PRIVATE hospitals are gearing up to cash in on an apparent growth in demand from women seeking natural birth instead of the standard caesarian section.
In Cape Town, an ambitious new venture backed by the Vumela Enterprise Development Fund is poised to launch the first of what it hopes will be a national chain of eight family-centred maternity hospitals.
And in Johannesburg, the JSE-listed private hospital group Life Healthcare group aims to roll out a new midwife-led maternity care package to 16 of its facilities by the end of next year.
SA’s private health sector has one of the world’s highest caesarian-section rates: last year, 70.7% of the births funded by medical schemes were caesarian sections, according to the latest Council for Medical Schemes annual report.
One of the reasons is the dominant model of maternity care being gynaecologist-led, even for low-risk pregnancies. Faced with an increasingly litigious population, gynaecologists are practising defensive medicine, and are quick to advise their clients to go under the scalpel.
Private hospitals cannot employ doctors, so rather than risk an after-hours emergency assembly of the specialists required for surgery, a woman who labours late in the afternoon may be pressed into having a caesarian rather than risk running into difficulties late at night.
...
There is little impediment to a woman seeking a caesarian on nonmedical grounds: medical schemes are apparently willing to pay, and there is little awareness among women of the risks associated with a preterm elective caesarian.
Caesareans are potentially life-saving for mother and child when there are labour complications or health conditions that require early or immediate delivery, but the procedure also increases the risk of neonatal respiratory problems.
As caesarian section rates have risen, the role of midwives has diminished and there are fewer practitioners with the requisite skills and experience to handle more complicated vaginal births.
Consequently, women who want a natural birth have limited options, says Suzette Cloete, founder and CEO of Origin Family Centred Maternity Hospital, which plans to open its first facility in Cape Town’s northern suburb of Panorama in December.
Its marketing material describes the facility as SA’s first "boutique maternity hospital" with chandeliers, king-sized beds and antique French furniture.
While it emphasises comfort and luxury, there is a more profound ambition: to give women a greater say in how they birth their babies.
"There’s no room in our obstetrics system to allow for spontaneous birth. Babies have no power to decide when to come, the system decides for them. The theatre, anaesthetist and pediatrician are all booked weeks in advance," says Cloete.
"When I was pregnant with my first child, every gynae I saw told me I looked like a C-section patient to him. I went to four. None of them were keen on me having a natural birth."
...
CLOETE did eventually find a doctor who confirmed she was a low-risk pregnancy and referred her to a private midwife. "She gave me the opportunity to labour in my own time, at the first active birth unit in SA, Linkwood."
Private midwives are more skilled at managing labour than many of their counterparts employed by private hospitals, as they have more experience, says Cloete. However, there are few private midwife practices. There are barely two dozen private midwives operating in Johannesburg. Cape Town is even more under-serviced, with about 10 operating in the southern suburbs, and there are none at all in the northern reaches of the city.
Midwives can only deliver babies in private hospitals that grant them privileges to do so and require the support of an obstetrician willing to cover emergencies.
Mediclinic says it has only one private midwife using its facilities nationwide. Netcare has opened the doors of four of its facilities to private midwives, and Life Healthcare does so at five.
"There is a massive untapped market for women who would like the option of birthing with a midwife in an environment that is family-focused while providing all the right medical backup," says Vumela Investment Officer Matthys Maré.
Vumela is managed by FNB in an alliance with Edge Growth. It funds start-up and more mature businesses with high growth potential that cannot raise loans from traditional lenders.
"We invest up to R20m and look for businesses with high growth potential because they create the most jobs. Origin is a project that can scale, and can be offered more broadly," says Maré.
Vumela has committed funding for the first hospital, and for building a pipeline of additional opportunities. Funding further hospitals will be considered case by case.
Much like Johannesburg’s Genesis Clinic, purchased this year by Life Healthcare, Origin aims to marry medical expertise with a comforting environment in which the mother has greater say than in a typical private hospital.
Family members and birth attendants — or doulas — are welcome. Women labour under the guidance of a midwife with whom they have established a relationship during pregnancy.
