“If my baby is dead, why don’t they just tell me?”

Nolitha Kamana lost her first child 15 years ago, soon after his birth. Her second child, now six years old, is disabled.

She fell pregnant again last year and went to Tygerberg Hospital in April to give birth.

“When I got there, I was given a bed and prepared to give birth.

“I was told to push but nothing was happening. The nurse told me that it wasn’t time yet but I should continue pushing. I told them that I was losing energy, I was sweating and could not push anymore and asked them to give me a caesarean.

“They told me that they couldn’t just cut me, I had to at least try to push. I tried again, but I just couldn’t and eventually I was told that I would be taken to theatre to get a caesarean. I was given something to sign. I went to theatre and I was put to sleep before the operation. The last image I have was the brightness of the theatre light on top of me.

“When I came to, I was not told anything. I was in another room. The following day — it was a Sunday — when I woke up, I was in pain from the operation and I had a catheter. A nurse came and asked me how I was feeling and I said I was in pain, but I tried to get up and go to the bathroom to wash my face. It was difficult and very painful.

“Later on a doctor came to me and asked me if I had seen my baby already. I said no, and he said OK and told me which ward the baby was in but said I could only see her later in the afternoon, after the catheters had been removed. I got agitated because I wanted to see my baby and my husband phoned me asking about the baby as well.”

The doctor came back, she says, and told her that a nurse would come to clean and dress the wound from the caesarean and remove the catheters.

“The day came to an end, but still no baby.

“The following day, on Monday, one of the catheters was removed. I washed and I was told that I could now go and see my baby. My husband came to visit so we went together.”

On the way to the ward, she says, she felt tired and sat down. A security guard came to ask where she and her husband were going.

“We asked the doctor about the baby. No reply. We asked again. No reply”

“I told him who I was, which ward I was coming from and when I arrived. He looked through a list of names on a paper on his desk and he couldn’t find me. He even showed me the paper, and my name was not there. He decided to let me into the ward nonetheless because he could see what a struggle it was for me to walk and get there.”

Kamana and her husband went into the ward and started to look for their baby. “I came across a nurse who asked me what I wanted, I told her I was there to see my baby. She asked me the baby’s name and I told her I hadn’t named the baby yet because I hadn’t seen her, but the doctor had told me which ward the baby was in. We then all started searching for the baby. None of us could find the baby.”

Kamana says the security guard showed them to another ward on a different floor. “My husband went and checked, and he came back with nothing.”

The couple went back to Kamana’s ward to get her handbag and cellphone, intending to go to the hospital reception to find out where their baby was.

“As I was there the doctor who had told me which ward my baby was in, came in. He asked whether the doctor who delivered my baby had said anything to me, I told him no. He said OK, then he left.

“After the doctor left, another one, a female doctor this time, came in and took my folder and started reading through it. We asked the doctor about the baby. No reply. We asked again. No reply, all she was doing was looking at my folder. Eventually she asked us to take a seat and wait for her to come back.

“All this time I was thinking to myself: if my baby is dead, why don’t they just tell me? She came back and said she would like to apologise for the damage that had occurred… I let out a huge cry because I realised that I would never see my baby.

“She said the baby was in the hospital mortuary. She gave us no explanation about what happened to the baby. All she did was apologise and say that she was waiting for the doctor who delivered my baby because she was standing in for him. I immediately asked to be discharged.”

Kamana says the doctor then called one of the hospital cleaners and asked her to tell the couple in Xhosa that she apologised, and ask if they wanted to see the baby. “ I told them I don’t want to see my baby in the mortuary and my husband refused as well. Then the doctor asked me to spend one more night because she would try to make sure that the doctor who delivered my baby was present.

“Tuesday came, we waited and waited, no doctor came, not even the female one who had told me that I should stay one more day. I was eventually discharged and given pain medication and I left without seeing that doctor. When I went for a check-up, I went to Michael Maphongwana Community Health Clinic in Khayelitsha.”

Kamana says when her first-born died 15 years ago, “everything was explained to me and I got a chance to see him so I got closure from his death”.

Her six-year-old cannot walk or talk. “His birth was delayed at Tygerberg Hospital. Even though I was overdue, 10 months pregnant, I was told to go home because it wasn’t time to give birth.

“I won’t have any more children because during labour I made of a spur of the moment decision and had my tubes tied, because I didn’t know that my child would not survive.”

Sibulelo Senoe found out in November 2014 that she was 20 weeks pregnant. She went for her check-ups at Michael Maphongwana Community Health Clinic in Khayelitsha and was told that since her pregnancy was proceeding without problems she could give birth there and need not be transferred to a hospital.

