This post was written in conjunction with the series Knocked Up Abroad. The second book in the series Knocked Up Abroad Again will be published with your help on Kickstarter!

 

Having a Baby in South Africa

What is it like having a baby in South Africa? I’ve been asked that question many times by readers who are moving to SA as expats, or who for various reasons have chosen not to give birth in their current country of residence.

I was fortunate to have my second son in Durban, South Africa. It was a beautiful natural birth in a world class hospital, with a post delivery foot massage and pedicure and a candle lit dinner thrown in for good measure. I kid you not.

South Africa is fantastically misunderstood in the international community. International media only show the worst, and whilst yes there is crime, yes there is poverty, yes the income gap is crippling, yes president Jacob Zuma is a corrupt megalomaniac (his days are numbered), there are many many wonderful aspects to this fascinating country: a palpable spirit, friendliness, creativity, compassion, a joy for life, and of course the weather!

So if you are considering having a baby in South Africa, are an expat who is ‘knocked up abroad’ in South Africa, or are considering South Africa for your next move but have reservations about starting a family there, read on!

1. Your obstetric gynecologist (OBGYN) will deliver your baby.

In South Africa you see one doctor throughout your pregnancy, and that same doctor will deliver your baby. I found this fantastic because I could really build a good relationship and level of trust with my doctor knowing that she would be there on the day (or night), and that my birth plan would be followed. Most hospitals have midwives on staff to help you through your labour, but when its time to deliver your OBGYN will take over. Whether you opt for a natural birth or a caesarean birth, or need an emergency c-section, your OBGYN will do it.

2. Private hospitals are world class.

An unfortunate reality in South Africa (and most of the world) is that if you have money, life is exceedingly good. In South Africa there are state hospitals and private hospitals. Expats always go to the latter. Private hospitals are absolutely world class. They are well equipped, immaculate, and you won’t wait hours to be seen. Pick up the phone, schedule an appointment with your doctor, and chances are you can be seen that same day.

When the time for delivery approaches, visit your chosen private hospitals in your area. Usually your OBGYN will be attached to a specific hospital, so be sure to check out the facilities before committing to a doctor. Schedule a tour of the birthing suites and maternity ward. Ask all your questions and don’t be shy! Are babies washed after birth? Can my baby stay in the room with me? Can I hold off on injections? Can my husband/partner sleep in the room with me and our baby? Can my other children visit the baby? Can I pre-book a private room even if I’m having a natural birth? In my experience everything was possible.

3. You’ll need private medical insurance

All this great service and convenience costs a pretty penny! Make sure you have private medical insurance that covers your pregnancy and the delivery. Most expats have private insurance from their own country, that’s fine, hospitals are used to dealing with foreigners. Call your insurance company, or check online, it’s fairly straightforward to set up a direct payment between your insurance company and the hospital. This means there is no settling of bills on the day you take baby home, which makes life much easier!

If you do not have international medical insurance, South African insurance is comprehensive. Look at Discovery, and Momentum.

You will pay your OBGYN and the hospital a fee. Depending on the level of care you need costs will vary. C-sections cost more than natural births.

4. Frequent ultrasounds

You’ll have an ultrasound every month! Yep, every single month. You can of course request fewer if you wish. There are the usual scans: 13 weeks, 20 week anatomy scan, and the rest are just to check everything is progressing well and to say hi to your baby! Between 26 and 30 weeks you’ll be offered a 4D scan which will show your baby in incredible detail. I opted out of this, but for many it’s a highlight.

5. I’m not an invalid, I’m just pregnant!

In South Africa pregnancy is seen as a natural, healthy state to be in. You won’t be treated like an invalid. This was a breath of fresh air after giving birth in Turkey where doctors view pregnancy as a life threatening situation, requiring medical intervention and superstition to see you through unscathed. In South Africa, you’re presumed healthy and able until proven otherwise, and the monthly ultrasounds mean your OBGYN will be on top of any complications that may arise.

6. Caesarean births are most common…

South Africa is not immune to the trend of scheduled c-sections that is sweeping the globe. A 2014 article in The Guardian says that 70% of women covered by a private medical scheme opt for a c-section. That is incredibly high.

