An Interview with Two South African Midwives | Doulas

I met Ruth Ehrhardt and Lana Petersen at one of their Home Birth Gatherings at the end of last year which I attended in order to learn more about pregnancy and birthing experiences for South African women.

I later contacted them and asked if they would be willing to meet and discuss some more questions and ideas I had around the subject.
We met at Marianne Littlejohns birthing clinic, Mtwana Birth House, in Muizenberg.

Midwives-Lana-Peterson-&-Ruth-Ehrhardt-South-Africa-003-Portrait-by-Leah-Hawker

Midwives-Lana-Peterson-&-Ruth-Ehrhardt-South-Africa-002-Portrait-by-Leah-Hawker
We talked about a number of different things revolving around what they do as well as my interest in some issues I’ve noticed related to the subject of pregnancy and birth for women.
How long have you been interested in birth and what made you decide to make it your vocation?

Lana: For me, my interest started when I worked in a primary health care facility where mother and their newborns would attend the clinic for postnatal care. I would hear their birth stories which ranged from ecstatic to traumatic. I became obsessed with everything related to pregnancy & birth when I was trying to conceive my 1st child and even more so once I had given birth – which was a life-changing experience, I knew I had been bitten with the oxytocin bug and needed to be around labouring women….I then trained as a doula and as demand grew, left my work at the clinic to pursue attending births full-time – best decision ever!

Ruth: Even though my mother was a midwife, I was completely uninterested in birth and babies (I think I was very self absorbed and selfish beforehand) until I had my own first birth and that experience completely transformed me. Wow! What an experience – eye opening, scary, empowering, enriching, beautiful, angry, painful, ecstatic, peaceful, energetic, strong, pathetic, humbling, awesome…I could go on.
And throughout…: This calm, quiet presence of my mother holding me, reassuring me with a soft touch, or a soft gaze.
Afterwards I thought, “I wanna do that!”

What is your personal birth philosophy?

Ruth: The more I experience working with pregnant, labouring, birthing and new mothers, the more I feel that my role, more than anything, is to provide a feeling of safety and security. It is not about giving birth in a particular way, or any particular outcome, but ensuring, as much as possible, that the mother and baby bond is intact and that the mother feels secure in her bond and ability to parent this baby.
I walk away after the birth. The new mother has to parent this child, and just as she innately knows where the best place is to birth that child, she knows instinctively what the needs of that child are.

My role is to protect that space for mother and baby, so that mother and baby can safely find their way.

Midwife-Ruth-Ehrhardt-South-Africa-002-Portrait-by-Leah-Hawker

Which are the most significant moments of a birth for you?

Lana: Geez, there are so many….

When a mother has put plans in place for her optimum birth and she feels excited and empowered for the experience of labour.

Moments when mothers feel desperate and afraid but then go ahead and do it anyway.

Midwife-Lana-Peterson-South-Africa-001-Portrait-by-Leah-Hawker

I absolutely love the moments when a woman is  naked and labouring hard and then suddenly, she looks like a Goddess! – breathtakingly beautiful!

The faces of fathers/siblings/extended family seeing a baby being born…those moments have brought me to tears often.

And finally – that moment when a mum realizes “she did it”….best thing ever.

Midwives-Lana-Peterson-&-Ruth-Ehrhardt-South-Africa-001-Portrait-by-Leah-Hawker

Ruth: The moment the mother realises that only SHE can give birth to this baby, only SHE.

And when she accepts that and finally surrenders to the process, it is quite miraculous and beautiful what unfolds.

Ruth said about her experience as a doula & midwife: fulfilling, exhausting, privileged, humbling, peaceful.

Ruth said about her experience as a doula & midwife: fulfilling, exhausting, privileged, humbling, peaceful.

It was great to be able to join an educational get-together with you both when I met you on the Home Birth Gathering last year. Ive since gone through your amazing resource site and been amazed at the feeling of community and sharing of information I found there.

Im fascinated by the descriptions I have read of the transition labouring women go through from self-consciousness/awareness to the primal instinctivness and responsiveness of the body (generally described in the cases of natural birthers). You must bare witness to this often.

I’ve noticed how often the issues of tearing and or stretching come up for women as a “problematic issue” post-birth. In a society that is quite effected by media influences about gender identity and sexuality, how have you found your experience on the issue of vaginal tearing and the issues with aesthetics associated around this for women?

Lana: The large majority of the women I work with come to realize that the body and the pelvic floor specifically is designed to withstand and recover from the experience of birth. My focus would be more to teach women to make the connection with their vagina’s and learn to trust that if they are healthy, choose to birth instinctively (specifically not being coached to push!) …then their perineums will weather the passing of  a baby either in tact or with minimal to moderate damage and to remember that vagina’s are fantastic and healing themselves afterwards!

A still from the birthing room at the Mtwana clinic in Muizenberg

A still from the birthing room at the Mtwana clinic in Muizenberg

I was sent this link to an interesting article about French photographer Christian Berthelot who documented a series of images of brand new babies, moments after their (cesarian) birth into the world.

