Job losses induce midwife crisis

‘We knew what the impact was going to be,” says Pretoria-based birth doula Sithabile Shobowale, recalling the announcement of the lockdown from March 26. 

Her voice is hoarse and is muffled by the hiss of static on the phone. She spent the morning home schooling her children and says she has been talking “too much”.

Doulas give nonmedical emotional and physical assistance during and after childbirth.

When the lockdown was announced, doula work — a field dominated by women — was considered nonessential, which effectively cut them off from their clients. 

“We felt the impact immediately.  Hospitals basically went into lockdown and didn’t allow for non-essential workers. And we are considered as ‘non-essential’,” says Shobowale.


As the Covid-19 pandemic rages on, research shows that its effect on women has been far-reaching. It has knocked their incomes, but increased the burden of unpaid childcare on them. Gender-based violence has intensified and the lockdown threatens to isolate women from their usual support systems.

Sithabile Shobowale.

The Covid-19 outbreak left doulas scrambling to ensure their clients were not left in the lurch. Under level 5 of the lockdown, home visits were prohibited and now, under level 3, many hospitals still don’t allow companions during birth. 

Doulas adapted to the new way of doing things. But the lockdown has made eking out a living in an already unsung profession even more difficult.

Like many others, Shobowale went digital. “Some support is better than none,” she says. “It is not ideal. But that was the only way, especially at the beginning of the lockdown. 

“Everyone was really scared about risking their own health and that of their clients. So the beginning was quite rocky.”

Shobowale is the cofounder of OoMamma, a platform that offers antenatal and postpartum support. Since the lockdown, OoMamma has held “virtual nurture circles” that connect mothers and childbirth practitioners.

Hiring a doula may not be as common in South Africa as it is in other parts of the world, but they provide a service that has existed for thousands of years. 

The word “doula” comes from ancient Greek, meaning “a woman who serves”. But the word’s contemporary use is linked to the natural birth movement that gained traction in the 1960s in the United States.

“In the period just after birth, all the focus is on the baby. And, as a mom, you’re also just worrying about your baby. Nobody’s worrying about you,” Shobowale says. “So your diet slips. You don’t sleep well … and you could also suffer from postpartum depression.”

This is where a doula comes in. In 2016, the World Health Organisation (WHO) recommended women have companions with them throughout labour, citing evidence that continuous support improves childbirth. The days and weeks after childbirth are also critical in the lives of mothers and newborn babies and also requires support, according to the WHO.

Tertia Alkema.

The Covid-19 pandemic has put mainstream support systems in jeopardy. The National Income Dynamics Coronavirus Rapid Mobile Survey released earlier this month found that 16% of the mothers and pregnant women surveyed at the end of June reported having last visited a hospital or a clinic in April or earlier. And 37% of the mothers cited Covid-19 fears as the reason they did not seek out care.

The report estimates that the pandemic has resulted in a 56% decrease in healthcare visits by mothers.

The same survey gave the troubling revelation that women also bore the brunt of the pandemic’s harsh economic effect. 

Of the estimated three million jobs lost during the first month of the lockdown, two million were those of women. Among those still working, women experienced a greater decline in the average number of weekly hours worked than men.

This is in line with global trends. According to a study by the International Labour Organisation, sectors that are dominated by women — including domestic and service work — have been hardest hit by the pandemic.

“Previous crises have shown that when women lose their jobs, their engagement in unpaid care work increases, and that when jobs are scarce, women are often denied job opportunities available to men,” the study reads.

“The bigger their losses in employment during the lockdown phase and the greater the scarcity of jobs in the aftermath of the Covid-19 crisis, the harder it will be for women’s employment to recover. This crisis therefore threatens to nullify women’s gains in the labour market.”

Shobowale says the doulas have already felt the effects of mothers having less disposable income. Some medical aid schemes pay for their services. But, according to Statistics South Africa, only 16.4% of South Africans are covered by a medical aid.

“It makes the pool a lot smaller, because not everyone has medical aid,” Shobowale says. “So people have to budget for a doula.”

