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As soon as the news of a new life is confirmed, many questions are sure to follow. Hospital birth or home birth? Natural birth or an epidural? Obstetrician-gynaecologists (ob/gyn) or midwife? Whilst we can’t make these decisions for our members, we can make deciding that much easier.

What many may not know, is that the practice of having babies delivered by a doctor or an ob/gyn in hospital is relatively new in the history of birthing. Prenatal care and birthing, also known as confinement, were mainly performed by midwives up until the mid-20^th century. A midwife is a trained health professional who helps healthy women during pregnancy, labour, delivery and after the birth of their babies. Midwives may deliver babies at birthing centres or at home, but most can also deliver babies at a hospital. Midwives can:

• Watch your physical and psychological health
• Help you make your birth plans
• Advise on diet, exercise, medication and staying healthy
• Educate and counsel you about pregnancy, childbirth and newborn care
• Give you emotional and practical support during labour
• Admit and discharge you from the hospital
• Deliver your baby
• Make referrals to doctors when needed

Is there a reason to choose an ob/gyn for your prenatal care and confinement?

Yes. Although you can take your pregnancy journey with a midwife from beginning to end, your midwife will refer mommy and baby to a doctor or an ob/gyn as soon as the pregnancy has the potential to be or is identified as complicated, a high risk or even in the case of multiple pregnancies. They are more equipped to deal with these complicated pregnancies and births. Although midwives can assist, only an ob/gyn can perform C-sections.

What’s the difference between the level of care that you receive from a midwife or an ob/gyn?

Midwives specialise in low-risk births and usually take a warm, personal approach to your pregnancy. They will get to know you and your family, and offer some emotional support before, during and after childbirth.

Ob/gyns specialise in both low-risk and high-risk births. They are more likely to take a more routine approach, where you can only see them by appointment and they usually won’t stay throughout the entire process of the labour and confinement.

Midwives can also perform a birth at home, at a birthing centre, in a hospital or even perform a waterbirth. However, ob/gyns only practice in hospitals.

What’s the difference in the cost of confinement with a midwife or an ob/gyn?

Midwives only perform natural births, which cost approximately R24 000 to R25 000, excluding the cost of the hospital stay and any additional items. Although an ob/gyn can also perform natural births, it will cost more. Ob/gyns also have a high likelihood of performing C-sections which cost approximately R38 000 to R44 000. Both health professionals can administer epidural on request.

While this may seem to be a new concept for many South African mothers, Bestmed already covers the following maternity consultations up to 100% scheme tariff:

• Up to 9 antenatal consultations at a GP, gynaecologist or mid wife
• 1 x 2D ultrasound scan at 1st trimester (between 10 to 12 weeks) at a GP, gynaecologist or radiologist
• 1 x 2D ultrasound scan at 2nd trimester (between 20 to 24 weeks) at a GP, gynaecologist or radiologist
• 1 antenatal consultation and prenatal supplements (only on specific options)

Confinements by both midwives and ob/gyns are also covered at 100% scheme tariff with Bestmed Medical Scheme. Hopefully, this gives you all the information that you need to decide which is the best care for you and your baby.