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Updated 17 February 2016

Horrifying treatment in SA's maternity wards

The Treatment Action Campaign wants the government to urgently probe the state of maternity and obstetrics care in the public sector following shocking and sad tales of death and disability.

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Sibulelo Senoe is lactating, but she isn't holding a baby in her arms suckling at her breast. Her daughter was born. She died.

The 33-year-old from the small town of Macassar in Cape Town throws her hands up in the air as she recalls the devastation of finding out that her first-born baby girl died shortly after birth.

Mothers march for better healthcare

Senoe's story was one of many highlighted during a march organised by the Treatment Action Campaign (TAC) on Thursday in Cape Town following complaints to the organisation.  

Hundreds of women, some with babies on their backs and others with protruding pregnant bellies, men and activists took to the streets demanding quality maternal and obstetric care.

They chanted as they waved posters with slogans such as 'Protect our unborn children' and 'Respect the patients, pregnant mothers'.

Read: South Africa's dying babies

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A memorandum of demands was handed over to the Western Cape provincial legislature and national parliament.

Scores of women shared their stories of poor treatment in maternity wards.

At nine months, Senoe said she went to a local community health clinic in Khayelitsha thinking she was in labour. However, she says nurses told her that she could not give birth yet because they were about to go home.

"The nurses said, 'No no, we are going home, you must wait for the other staff to come'."

During this time Senoe noticed that she had started bleeding, but the nurses allegedly told her that the blood was a result of her pushing.

Alarm bells go off

When nurses from the next shift took over, Senoe was rushed to Khayelitsha Day Hospital where she gave birth. However, her baby had difficulty breathing and there was also concern about the child's slow heart rate.

They were then transferred to Groote Schuur Hospital.

"I went in a big machine," said Senoe, adding that it was the biggest machine she had ever seen. After this, she said the doctor had apparently told her that her baby had inhaled faeces during delivery.

She was then sent to the maternity ward and only saw her baby when her husband visited her and demanded to see the baby.

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"The baby was in the incubator and had pipes in the nose."

That was the first and also the last time they would see their baby alive.

The baby died the next morning, said Senoe.

However, she feels that her baby would have been alive had she been assisted by the nurses at the first clinic. 

Senoe said she feels deeply saddened when she sees other mothers, who were also pregnant at the same time as she was, holding their children.  

"I dream a lot about my baby. I dream about carrying my baby and breastfeeding her. On the 21st of every month I think my child would have been a month older."

What is meconium aspiration?

Health24 resident doctor, Dr Heidi Van Deventer, explained that the baby could have suffered from meconium aspiration.

"Meconium is the baby's first 'faeces' and when a baby develops 'stress' during birth or delivery they can pass the meconium while still in the uterus.

She said when a baby breathe in this meconium it is very dangerous and difficult to get it out of the lungs and can cause serious illness and respiratory distress.

"If the baby is crying and responsive when born the outcome is usually good and supportive therapy is given as well as observation, but when the baby is unresponsive at birth the airways needs to be cleared with suctioning and specialist treatment is necessary, which can include intubation and ventilation of the baby."

Van Deventer also noted that it is possible, sometimes during delivery, that a mom can "produce" feaces as part of the "pushing" during delivery.

"This can happen but it is rare as far as I know for the child to aspirate the feaces of the mother as it should be cleared as soon as it is there."

The baby can become even more ill if it inhales the mothers feaces as this is not sterile and has bacteria in it, she said.

"If it is inhaled into the lungs it is very serious and difficult to get rid of, the treatment is usually the same as for meconium aspiration with strong antibiotics added."

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Difficult baby deliveries

Two other women told Health24 that their children were left disabled allegedly after not receiving adequate help at the time of giving birth.

26-year-old Bulelwa Siyo said she had complications during her pregnancy in 2007. After experiencing pains she went to her local clinic, but was sent back home.

"The nurse turned me away saying I must go back home because I am too far."

However, she returned to the clinic because the pains got worse. Siyo also experienced an onset of high blood pressure.

The next day she was sent to another hospital where she gave birth. Her baby was kept in ICU and stayed in hospital for over a month, but Siyo claims that no one told her what was happening.

It was only discovered several months later that her baby was disabled and suffered from epilepsy. "She can't talk or sit, but she is going for physiotherapy."

Khululwa Bam told Health24 after spending hours in labour in 2012 she was also told months later that her baby was disabled.

The 26-year-old said following a check-up at 5 months, a doctor told her that her baby is sick because of struggling during birth.  

Between 2011 to 2013, South Africa recorded more than 60 000 perinatal deaths, a combination of foetuses born dead, known as stillbirths, and babies that die in their first week.

Women’s health a primary concern

TAC national campaigns manager Fredalene Booysen told Health24 that women’s health is a top priority for the activist organisation, which was co-founded by the HIV-positive activist Zackie Achmat in 1998.

"As the TAC we have always spoken out for the poor and marginalised who do not have a voice or whom our government in general ignore."

Booysen said several people reported serious healthcare problems to the TAC.

"We then collected evidence in the form of testimonials. Today we have over 50 testimonials that speak about people's challenges that they have experienced at the MOUs [maternity and obstetrics units] and in the public healthcare system."

What the memo outlines

The TAC memorandum called for an urgent investigation by the Department of Health into the state of maternity and obstetrics care in the public sector in the province.

"The outcomes of such an investigation must be made public," it stated.

It further outlined six key areas for urgent intervention, which included sufficient space and better monitoring of mothers in maternity units; improvement of the quality of education and counselling pre and post birth; an increase in the number of doctors; a focus on early bookings and diagnostics to avoid mothers giving birth at home; and the availability of the BCG tuberculosis vaccine.

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The memorandum was accepted by Frank Makua (above) at national parliament and Siviwe Gwarube (below) at the provincial legislature.

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Here are some more images of the march:

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Women sit on the pavement outside the parliamentary precinct in Cape Town. (Image: Adiel Ismail)

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Scores of activists chant outside the gates of parliament. (Image: Adiel Ismail)

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Women sit down while waiting for an official from the department of health to accept the memorandum of demands. (Image: Adiel Ismail)

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A women sits on the pavement outside parliament while feeding her child. (Image: Adiel Ismail)

Activists walks to parliament while displaying a poster. (Image: Adiel Ismail)

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A crowd gathers outside the the Western Cape provincial legislature. (Image: Adiel Ismail)

Also read:

Mom loses baby in Joburg hospital after three days of hell

Surgeon walks out on patient, not once but twice

Doctor declares miscarriage without examination

 
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