From the article I found this piece quite interesting:

“When I saw [my son] for the first time, he was bloodied and covered in this white substance called vernix,” Berthelot recalled of his first experience with a caesarean. “He was like a warrior who has just won his first battle, like an angel out of darkness. What a joy to hear him scream”.
The babies captured through Berthelot’s lens reveal various ways to enter the world. Some scream and cry, some gesticulate wildly, while others appear still and calm, and a few, in the words of the artist, “do not yet appear to belong to the world of the living.”

Leanne - born April 8, 2014 at 8:31 am
1kg 745 - 13 seconds of life. Photograph by Christian Berthalot

Leanne – born April 8, 2014 at 8:31 am
1kg 745 – 13 seconds of life. Photograph by Christian Berthalot

His images are raw, beautiful and dramatic and are so very different to the pristine, rosey-cheeked newborn images one more often sees. Berthelots images, however, represent the messy miracle of birth in the way that only midwives and obstetricians really get to see; those first living moments of a human being. What do you think about the images or about your perception of birth as apposed to societies adjusted one?

Liza - born February 26, 2013 at 8:45 am 
3kg 200 - 3 seconds of life. Photograph by Christian Berthelot

Liza – born February 26, 2013 at 8:45 am 
3kg 200 – 3 seconds of life. Photograph by Christian Berthelot

 Ruth: When I first saw these images I thought, “That’s it! That’s that moment! That’s what we get to see!”

There is still a part of me that wonders at whether we should be allowed to capture this very sacred and personal moment but at the same time I see how for people who do not work in this field, it is so incredible to see how fresh and raw and real these images are.

A still from the birthing room at the Mtwana clinic in Muizenberg

A still from the birthing room at the Mtwana clinic in Muizenberg

I remember the first image of a birth I ever saw, it was an incredible and very beautiful B&W, grainy image, I’ve never forgotten it.

At that stage, about 10 years ago, I had never considered these moments from a photographic perspective and am interested in the idea since I find the idea of birth to be such an intimate experience for a couple. How do you feel about having a photographer present and working on births and what are the differing feelings about this subject you’ve heard from clients?

 Ruth: We have all obviously been influence by images of birth, breast feeding and babies and what wonderful tools they are to show what we want to teach and convey.
At the same time though, and as I said previously, are we tampering with the sacredness of it all by having someone there snapping away?
Does it change anything? Does it alter the event?

Would we have someone there to photograph the intimacy of our wedding night? Giving birth is as intimate and personal as that and I completely understand wanting the moment captured but I sometimes wonder at what cost?

Dr. Michel Odent talks about observers (including cameras) at a birth inhibiting the release of oxytocin during labour (the hormone which contracts the uterus, but also the hormone of love) so basically, if a mother is aware of a camera or an observer, this may hinder the labouring process.

Just something to consider and think about.

Clients are usually very happy and grateful for the photos they have of their births. I know I am of mine. But I do remember feeling slightly distracted by having photos taken…

After our meeting Ruth sent me a link to a series of photographs of “half born humans” which we had discussed.
They show the moment that also Berthelot discussed when he explained how the brand new baby does “not yet appear to belong to the world of the living”, I’d never quite put my mind to it in this way, but that is exactly what it is, a kind of in-between moment… these incredible images are by Jaydene Freund:

From her series of "Amazing Birth photos of Half Born Humans". Photography by Jaydene Freund

From her series of “Amazing Birth photos of Half Born Humans”.
Photography by Jaydene Freund

Jaydene writes:

“I have rarely shared images of the actual moment of birth to protect my client’s privacy, however I have received permission to post these incredible images of these little super-humans when they were only half earth-side. Don’t be scared to be amazed by these images! This is human life before it has taken it’s first breath. Suspended between 2 worlds, life is waiting for that final push to be born.” 

From her series of "Amazing Birth photos of Half Born Humans". Photography by Jaydene Freund

From her series of “Amazing Birth photos of Half Born Humans”.
Photography by Jaydene Freund

If you could communicate one message to women about the birth experience, what would that be?

Ruth: Listen to yourself and what your needs are…the decisions you make around your pregnancy and birth are your first parenting decisions, so find a caregiver who really gets you and what you want.

I asked Lana & Ruth which 5 words best describe their experience as a doula or midwife. Lana: "awesome, sleep-depriving, life-affirming, addictive, soul-fulfilling! "

I asked Lana & Ruth which 5 words best describe their experience as a doula. Lana: “awesome, sleep-depriving, life-affirming, addictive, soul-fulfilling! “

Lana: Women are not doing nearly enough research into pregnancy & birth in this day and age! There’s far too much focus on obtaining the latest gadgets that will “make parenting easier”….Nonsense! Parenting is the hardest thing you’ll ever do – otherwise you’re doing it wrong!…

Rather focus on what type of pregnancy and birth you would like and explore ALL the options …..you only get to have your 1st birth experience once!

Make sure its a good one!

A still from the birthing room at the Mtwana clinic in Muizenberg

A still from the birthing room at the Mtwana clinic in Muizenberg

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