Origin is also offering women the option of staying on beyond the standard day or two after the birth of their baby, for up to a fortnight if they so wish.
...
WHILE the antenatal care is to be primarily delivered by a team of midwives, Origin has also recruited consultant gynaecologists and foetal medicine specialists to provide additional expertise and help identify risk factors that might preclude a natural birth.
The facility has an on-site theatre, and has arrangements in place to refer babies and mothers in need of intensive care to the nearby private hospital Mediclinic Panorama, says Cloete.
Origin plans to charge medical aid rates negotiated on its behalf by the National Hospital Network, but it has also designed a cheaper package for patients who cannot afford medical aid cover and pay out of pocket.
The cheaper offering is similar to the packages offered by Life Healthcare’s Genesis Clinic and Netcare’s Linkwood Clinic: these rely on in-house midwives employed by the hospital rather than private midwives, and do not provide private rooms. Linkwood is a 48-bed maternity hospital, with four operating theatres and a 13-bed neonatal intensive care unit. Its GM, Erich Bock, says about 30% of the facility’s patients pay out of pocket.
"The market determines the pricing," he says.
About 100 babies are born there monthly, but unlike Genesis, most are born by caesarian section because relatively few of the women it serves are under the care of a private midwife.
Netcare also allows private midwives to deliver babies at its Femina, Park Lane, and Mulbarton hospitals.
Genesis Clinic manager Marié Hattingh says the traditional gynaecologist-led maternity service is still a key offering from Life Healthcare, but there is growing demand from women for midwife-led maternity care and the opportunity to deliver in a nonmedical environment.
Life Healthcare has begun rolling out Birth Basics, a programme that offers cheaper midwife-led care to patients who do not have medical aid cover. The programme is offered at two hospitals, but will hopefully be available at 16 hospitals by the end of next year.
"We are about to see a paradigm shift. Midwives are fully capable of doing an uncomplicated delivery," says Hattingh.
Suzette Cloete, founder and CEO of Origin Family Centered Maternity Hospital. Picture: SUPPLIED
PRIVATE hospitals are gearing up to cash in on an apparent growth in demand from women seeking natural birth instead of the standard caesarian section.
In Cape Town, an ambitious new venture backed by the Vumela Enterprise Development Fund is poised to launch the first of what it hopes will be a national chain of eight family-centred maternity hospitals.
And in Johannesburg, the JSE-listed private hospital group Life Healthcare group aims to roll out a new midwife-led maternity care package to 16 of its facilities by the end of next year.
SA’s private health sector has one of the world’s highest caesarian-section rates: last year, 70.7% of the births funded by medical schemes were caesarian sections, according to the latest Council for Medical Schemes annual report.
One of the reasons is the dominant model of maternity care being gynaecologist-led, even for low-risk pregnancies. Faced with an increasingly litigious population, gynaecologists are practising defensive medicine, and are quick to advise their clients to go under the scalpel.
Private hospitals cannot employ doctors, so rather than risk an after-hours emergency assembly of the specialists required for surgery, a woman who labours late in the afternoon may be pressed into having a caesarian rather than risk running into difficulties late at night.
...
There is little impediment to a woman seeking a caesarian on nonmedical grounds: medical schemes are apparently willing to pay, and there is little awareness among women of the risks associated with a preterm elective caesarian.
Caesareans are potentially life-saving for mother and child when there are labour complications or health conditions that require early or immediate delivery, but the procedure also increases the risk of neonatal respiratory problems.
As caesarian section rates have risen, the role of midwives has diminished and there are fewer practitioners with the requisite skills and experience to handle more complicated vaginal births.
Consequently, women who want a natural birth have limited options, says Suzette Cloete, founder and CEO of Origin Family Centred Maternity Hospital, which plans to open its first facility in Cape Town’s northern suburb of Panorama in December.
Its marketing material describes the facility as SA’s first "boutique maternity hospital" with chandeliers, king-sized beds and antique French furniture.
