Affordable maternity care for moms without medical aid


An innovative private maternity care service called The Birthing Team is making affordable, quality care available to pregnant women who do not have medical aid.

Supported by healthcare management company PPO Serve, The Birthing Team has introduced a local support system to deliver end-to-end affordable maternity care that gives uninsured women access to private care.

Also see: SA's government hospitals: The Good, The Bad and The Ugly

As a part of the service, pregnancy and birth are overseen by medical teams made up of midwives, obstetricians and general practitioners. This promotes comprehensive and proactive care, including best use of clinical resources, all of which reduces the risks to mother and baby. It comes at a predetermined, fixed cost, avoiding unexpected costs that could put expectant parents seriously out of pocket.

SA's obstetrics crisis

The Birthing Team’s solution addresses the current crisis in the field of private obstetrics in South Africa. Many obstetricians and gynaecologists are ceasing active obstetric practice because of the very high litigation insurance premiums they must pay, which can reach R850 000 a year.

Currently, practitioners work alone for very long hours and are overburdened by clinical and administrative duties. Despite best efforts, this can inadvertently lead to gaps in care, with higher risks and potentially avoidable health problems. This all contributes to higher costs, making private healthcare unaffordable for non-scheme patients.

“For families paying cash out-of-pocket, maternity care has become very costly and unpredictable. To achieve better outcomes at an affordable cost, we need systematic, data-driven improvement, which requires the restructuring of healthcare practitioners into coordinated teams, especially in the private sector,” says Dr Howard Manyonga, an obstetrician himself and a health systems management expert at PPO Serve.

Pooling resources, intelligent tracking

Manyonga and the team at PPO Serve designed and launched The Birthing Team to deliver individualised care, beginning with pre-natal assessments and tests, through delivery and ending with postnatal care up to six weeks after birth. The initial screening requires a R1500 upfront payment as a part of a total capped bill of R19 500, provided no complex clinical complications are identified.

The Birthing Team works with a clinical workflow and patient management IT system that ensures complete documentation from the first set of biomedical and psychosocial assessments that patients undergo. The system routinely flags any additional assessments that may be relevant – for example, a woman’s age may highlight the risk of deep vein thrombosis, prompting further assessments and special management.

Patient satisfaction with the care they are receiving is tracked and complex patients are discussed by the whole team at regular meetings. Midwives conduct regular assessments, update records and communicate regularly with patients, freeing obstetricians up to focus on complications and oversee many more births than they can do in the current system.

“Specialists are a rare and expensive resource and we need to use them more intelligently and efficiently. The Birthing Team makes this possible by putting midwives and obstetricians on the same team, earning together, rather than each working alone,” says Manyonga.

The Birthing Team pilot is operating from Netcare’s Rand Hospital in Hillbrow, Johannesburg.

More about maternity benefits on medial aids:

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