On 21 June 2015, she went into labour and went to the clinic with her husband at about 1:30pm.

“The nurse who checked me said I was not ready to give birth and I would probably give birth around 10pm. I managed to find a bed and lay there. The pain got worse as time went by and I even struggled breathing. One of the nurses who saw me asked me why I was lying on the bed, and who told me to do so. She said I must get up and sit on the chair. I did so. Then she shouted and said I must stop pushing. She left then came back again and called me and gave me a bed.”

Senoe was told to go to the toilet and urinate. “I went, but nothing came out. When I came back to the bed, I was bleeding. “

The nurse said she was bleeding because she was pushing “without being told to do so”.

““All this time I was being told that I don’t listen and I am the one who is killing my baby and making my baby tired.”

“Then she inserted a catheter inside me. She checked my baby’s heart rate, then asked me if I had eaten. I told her the last time I had eaten was porridge in the morning. Then she shouted and said I was hungry and the baby was hungry as well. Then she had asked if I had drunk labour inducing pills, I told her no, I did not know anything about those pills. She then said my baby was tired.”

Senoe says when the nurse checked again she said she could see the baby’s head. “But my waters hadn’t broken yet. I was then told to lie on my side. At this point I was given oxygen and a drip. I was told to sleep on my left side and the baby would come out.

“All this time I was being told that I don’t listen and I am the one who is killing my baby and making my baby tired.”

An ambulance was called and as Senoe was being put on the stretcher, she heard one of the paramedics talking about seeing the baby’s head. “As I was being rolled out to the ambulance the nurse followed behind me screaming that I don’t listen and I should stop pushing. In the ambulance there was no nurse, I was alone.”

She passed out in the ambulance and woke up in Khayelitsha District Hospital.

“I was tied up with belts at the wrists to the bed and I was told to push. It was difficult but I eventually did it and the baby came out. The baby wasn’t crying. I overheard one of the doctors say ‘I have never seen such a flat baby’, then my baby was taken away.

“One of the doctors who had stayed behind with me said ‘Do you see what you’ve done?’ After that she said her time was up, she had worked her hours and she needed to go, but she wouldn’t leave without cleaning and sewing me up. She did so.

“When the night nurses came in, I asked the first one I saw what gender my baby was. She told me she was going to check, but that was the last I saw of her. The same thing happened with the second and third nurses that I asked. I started to think that maybe my baby had died and nurses were scared to tell me the news.”

The next day, 22 June, Senoe a nurse told her that the baby was a girl but that she was no longer in the hospital but in Groote Schuur.

“Around 1pm, one of the doctors came and closed the curtain. I was certain that my baby had died. He told me that my baby was in Groote Schuur but was extremely ill. He said the reason the baby was sick was because she had excreted inside my womb and then eaten the faeces, which affected her lungs. This is why she was rushed to Groote Schuur to insert pipes so they could clean the lungs out.”

Senoe was discharged and the next day she got a telephone from Groote Schuur, telling her to come and see her sick baby.

“When we arrived she had pipes and was on a drip and the doctor said even though the baby was attached to machines, it was still a struggle for her to breathe and they couldn’t clean the lungs. He said we should expect the worst. I asked if there was a bed that I could get so that I could be close to my child but was told that there were no beds available, they were full, and I couldn’t sit on the chair because of my stitches.”

On 24 June, she received another summons from Groote Schuur, calling me. “My husband and I got there around 10am and the baby was not in the room we’d left her in. Then one of the doctors came to us and told us to wait a few minutes while they got the key. I wondered what key they were referring to. Had they locked my baby in a room somewhere alone?

“It turns out my baby had been put in a small air-conditioned room. She was dead. We went in and she was covered and the doctor apologised and told us to take the baby.

“That was the first time I held my baby in my arms, it was the first time I saw her clearly with no pipes.

Senoe and her husband were asked to sign a form to say whether they wanted the hospital to bury the baby or to take her home and bury her themselves. “We chose to leave the baby but we were disappointed to learn that we won’t get any certificate or anything that says we had a baby.”

Khululwa Bam fell pregnant in 2011 and went to Site B clinic for her regular check-ups.

“I had a good pregnancy, there were no complications at all.”

On 15 January 2012, she started having cramps which got worse as time went on. She went to the clinic at about 8am.

“I was told that it wasn’t time for me to give birth yet and I should take off my clothes, put on a nightgown and walk around the hospital passage just to pass time. I did as I was told. While I was walking around the passage, my waters broke and one of the women who was also there to give birth said someone would come to me and tell me to get a mop and clean the floor. Right enough, the clinic cleaner came and told me to go and get the mop and clean up the mess I made. This was while I was still in labour. I fetched the mop and cleaned and I also had to bend because I had to wring the mop before using it.

