What if our understanding of women’s health has become so focused on treating the body that we have forgotten to understand the woman who lives inside it?

I recently sat down with Nomazizi Sihlahla, a traditional African healing practitioner whose work centres on indigenous healing, womb health, fertility and the cultural practices that have historically accompanied African women through different stages of life.

What I anticipated would be a conversation about womb health and traditional medicine became something far more profound.

We spoke about amasiko, generational trauma, the medicalisation of childbirth, ancestral knowledge and the spaces women desperately need to heal.

As a mother of three and a practising doula, I found myself recognising striking parallels between Nomazizi’s work and my own growing questions about women’s reproductive health.

And somewhere between discussing the placenta, the spiritual significance of birth and the ways our grandmothers prepared young girls for womanhood, I found myself confronting a question that has occupied my mind for years:

At what point did we stop trusting women to understand their own bodies?

Before There Were Hospitals, There Were Women

One of the most fascinating parts of my conversation with Nomazizi was her explanation of amasiko, our traditional customs and rites of passage.

She spoke about how African communities historically recognised the different transitions in a woman’s life, from childhood into puberty, womanhood, marriage and eventually motherhood, for those who chose that path.

In particular, she referenced intonjane, a traditional isiXhosa rite of passage associated with a girl’s transition into womanhood.

These weren’t simply ceremonies involving clothing, celebration and family gatherings. They also created opportunities for education.

Young girls were introduced to their changing bodies, menstruation, sexuality, relationships and the responsibilities that accompanied adulthood.

Nomazizi explained that these practices reflected a sophisticated understanding of preparation. A young girl was not expected to arrive at womanhood without guidance.

There was an understanding that womanhood required preparation, community and intentional education.

Today, we teach young girls how to use sanitary pads, perhaps explain the menstrual cycle briefly during Life Orientation, and then send them into the world to figure out the rest.

But how many girls understand the different phases of their menstrual cycles?

How many know what hormonal changes can mean for their mood, energy, sleep and physical wellbeing?

How many understand their reproductive anatomy beyond being told not to fall pregnant?

We have become very good at teaching girls to prevent pregnancy, but are we equally intentional about teaching them to understand their bodies?

Nomazizi’s argument is that this education should begin long before a woman considers having children.

And I agree.

A girl deserves to understand her reproductive health whether she chooses to become a mother or not.

The Womb Is More Than a Reproductive Organ

During our conversation, Nomazizi described the womb as a centre of creative energy.

Within her spiritual understanding, the womb is not simply where babies grow. It is connected to a woman’s creativity, emotional experiences, ancestral lineage and sense of self.

She spoke about women arriving at her practice experiencing infertility, fibroids, polycystic ovary syndrome (PCOS), emotional difficulties and what they described as stagnation in their lives.

Her approach considers both physical health and spiritual beliefs.

Nomazizi explained that some women seek her assistance because they feel disconnected from themselves, while others arrive with specific reproductive health concerns.

She described her work as integrative, combining traditional spiritual practices, plant-based medicine and, where appropriate, physical assessments and investigations.

These are her approaches and interpretations, rather than established treatments for reproductive disorders. Conditions such as fibroids, PCOS and infertility require appropriate medical assessment, and traditional remedies need careful safety evaluation.

Still, what fascinated me was the broader question behind her philosophy.

What happens when we begin to see a woman as more than a collection of symptoms?

As a doula, I spend considerable time around pregnant women, watching their bodies undergo extraordinary physiological changes.

I have witnessed women birth babies after hours of labour. I have examined placentas after delivery as part of the birth-care work I participate in. I have watched the incredible relationship between a mother, her baby and the organ that sustained that baby throughout pregnancy.

And I often find myself wondering whether we give enough attention to the woman after the birth.

The placenta separates from the uterine wall, leaving an area that must heal. The uterus contracts, the body begins its recovery and hormones shift dramatically.

Yet somewhere in this process, the focus moves almost entirely to the newborn.

How is the baby feeding? Is the baby sleeping? Is the baby gaining weight?

