​Vuyo Sabani
Are you pregnant or your partner is expecting? Did you know that you do not have to deliver your bundle of joy at a hospital? Yes, the Gauteng Department of Health has 22 Midwife-Obstetric Units (MOUs) based at Community Health Centres (CHCs) across all five health districts for non-complicated deliveries. 
These MOUs offer various services including antenatal, labour and post-labour deliveries for non-complicated mothers. 
"Any pregnant woman classified as low risk during first booking and subsequent visits. Patients who do not have the following medical or debilitating conditions relating to pregnancy such as cardiac, chronic hypertension, pregnancy induced hypertension, chronic diabetes or diabetes in pregnancy, TB (MDR, XDR), AIDS defining conditions," said programme manager Sikhonjiwe Masilela. 
The advantage of MOU's according to Masilela is "that patients can be readily be visited by the family or partner and they're discharged home after six hours post-delivery if all is well with both mother and baby – saving transport money and time, and there is psychological support by family and partner." 
Masilela further added that patients that require higher level of care or specialised care are referred to hospitals. "The patient can be jointly managed by the MOU (referred back) and hospital as per the opinion of the specialist until a few weeks before delivery at the hospital (normally at 36 weeks of pregnancy for further review)," he said.
 
Midwife at Kgabo Clinic in Winterveld, north Tshwane, Kate Mathatho said: "When a patient comes to deliver we assess them to check if they are high risk or low risk. If it's a low risk we admit the patient and monitor the progress of labour. However, if it's high risk, there are classifications for referral, which we use to refer patients based on each patient's condition. We then call the ambulance to ferry the patient to hospital. We also call the doctor at the hospital to inform them that they should expect the patient. Kgabo Clinic refers patients to either Odi or Dr George Mukhari Hospitals. 
 
In terms of patients who deliver at Kgabo Clinic Mathatho says they vary from repeat patient to first time deliveries. She, however, bemoaned the fact that some patients who should not be delivering at clinic level still go to clinics. "The other day we delivered someone who came to deliver their seventh child, we shouldn't do that at this level but when someone is here and in labour there is nothing we can do, but help them deliver."
Sister Mathatho said early bookings were vital for detection of complications. "We are promoting early booking as it is important. Immediately a woman misses her period she must come in so that we can check her and in that way we can rule out high risk cases. The other thing we are able to diagnose if there are any congenital abnormalities or the patient is diabetic, epileptic or asthmatic. We even start supplements as early as possible to prevent congenital abnormalities. With the prevalence of HIV/AIDS, if they come in we able to check their status and if need be we initiative treatment, said Mathatho. 
Sister Mathatho view were echoed by Alexandra CHC midwife, Sister Ntombifuthi Khawula who said even though their facility was busy it was not as busy as a hospital and the fact that mothers were discharged home early ensured enough bed space for new deliveries. 
 
Patients pleased with services at MOUs
Many mothers Health Talk spoke to about services at Kgabo Clinic in Winterveld, Tshwane and Alexandra Community Health Centre in the Joburg MOU said they were pleased with the quality of service at the facilities, the relatively short waiting times and the professionalism. 
At Kgabo Clinic Mariza Langa said: "I got here at 10am I gave birth at 11am. There was no queue. I have three children. This is my first time giving birth here my other children were born at home in Maputo. The only thing I wish they could improve is that there is no food for patients. I had to ask family to bring me food from home. The services was quick though and professional."
"I got here around 3am in the morning and I gave birth now at 10am. I have four children and of those two was born here and with the third child I was referred to Odi Hospital from this clinic after check-up by nurses and midwives, who then said my baby was too big. I was attending my antenatal visits here so that helps a lot. The only thing I wish they had pampers and pads, but besides that I am pleased with service," Maria Moyo at Kgabo Clinic. 
Alexandra CHC Phumeza Mkhobeni said: "I have three children who were all born here. I'm always happy with the quality of services. The nurses are professional and courteous."
Ngudo Gumbu of Alexandra CHC said: "I used to do my antenatal classes at East Bank Clinic and they referred me here for delivery. I would definitely refer other mothers to use MOUs instead of hospitals. There relatively small queues. My only concern is that at night there are many deliveries so if we could have as many nurses at night as well."   
 
 
LIST OF CLINICS WITH MOU FACILITY
Ekurhuleni Health District
KwaThema & Twatwa – Phillip Moyo Clinic
Thembisa –  Ethafeni Section Clinic and Esangweni Section Clinic
Vosloorus – J Dumane Clinic, 
Katlehong – Ramokonopi Clinic, 
Thokoza – Phola Park Clinic

 
Johannesburg Health District 
Soweto – Itereleng Clinic, Lilian Ngoyi Clinic, Tshiawelo, Zola Clinic, Orange Farm Clinic
Lenasia South, Stretford Clinic
Roodepoort – Discoveres Clinic

 
Sedibeng Health District
Evaton – Levai Mbatha, 
Sharpeville, Vanderbeijlpark, Boipatong – Johan Heyns

 
Tshwane Health District
Soshanguve 3, Winterveldt – Kgabo Clinic, 
Bronkhorstspruit – Dark City, 
Mamelodi – Stanza Bopape, 
Mabopane – Boukenhout, 
GaRankuwa – Phedisong 4, 
Laudium, Eesterus, Stenkwater – Refentsi, 
Hammanskraal – Themba Clinic 

 
 
West Rand Health District  
Carletonville – Khutsong, 
Randfontein – Mohlakeng, Bekkersdal