FREQUENTLY ASKED QUESTIONS

 

What is family-centred maternity care?

Origin Family-Centred Maternity Hospital operates according to family-centred maternity care principles, which means we provide a family-friendly environment focused on prevention, health, wellness, support and the special and unique needs of each childbearing woman and her baby.

The family-centred maternity care principles which Origin embraces include the following:

  • Childbirth is seen as a state of wellness, not as illness – a normal life event involving dynamic emotional, social and physical change.

  • Prenatal care is personalised to the psychosocial, educational, physical, spiritual and cultural needs of each woman and her family.

  • A comprehensive programme of perinatal education prepares families for active participation throughout the evolving process of preconception, pregnancy, childbirth and parenting.

  • Our team helps the family make informed choices during pregnancy, labour, birth and after birth and newborn care, striving to provide the experience they desire.

  • The father, partner and/or other supportive persons of the mother’s choice are actively involved in the educational process, labour, birth, and after birth and newborn care.

  • If the client wishes, a limited number of family and friends are encouraged to be present during her labour and birth (provided that the nursing staff assess the situation).

  • Encouragement of freedom of movement as beneficial for the labouring woman. This is why we are the first maternity hospital in Africa to have a wireless cardiotocograph to monitor the baby’s heartbeat and contractions, if necessary, while a woman is moving freely or birthing in water).

  • Avoidance of ‘routine’ interventions that are unsupported by scientific evidence.

  • Skin-to-skin contact immediately after birth and exclusive breast-feeding.

Who may give birth at Origin Family-Centred Maternity Hospital? (What does low risk mean?)

Origin Family-Centred Maternity Hospital and the midwives of its Grové de Beer Midwife Practice offer care only for low-risk women. The process involved in identifying risk includes assessing results from sonar examinations and laboratory tests, as well as consultations with the healthcare team. This process is called your clinical pathway.

If you enter the clinical pathway later than 20 weeks of pregnancy, then you are required to have at least one scan with a Foetal Medicine Specialist in order to assess foetal wellbeing. The results of this a scan will determine whether you are able to continue with the model of antenatal care in order to birth at Origin Family-Centred Maternity Hospital.

You may see full details of the clinical pathway that we follow under Midwife Practice.

 

Women with the following may NOT be admitted to Origin Family-Centred Maternity Hospital:

  • Severe psychiatric conditions, i.e. psychosis, suicidal persons

  • Pre-eclampsia (hypertension with proteinuria)

  • Rhesus and other antibody sensitisation

  • Preterm labour <37 weeks

  • Fever >38 degrees before admission

  • Suspected foetal compromise

  • Twin pregnancies

  • Breech presentation

  • Acute obstetric emergencies before admission, i.e. antepartum haemorrhage, cord prolapse, etc.

  • Complicated home births

  • Any client whose baby will knowingly need neonatal intensive care unit (NICU) admission

  • Social induction of labour

  • Chemical induction of labour for a client wishing to have a VBAC (vaginal birth after caesarean) after having had one previous caesarean section

  • The intent to have a VBAC after having had more than one previous caesarean section.

 

The following clients may be admitted under direct consultation with the back-up obstetrician, on condition that the back-up obstetrician has assessed the client’s risks and has agreed to her admission to Origin Family-Centred Maternity Hospital; women with:

  • Existing medical conditions, e.g. cardiorespiratory disease, renal disease, diabetes, epilepsy, etc.

  • Elective caesarean sections for any reason

  • Who have Human Immunodeficiency Virus (HIV) but have made an informed choice to have a vaginal birth (client must bring her and her baby’s antiretroviral medication with her to the hospital)

  • Induction of labour for a medical reason or for postdates (no less than 7 days, confirmed by scan)

  • Induction of labour with intra-uterine foetal death at any gestation

  • Morbidly obese clients (body mass lndex >= 35)

  • Pregnancy-induced hypertension – the client must be on antihypertensive treatment, and there must be NO proteinuria on admission.