While it emphasises comfort and luxury, there is a more profound ambition: to give women a greater say in how they birth their babies.
"There’s no room in our obstetrics system to allow for spontaneous birth. Babies have no power to decide when to come, the system decides for them. The theatre, anaesthetist and pediatrician are all booked weeks in advance," says Cloete.
"When I was pregnant with my first child, every gynae I saw told me I looked like a C-section patient to him. I went to four. None of them were keen on me having a natural birth."
...
CLOETE did eventually find a doctor who confirmed she was a low-risk pregnancy and referred her to a private midwife. "She gave me the opportunity to labour in my own time, at the first active birth unit in SA, Linkwood."
Private midwives are more skilled at managing labour than many of their counterparts employed by private hospitals, as they have more experience, says Cloete. However, there are few private midwife practices. There are barely two dozen private midwives operating in Johannesburg. Cape Town is even more under-serviced, with about 10 operating in the southern suburbs, and there are none at all in the northern reaches of the city.
Midwives can only deliver babies in private hospitals that grant them privileges to do so and require the support of an obstetrician willing to cover emergencies.
Mediclinic says it has only one private midwife using its facilities nationwide. Netcare has opened the doors of four of its facilities to private midwives, and Life Healthcare does so at five.
"There is a massive untapped market for women who would like the option of birthing with a midwife in an environment that is family-focused while providing all the right medical backup," says Vumela Investment Officer Matthys Maré.
Vumela is managed by FNB in an alliance with Edge Growth. It funds start-up and more mature businesses with high growth potential that cannot raise loans from traditional lenders.
"We invest up to R20m and look for businesses with high growth potential because they create the most jobs. Origin is a project that can scale, and can be offered more broadly," says Maré.
Vumela has committed funding for the first hospital, and for building a pipeline of additional opportunities. Funding further hospitals will be considered case by case.
Much like Johannesburg’s Genesis Clinic, purchased this year by Life Healthcare, Origin aims to marry medical expertise with a comforting environment in which the mother has greater say than in a typical private hospital.
Family members and birth attendants — or doulas — are welcome. Women labour under the guidance of a midwife with whom they have established a relationship during pregnancy.
Origin is also offering women the option of staying on beyond the standard day or two after the birth of their baby, for up to a fortnight if they so wish.
...
WHILE the antenatal care is to be primarily delivered by a team of midwives, Origin has also recruited consultant gynaecologists and foetal medicine specialists to provide additional expertise and help identify risk factors that might preclude a natural birth.
The facility has an on-site theatre, and has arrangements in place to refer babies and mothers in need of intensive care to the nearby private hospital Mediclinic Panorama, says Cloete.
Origin plans to charge medical aid rates negotiated on its behalf by the National Hospital Network, but it has also designed a cheaper package for patients who cannot afford medical aid cover and pay out of pocket.
The cheaper offering is similar to the packages offered by Life Healthcare’s Genesis Clinic and Netcare’s Linkwood Clinic: these rely on in-house midwives employed by the hospital rather than private midwives, and do not provide private rooms. Linkwood is a 48-bed maternity hospital, with four operating theatres and a 13-bed neonatal intensive care unit. Its GM, Erich Bock, says about 30% of the facility’s patients pay out of pocket.
"The market determines the pricing," he says.
About 100 babies are born there monthly, but unlike Genesis, most are born by caesarian section because relatively few of the women it serves are under the care of a private midwife.
Netcare also allows private midwives to deliver babies at its Femina, Park Lane, and Mulbarton hospitals.
Genesis Clinic manager Marié Hattingh says the traditional gynaecologist-led maternity service is still a key offering from Life Healthcare, but there is growing demand from women for midwife-led maternity care and the opportunity to deliver in a nonmedical environment.
Life Healthcare has begun rolling out Birth Basics, a programme that offers cheaper midwife-led care to patients who do not have medical aid cover. The programme is offered at two hospitals, but will hopefully be available at 16 hospitals by the end of next year.
"We are about to see a paradigm shift. Midwives are fully capable of doing an uncomplicated delivery," says Hattingh.
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