7. …So choose your OBGYN wisely.

With c-sections being so common, it follows that doctors tend to either assume that is what you want, or gently encourage you to have one (it’s easy to schedule a c-section during working hours). If you want a natural birth, and by natural I mean vaginal (with or without an epidural) you’ll have to do your research well. Google doctors in your area, read reviews on mommy networks, or chat with the doctor directly to get a sense of how committed he/she is to your natural birth. Referrals will help you greatly, but take everything you read with a pinch of salt, all births are different and just because one person had a bad experience doesn’t mean you will. Keep your wits about you as you make your choice, and listen to your gut.

8. Pediatricians are thorough.

Your new baby’s pediatrician will most likely visit your baby a few hours after birth. He/she will talk to you about the importance of vaccinations, mainly BCG (against tuberculosis, which is compulsory in South Africa) and Vitamin K. Everything is negotiable though, so if you’d like to wait a few days before inoculating your baby, that is your choice. Be firm in your decision. Follow up visits and inoculations are scheduled directly with your pediatrician. There is an option to visit a clinic in your area for subsequent vaccinations, and they will be free, however, I always either took my kids to their pediatrician or had them done at a Storks Nest which is linked to Netcare, one of South Africa’s largest private hospital groups.

9. Help is affordable.

Hiring a nanny or a cleaner to help in the home is normal in South Africa. This seems to be quite a sticky topic with expats who feel weird having someone working for them, as if it’s some sort of master and slave arrangement. I can assure you it is not! The domestic service sector is a large part of the economy, and in a country where unemployment hovers at 30, maybe 40% a job as a cleaner or nanny means food on the table back home.

If you choose to hire a domestic worker, think carefully about what you need. Do you need someone to help around the house and occasionally watch the baby, or do you need more of a nanny who will do light housework? Most domestic workers do both. The best thing is to get a referral, but you can also place an advert on Gumtree. Be very specific in your requirements, and don’t give a phone number as you’ll be inundated with calls. I got more than 50 emails in response to the advert I posted on Gumtree. Interview as many as you like. Ask tough questions. Try to get a sense of the type of person they are. Do a one or two day trial to see how you get along. It’s important you click.

Many domestic workers live in. Houses in South Africa often have domestic quarters either attached to the main house, or elsewhere on the property. If this is sounding all a bit surreal, don’t fret, it’s completely normal! You can choose what suits you though: live in, live out, full time, part time. Just be clear from the start. If you opt for a live in position, you will be responsible for buying her food. If you choose live out, you’ll have to pay transport costs.

10. Paperwork is not complicated

Getting your new baby’s birth certificate is pretty straightforward! You can fill out the paperwork at the hospital, and you’ll get a birth certificate in a few days. You officially have thirty days to register the birth of your baby. A good source of info for negotiating the red tape in SA is here…although there really is very little red tape!

11. There’s no excuse not to get fit postpartum!

Commit to getting your pre-baby body back! South Africa enjoys a wonderful climate. OK, winters can be chilly, downright freezing if you’re in the Western Cape, but in general the weather is great. Sport plays a huge role in South Africa, and running in particular is a national obsession. Wrap baby up in your brand new jogging stroller, and join one of the many running or walking groups that meet a few mornings a week. There will be one in your area, trust me! It’s social, fun, and a great way to get fit. Otherwise Google a Park-run near you and do 5kms on a Saturday. South Africans enjoy an outdoor lifestyle, so go on, get involved!

South Africa is a wonderful place to have and raise a baby with excellent health care, world class hospitals, readily available help in the home, and a fantastic climate (nearly) all year round. If you are moving there in the future, or plan to start a family in South Africa, be rest assured you and baby will be in great hands.

Curious about what it is like to give birth or raise kids in different countries around the world?

The Knocked Up Abroad series is a collection of stories from expat parents having and raising their babies in foreign countries. 26 writers in 25 countries have contributed to the second book in the series, Knocked Up Abroad Again which will be published at the end of this year, but we need your help to get this project off the ground! To see how you can help, please have a look at our Kickstarter Campaign!

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