • You have access to pain control such as an epidural during labour.
  • There is an onsite staffed theatre should you need it.

Disadvantages:

  • The experience can feel more medical as you are in hospital.
  • Government hospitals often tend to be extremely busy and under staffed.

How much will it cost?

Free. It is covered under the Department of Health.

Obstetrician in private practice

You can opt for a private obstetrician. This would then be your primary care giver throughout your pregnancy. All your check-ups and the delivery will be performed by your chosen doctor. The birth would take place in a private hospital that your chosen professional practices out of. You can choose to have either a vaginal delivery or a C-section.

ALSO SEE: How to choose a pregnancy doctor

Advantages:

  • You get to choose where you have the baby. Throughout your pregnancy, you see the same doctor and can build a relationship with him or her before the birth.

Disadvantages:

  • It can be quite costly depending on the fee structure of your chosen doctor. Medical aid would be ideal if you are planning to give birth in a private hospital.

How much will it cost?

  • The delivery ranges between R16 000 and R25 000 on average.
  • All appointments range between R400 and R1 200 on average per appointment.
  • The hospital fee is between R20 000 ­­and R30 000 depending on the length of your stay.

Birthing centre

This is a private midwife-run birthing centre where you can receive all your antenatal or pregnancy care as well as deliver your baby. This is just like the government MOU. You can only have a vaginal delivery in this type of facility if you have had a normal healthy pregnancy and no potential risk factors are present at birth. Most of these centres are affiliated with either a private obstetrician and hospital or a government hospital should any complications arise.

Advantages:

  • You can choose where you want to go as it is not area dependant. Midwife-based care means you will be well supported in a normal vaginal delivery.

Disadvantages:

  • There is usually no onsite theatre. If complications arise during the delivery, you will need to be transferred to a private or government hospital.

How much will it cost?

  • Around R12 000 for the delivery.
  • Appointments range between R250 and R400 on average.

ALSO SEE: Your top 5 questions about birth centres answered 

Private midwife

Private midwives offer the option of delivering in either a birthing centre or associated private hospital. They can also offer a home delivery. A midwife of your choice will care for you throughout your pregnancy. You will attend antenatal appointments with her and will be seen (usually twice) by an obstetrician that she works with.

She will be able to offer a vaginal delivery at home if that is what you choose. It is important to plan in advance if you are hoping for a home birth. The midwife would most likely want to have a pre-delivery visit to the house. If any complications arise during labour, you will need to be transferred to hospital for further management by an obstetrician. It is therefore very important to have a back-up plan that includes a doctor and a hospital.

Advantages:

  • Midwife-based care promoting a non-surgical birth. For many being at home is preferred and midwives are the most likely to offer a home birth.

Disadvantages:

  • You are possibly quite far from a medical facility for emergency care should you or the baby need it.

How much will it cost?

  • Midwife’s fee: between R10 000 and R15 000.
  • Birth pool hire (medical aids usually pay for this:) between R2 500 and R3 000.
  • Doula: approximately R3 500 (although it’s not compulsory to have one).
  • You should also consider a back-up retainer fee for a private obstetrician should complications arise during delivery.
Pippa Hime

About Pippa Hime

Pippa is a Registered Professional Nurse and trained as a Registered Midwife at Chris Hani Baragwanth Hospital. She has extensive experience in all things baby related with a special interest in preparing couples for the exciting journey of parenthood as well as supporting them in the weeks that follow the birth. She and her husband Richard are the proud parents of Becca age 6 and Tom age 4. Pippa has a comprehensive private clinic service that includes Childbirth Education classes, a Well Baby Clinic including Immunization as well as Post Natal and Lactation support. With over 5 years of running a private clinic facility and raising 2 children Pippa comes with a wealth of knowledge and first-hand experience of parenthood. Learn more about Pippa Hime