 

The following increased-risk client may be admitted under direct consultation with the back-up obstetrician and with a theatre team placed on standby when she is admitted:

  • A client wishing to have a VBAC after having had one previous caesarean section, who must also be willing to have a special scan to determine the position of the placenta.

Do I have to be referred to Origin Family-Centred Maternity Hospital?

No you do not need to be referred, just phone us for an appointment on 021 911 0650.

However, please do ensure that you meet the criteria mentioned above under ‘Who may give birth at Origin Family-Centred Maternity Hospital? (What does low risk mean?)’. Origin Family-Centred Maternity Hospital looks so glamorous – do you have all the necessary safety and emergency equipment available?

Yes we do, as per the requirements of the Department of Health, and the Board of Healthcare Funders. Emergency treatment is performed according to the Scope of Practice of the following legal bodies: Department of Health, Board of Healthcare Funders, the South African Nursing Council Scope of Practice for Registered Midwives, and the Health Professions Council of South Africa for doctors and medical specialist practitioners.

We have state of the art equipment for most neonatal emergencies and all nursing staff are certified as Advanced Neonatal Resuscitators.

Please note: In the unlikely event of your baby needing intensive care, the baby will be transferred to a registered neonatal intensive care unit, e.g. Panorama, Mediclinic, N1 City netcare and Blaauwberg Netcare or Constantia Mediclinic.


Why did you choose to furnish Origin Family-Centred Maternity Hospital in the way that you did?

We feel quite passionately that women need to feel safe, secure, warm and comfortable in order to be in their best space to give birth, and we regard birth as sacred. Our entire motivation behind giving Origin Family-Centred Maternity Hospital its antique French luxurious feel is the comfort and care of the birthing woman. From the scent in the air to Egyptian cotton sheets and King Koil beds, en suite bathrooms with non-dripping faucets and cisterns, hands-free sanitary bins, cinnamon-infused nappy bins, luxurious black-out curtains, the chandeliers and lamps, with all medical equipment tucked out of view, is all for this purpose. We have yet to show a woman round who does not love it!


Does the luxuriousness of the furnishings mean that Origin Family-Centred Maternity Hospital is really expensive?

Not at all. On the contrary, if you phone around and do your research you will find that Origin Family-Centred Maternity Hospital is less expensive than most other private maternity hospitals. Also, our packages include a 24-hour package for uncomplicated vaginal births (see ‘Packages’). There is a great deal of scientific evidence that midwife-led births lead to reduced hospitalisation time.


What is the difference between your Birth Suites and your Birth Rooms?

The Birth Suites include a birth bath and also have a queen-sized bed, since partners are allowed to stay over in these rooms (there is an extra cost for partners after the first night). The suites are what other countries refer to as ‘labour, delivery, postnatal and recovery’ (LDPR) rooms, not previously seen in South Africa. This means that you will labour and birth in the Birth Suite and then stay in there with your partner and baby (unless you go to the theatre for a caesarean, in which case you will return to the Birth Suite after surgery and all the necessary checks).

The Birth Rooms do not include a birth bath, and after birthing in one of these rooms, once mother and baby are settled (after about 2 hours), they move into one of our Two-Bed Postnatal Rooms. Partners may provide support to clients while they are in the Two-Bed Postnatal Room, but partners do not stay over.

Please see ‘Packages’ for more information.


May other of my own children also stay over in the Birth Suites?

Yes, we allow up to two of your children to stay over with the family in the Birth Suite, at the discretion of the General Manager. Please note that the cost of their meals is not included and these will have to be ordered from the Menu and paid for separately.


What does ‘midwife-led’ mean?

Midwife-led means that a midwife or team of midwives, working together with a woman, take the lead in the planning, organising and delivering of her care, from her first antenatal booking to the postnatal period. At Origin Family-Centred Maternity Hospital the midwife team works in conjunction with back-up gynaecologists/obstetricians as a multidisciplinary team.


May I bring my own gynaecologist?