Tertia Alkema, who has been a doula for 12 years, says her income has been cut by two thirds because of the lockdown.

“A doula has to do a lot of things in person, because it’s a hands-on profession. We do massaging and help with pressure points. We help with pain relief, get the baby in a good position and help with progress,” she says. “And just being in the room brings some kind of peace and trust. So it’s been challenging doing all that online. And not everyone wants to do that … We’ve managed, but it’s not been the best.”

Alkema has been able to do home births. She says the lockdown has been lonely for some mothers, especially single parents without family nearby. “Imagine you’re a single mom and you have to be on your own. I mean, it’s unthinkable … So it makes for a lot of lonely people.”

Soweto-based doula Mapule Seakamela says she chose to go into the profession because she wanted to create a peaceful birthing experience. 

She says the lockdown has been tough, but adds: “I can’t focus on the difficulties. Instead I try to find ways to always be encouraging.”

Seakamela says if people really understood the role the doulas play in childbirth, they would be considered essential. Through her training, she discovered the difference having a companion at birth can have on the experience. 

“It made me truly understand how special that connection with a doula is. They are always reflecting positivity, encouragement and strength onto the mother, letting them know that they’ve got this. They can do it.” 

Subscribe to the M&G

These are unprecedented times, and the role of media to tell and record the story of South Africa as it develops is more important than ever.

The Mail & Guardian is a proud news publisher with roots stretching back 35 years, and we’ve survived right from day one thanks to the support of readers who value fiercely independent journalism that is beholden to no-one. To help us continue for another 35 future years with the same proud values, please consider taking out a subscription.

Sarah Smit
Sarah Smit
Sarah Smit is a general news reporter at the Mail & Guardian. She covers topics relating to labour, corruption and the law.

Related stories

Corruption forces health shake-up in Gauteng

Dr Thembi Mokgethi appointed as new health MEC as premier seeks to stop Covid-19 malfeasance

Hope grows on Durban beachfront

Ten homeless men who turned a vacant lot into an organic vegetable garden are now reaping the rewards of their toil

Biodiversity is crucial for South Africa’s food security

Farming must embrace sustainable, regenerative agriculture practices to secure our future

‘Where the governments see statistics, I see the faces of my friends’

Yvette Raphael describes herself as a ‘professional protester, sjambok feminist and hater of trash’. Government officials would likely refer to her as ‘a rebel’. She’s fought for equality her entire life, she says. And she’s scared of no one

Q&A Sessions: Frank Chikane on the rainbow where colours never meet

Reverend Frank Chikane has just completed six years as the chairperson of the Kagiso Trust. He speaks about corruption, his children’s views and how churches can be mobilised

Covid-19 stems ‘white’ gold rush

The pandemic hit abalone farmers fast and hard. Prices have dropped and backers appear to be losing their appetite for investing in the delicacy
Advertising

Subscribers only

Dozens of birds and bats perish in extreme heat in...

In a single day, temperatures in northern KwaZulu-Natal climbed to a lethal 45°C, causing a mass die-off of birds and bats

Q&A Sessions: Frank Chikane on the rainbow where colours never...

Reverend Frank Chikane has just completed six years as the chairperson of the Kagiso Trust. He speaks about corruption, his children’s views and how churches can be mobilised

More top stories

Eusebius McKaiser: Mpofu, Gordhan caught in the crosshairs

The lawyer failed to make his Indian racist argument and the politician refused to admit he had no direct evidence

Corruption forces health shake-up in Gauteng

Dr Thembi Mokgethi appointed as new health MEC as premier seeks to stop Covid-19 malfeasance

Public-private partnerships are key for Africa’s cocoa farmers

Value chain efficiency and partnerships can sustain the livelihoods of farmers of this historically underpriced crop

Battery acid, cassava sticks and clothes hangers: We must end...

COMMENT: The US’s global gag rule blocks funding to any foreign NGOS that perform abortions, except in very limited cases. The Biden-Harris administration must rescind it
Advertising

press releases

Loading latest Press Releases…