“I finished and I started feeling my baby coming.”

“I went to one of the sisters and told her that the baby was coming, and she told me to lie on the bed. I lay on the bed and tried to push, but I just couldn’t, I had no energy.”

Bam was told to mop up after her waters broke.

Bam said she asked to be transferred to the Mowbray Maternity Home where her first child had been born. She said she thought the staff there would know what to do and could perform a caesarean “or something”. But the nurses at Site B clinic said they could not transfer her.

She says she thinks it was about 4am in the afternoon when she gave birth. “That was after one of the nurses injected me. I don’t know what the injection was or what it was for, but after she injected me, I gained strength and started to push and eventually the baby came out. The nurses told me that the reason I struggled to get the baby out, was because of the baby’s weight, he was too big.

“They gave me my child, I breastfed him and I was discharged the following morning and there was nothing wrong with the baby.”

On 26 February 2012 she received a call from one of the nurses who asked how her son was and said that the doctor wanted to see him.

“I took him to the clinic the following day. I received my folder accompanied by a letter referring me to Mowbray where I was told everything would be explained to me. I was confused because I didn’t give birth at Mowbray, I gave birth at Site B clinic. In Mowbray, the doctor told me that he would run tests on my son’s blood and urine and then I would be referred to the Red Cross Children’s Hospital where my son would be treated.”

She went to Red Cross the following week and she says a doctor told her that she or the child’s father had “weak genes”. “Then he gave me treatment for my child. He said my child was sick and would either suffer from epilepsy or be a slow learner. I started using the treatment on my child even though I didn’t know what it was for, because there was nothing wrong with my child.” “I didn’t question anything at the time and I regret it now, not asking questions back then.”

Early one morning in June, says Bam, her son lost feeling in his right side and became unresponsive. “I rushed him to the Site B clinic because the doctor had told me if anything happened I should take him immediately there or to Red Cross. I took him to Site B and I was told that the clinic only opened at 8h00 am. As I rushed to take a taxi to Red Cross I noticed that foam was coming out of his mouth.

“We eventually arrived at Red Cross after taking two taxis, and my son was admitted.”

After tests, the doctors did not find what caused the foaming, she says. But her son stayed in hospital for five months. “During that time he underwent an MRI scan and they said there was some interruption to my child’s brain and his life would not be the same.”

Solulele is now three years old. “He uses a pipe to eat, and he uses a wheelchair. I overheard some of the doctors at Red Cross saying that they suspect that I took too long to give birth and because my baby was big, I should’ve had a caesarean sooner.”

Bam was the first of many mothers to report poor treatment at city hospitals to the Treatment Action Campaign. Since then, says TAC, the organisation has received a stream of complaints from women.

TAC has now launched a campaign, with a march last week on the provincial legislature and parliament to highlight the problems women face in some maternity wards.

In a memorandum to health MEC Nomafrench Mbombo, TAC demanded an urgent investigation by the Department of Health into the state of maternity and obstetrics care in the public sector in the province.

It also demanded sufficient space and better monitoring of mothers in maternity units; improvement of the quality of education, counselling and birth preparation; an increase in the number of professional healthcare workers; implementation of a system of early bookings and diagnostics to avoid mothers giving birth at home; and better availability of the BCG tuberculosis vaccine at health facilities. The memorandum called for women to be treated with dignity and respect.

Michael Hamnca, one of the leaders of TAC in Khayelitsha, said the organisation had received nearly 100 testimonies from women who had had problems in maternity and obstetrics units and was still conducting interviews. “We want to put the spotlight on the problems mothers experience in hospitals and clinics in the province. And we want to make sure that, should some of the mothers need help or compensation, they receive it”.

Asked to comment on the stories here, a public hospital doctor said they were not surprising, given the state of the health system. She said that it was difficult to know if the deaths of the babies could have been prevented, but the “psychological management” of the mothers was “definitely sub-standard”. Pregnant women needed to be “empowered” to understand the birth process, she said.

Colleen Smart, spokesperson for Mbombo, said the department had launched an investigation in response to the affidavits. Because of the number of affidavits and the fact that some dated back to 1991, the outcome of the investigation would be communicated by the end of September 2015, she said.

Smart said the department had a complaints procedure and a system which could track complaints. Improving maternal and child health was one of the department’s priorities.

“The Patient Centred Maternity Care Code of Practice was adopted as a guiding document to improve on the quality that is being delivered at maternity and obstetrics units.”

She said complaints could be lodged directly with facilities. People can also dial the department’s hotline 0860 142 142, e-mail service [at] westerncape.gov.za or send a please call me to 079 769 1207.