At Origin Family-Centred Maternity Hospital all gynaecologists must have admission rights, which may be gained by applying to the Clinical Governance Committee of the hospital. We welcome these professionals once they indicate their commitment to the philosophy of our multidisciplinary team.


What is a VBAC?

VBAC is a vaginal birth after a caesarean. It means having your baby vaginally when you've previously had at least one baby by caesarean section. We support women who wish to attempt a VBAC, as long as they meet the following criteria:

  • They have previously had only one caesarean section.

  • At least 18 months has elapsed since the previous caesarean section.

  • Such an increased-risk client will be admitted under direct consultation with the back-up obstetrician and with a theatre team placed on standby.

  • They are willing to have a special scan to determine the position of the placenta.


We do not admit women who have had two or more previous caesarean sections.


How is the third stage of labour (delivery of the placenta) handled at Origin?

Origin Family-Centred Maternity Hospital combines the effectiveness of the Midwives Model of Care with evidence-based medical research so that when necessary, appropriate interventions are made.

This means that women can expect respectful treatment; personal attention; appropriate monitoring; natural techniques for support; and information about options and choices.

Families receive meaningful care and encouragement in order to feel comfortable. Thus the natural labour and birth process can unfold.

We are well aware of the cycle of intervention that may cause an escalation of unnecessary procedures. However, we are also professional people who upskill continuously. The skill is in balancing a Natural Birthing approach with the appropriate medical knowledge and skills.

This approach is particularly important in our attempts to identify risk. One of the risks is a PPH (postpartum haemorrhage - abnormal amount of bleeding after the birth of the baby). A PPH can very quickly turn a serene labour and birth into a dramatic obstetric emergency.

According to the Saving Mothers report of 2011-2013, 15.8% of women that died in childbirth in South Africa during this time period were due to obstetric haemorrhage. It is surmised that 89% of those deaths could possibly and probably have been prevented. Indications are that relevant staff showed, amongst others, poor clinical assessment, lack of responding to abnormalities noted during monitoring, as well as not following procedures.

At Origin we recognise the importance of standards and protocols to achieve a Centre-of-Excellence standard. One of the protocols in place is the management of the birth of the placenta (3rd stage of labour). Based on guidelines from the RCOG (Royal College of Obstetricians and Gynaecologists) in the form of Greentop Guideline No. 52 of 2009, it is recommended that women without risk factors should be given an intramuscular injection at the birth or straight after the birth of the baby in order to markedly reduce the incidence of abnormal blood loss.

In previous years this injection was combined with several other manoeuvres in order to birth the placenta speedily. One factor was the immediate clamping of the baby’s umbilical cord.

However, research has shown that delayed cord clamping for at least 2 minutes is beneficial to the newborn. National Institute for Health and Care Excellence guidelines recommend that the cord should not be clamped earlier than 1 minute after the birth of the baby (if there are no concerns over baby’s wellbeing).

The RCOG Scientific Impact Paper states that administering the medication to contract the uterus is unlikely to have a major effect on the placental transfusion (blood flowing from placenta to baby), which is largely completed by 2 minutes after term birth.

Thus Origin Family-Centred Maternity Hospital protocol to decrease the incidence of PPH is to administer the oxytocin by intramuscular injection 2 to 3 minutes after the birth of the baby and to clamp the baby’s cord 5 minutes after birth. By implementing this protocol we support the baby receiving the benefit of delayed cord clamping and give the mother the benefit of reducing her risk of PPH.


What is a ‘sensitive section’?

At Origin Family-Centred Maternity Hospital the caesarean sections that we carry out are ‘sensitive sections’. This means that the midwife who has attended the client will also go into theatre with her along with the obstetrician, and any conversation will be hushed and will focus only on the woman, her partner and the baby. The client will be told at all times what to expect and what is going to happen so that she does not become anxious. The baby will be shown to the mother straight away and will spend as short a time as possible with the paediatrician, after which it is placed straight back onto the mother’s chest. Delayed cord clamping is also applied if circumstances permit. This may also include the harvesting of blood from the placenta for stem cell storage.


