By: Hloni Manare
Bringing new life into the world is a life-changing experience for any mother.
For 26-year-old, South African-born Maria Matthews*, news that she would become a mother for the second time was an exciting possibility. Like any other expectant mother, Maria prepared to welcome her newest addition into her family. For several months during her pregnancy, Maria attended ante-natal care classes at Heidelberg Hospital in Gauteng.
She vividly remembers 11 August 2023 – the day she was admitted to the hospital’s maternity ward.
After several excruciating hours in labour, Maria finally heard the first cries of her healthy, newborn baby girl, whom she named Neo*.
For the second time mother, it was an indescribable, life-changing experience. But Maria’s excitement was short-lived.
What should have been a joyous occasion was plagued by bureaucratic delays when she tried to register the birth of her newborn.
On 12 August 2023, the pair was discharged from Heidelberg Hospital’s maternity ward, after spending a night at the facility.
Three days later, Maria returned to the hospital to request her baby’s clinic card and proof of birth, but she was met with obstacles at every turn.
South Africa’s Births and Deaths Registration Act 51 of 1992 requires that a child’s birth must be registered within 30 days at the Department of Home Affairs. After registration, an unabridged birth certificate is issued.
Maria is a South African citizen by birth but remains undocumented because she was not delivered at a hospital or clinic. The 26-year-old was born into abject poverty at her family home in Heidelberg and has neither a birth certificate nor an identity document.
Due to the socio-economic conditions affecting communities like Heidelberg, Maria, her mother and siblings are all undocumented South Africans and are unable to access basic education, healthcare and other crucial social services – perpetuating a generational cycle of poverty.
In South Africa, Maria and her relatives are classified as stateless persons and are regarded as non-citizens.
Due to Maria’s undocumented status, officials at the Heidelberg Hospital refused to issue her with her newborn, Neo’s, proof of birth and clinic card for her to register the infant at the Department of Home Affairs.
According to the National Department of Health, undocumented patients who cannot produce a South African identity document are classified as private patients under the Uniform Patient Fee Schedule. This applies to both South African citizens and foreign nationals who require services which are not categorised as basic healthcare services.
Due to Maria’s undocumented status, she was categorised as a private patient and charged R8000 for the natural birth of her newborn baby, a fee she had no means of paying.
Seeking resolution, Maria met with several senior officials, including Heidelberg Hospital’s CEO. They acknowledged her case and promised to investigate the matter within 25 days.
Despite numerous follow-ups, the hospital never responded.
Frustrated and dejected, Maria sought help from SECTION27 after her brother located the organisation online and contacted them on her behalf. She was assisted by our Advice Office paralegal, Kholofelo Mphahlele.
On 31 October 2024, a letter of demand was emailed and hand delivered to Heidelberg Hospital, which highlighted Maria’s rights enshrined in section 27 of the Constitution, which states that everyone has the right to access healthcare services, including reproductive healthcare.
Ms. Mphahlele also referenced a 2023 Gauteng High Court order obtained by SECTION27 which ruled that all public hospitals and clinics cannot withhold proof of births as guarantee of payment.
After prolonged negotiations, the hospital finally relented.
On 6 November 2024, Maria was contacted by hospital officials to collect Neo’s birth certificate and clinic card.
Maria’s fight was not only about obtaining the required documentation to register her newborn’s birth, but exposed Heidelberg Hospital’s violation of a court order protecting undocumented mothers from having their newborns’ proof of birth withheld over unpaid fees.
While Maria’s victory is partial, as she remains undocumented, she was determined to break the generational cycle of poverty so that her daughter could have a better future than the one she and her relatives have been excluded from.
If you are an undocumented South African, you can visit organisations like the Centre for Child Law (CCL) and Lawyers for Human Rights (LHR) who provide legal assistance to persons who do not have identification documents, including persons born in South Africa who do not have documentation to prove their citizenship. These services include assistance with applying for late birth registration and accessing identity documentation at the Department of Home Affairs.
*Not their real names.
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