What is delayed cord clamping, and why is it done?

Delayed umbilical cord clamping (not earlier than 1 minute after birth) is recommended by the World Health Organization for improved maternal and infant health and nutrition outcomes, and is carried out at Origin Family-Centred Maternity Hospital. The umbilical cord is not clamped or cut until after pulsations have ceased, or until after the placenta is delivered.

Research has shown that when cord clamping is delayed, the newborn receives up to 30% more of the foetal-placental blood than it would have if the cord was clamped immediately.

Benefits of delayed cord clamping for the baby include a normal, healthy blood volume for the transition to life outside of the womb, and a full count of red blood cells, stem cells and immune cells. For the mother, delayed clamping keeps the mother-baby unit intact and can prevent complications with delivering the placenta.


What is stem cell storage?

After a baby is born, cord blood is left in the umbilical cord and placenta. It is relatively easy to collect, and the painless procedure holds no risk for the mother or the newborn baby.

The cord blood contains blood stem cells, which are special because they can make every type of cell in the blood – red cells, white cells and platelets. Blood stem cells are responsible for maintaining blood production and your immune system throughout our lives and can be used to treat more than 75 diseases, including blood cancers like leukaemia, and blood disorders like bone marrow failures, inherited metabolic diseases, immune deficiencies and recently, some auto-immune diseases. For blood stem cell therapy, genetic matching is required.

Storing your baby’s cord blood stem cells will give you the peace of mind that he or she has immediate access to the stem cells.  Also, if a brother or sister needs a donor, they have a 25% chance of it being a perfect match and a 50% chance that it will be a partial match.

Origin Family-Centred Maternity Hospital has partnered with Salveo Biotechnology South Africa in order to provide world-class yet affordable stem cell storage for those who choose it. For more information see under ‘Our partners’.


Do you cater for water births?

Yes we do. Origin Family-Centred Maternity Hospital has more water birth baths (six in all) than any other maternity hospital in the country. Water birth means at least part of your labour and birth or both happen while you're in a water birth pool filled with warm water. Our custom-made water birth baths are set inside our Birth Suites. We know that warm water is soothing, comforting, and relaxing. Buoyancy facilitates the birth process, promoting more efficient uterine contractions and improved blood circulation, resulting in better oxygenation of the uterine muscles, less pain for the mother, and more oxygen for the baby.

In summary, water births provide a soothing and shortening of labour – provided that there are no signs of obstructed labour. Some women choose to birth in the birth bath, while others will get out of the bath and birth elsewhere in the suite. Partners may also join the woman in the bath if they wish. The baths are certainly big enough!


Are water births safe?

Yes they are. Water births have been taking place in private hospitals in South Africa for the past 25 years. Our midwives have a great deal of experience in water births and our General Manager pioneered the use of water births in South Africa. They are safe for both the woman in labour and the baby. If the baby emerges into water, they are still ‘breathing’ through the umbilical cord, so cannot drown! They will only draw breath once they are lifted from the water and the cord is cut.


May I bring a birth photographer to capture the birth?

You may, after they have had an interview with the General Manager of Origin, and have signed our Release Form which includes a Confidentiality Clause. We do have some excellent accredited birth photographers and newborn photographers on board – see under ‘Our partners’.


What sort of security system do you have in place?

Please see full details under our section on Security under ‘Facilities’. Origin Family-Centred Maternity Hospital has a state of the art anti-baby theft system in operation at all three of its entrances and exits, and is the only hospital in South Africa with such a system. The hospital itself has nine security cameras, while Panorama Healthcare Centre has 24/7 security services at the concierge desk in the ground floor lobby. The entire complex is monitored by CCTV cameras.


What type of special food requirements do you cater for?

The kitchen is not Halaal or Kosher; however, all food ordered comes from Halaal-friendly suppliers. A superior a la carte menu is available. Clients do not pay for meals, but relatives, visitors, children and partners (after their first night, if staying over in Birth Suite) do so. Fridges are available should you wish to bring in your own special requirement food.