All important questions.

But what about the mother?

Who is holding her while she heals?

Who is paying attention to the physical, psychological and emotional transformation she has just experienced?

Are We Carrying What Our Grandmothers Couldn’t Put Down?

Our conversation eventually turned to generational trauma.

Nomazizi spoke about women carrying emotional burdens that, within her spiritual framework, may extend beyond their own experiences.

She described the womb as a place where unresolved emotional and ancestral experiences may be held, and spoke about healing practices intended to help women release these burdens.

I asked whether the increasing conversations around autoimmune conditions, reproductive disorders and women’s chronic illnesses might also require us to examine generations of women who lived through trauma.

There is an important distinction here: trauma and chronic stress can affect health, but we cannot conclude that trauma causes fibroids, PCOS, cancer or autoimmune diseases. These conditions have complex biological and environmental influences.

Still, the emotional question deserves attention.

Our grandmothers lived through extraordinary hardship.

Many navigated poverty, patriarchy, racial oppression, reproductive inequality and marriages in which their autonomy was limited.

But many also had something we are increasingly losing.

Community.

There were mothers, sisters, aunts, cousins and grandmothers who participated in the everyday running of a home and raising of children.

This did not mean their lives were easier or their suffering less significant. It meant that, for some, the burden was shared.

Today, we have exchanged communal living for increasingly isolated versions of independence.

We move to cities. We build careers. We raise children. We run businesses.

We are CEOs, managing directors, entrepreneurs, mothers and partners.

We are expected to be composed in the boardroom, emotionally available at home and somehow still find time to maintain ourselves.

And when everything becomes too much?

We wait until the children are asleep.

We cry for fifteen minutes.

We wipe our faces.

And tomorrow, we do it again.

There is almost nowhere for the modern woman to fall apart.

Nomazizi spoke about wanting to create spaces where women can release what they are carrying without having to perform strength.

And I found myself thinking about how desperately we need those spaces.

Not another wellness experience that requires us to arrive looking composed, but somewhere we can be human.

Somewhere we can simply be.

Nomazizi Sihlahla: Between the Corporate World and an Ancestral Calling

What makes Nomazizi’s story particularly interesting is that her journey into traditional healing did not begin in a world removed from modern professional life.

She spoke about growing up in a middle-class family, attending a Catholic boarding school and eventually building a career in corporate South Africa.

She worked at Discovery Health before moving into entrepreneurship and commercial property development.

But throughout her life, she says, she experienced dreams, spiritual encounters and what she understood to be an ancestral calling.

She recalled experiences beginning in childhood, including recurring dreams involving water and an underwater village.

As her career developed, she described increasingly difficult personal experiences that eventually led her to pursue traditional spiritual training.

Her journey took her through the Eastern Cape, Lesotho, Mozambique and Zimbabwe, where she explored different ancestral practices and healing traditions.

It was not a straightforward journey.

Nomazizi spoke candidly about the emotional difficulty of navigating a calling that was not always understood or accepted by those closest to her.

What struck me was her willingness to acknowledge that the process required her to question what she had been taught, what she believed and where she belonged.

Today, her practice represents what she describes as a smaller version of a much bigger dream.

She hopes eventually to establish a farm-based centre where women can access education and support throughout their reproductive lives, from menstruation and fertility to pregnancy, postpartum recovery and menopause.

And when she described this vision, I smiled.

Because, in many ways, she was describing a dream I have carried for years.

Who Prepared Us to Give Birth?

I have three children.

My first two were born by Caesarean section. My third was born vaginally.

My experiences were profoundly different, and with hindsight, I often wonder how differently I might have approached my earlier births had I been equipped with more information, support and confidence.

I was not necessarily lacking medical care.

I was lacking the ability to confidently participate in decisions about my own body.

By the time I prepared for my third birth, something had changed.

I had found my voice.

I understood that I could ask questions, challenge recommendations, seek explanations and participate meaningfully in decisions.

That does not mean a Caesarean section is a failure, or that vaginal birth is inherently superior. Caesareans save lives, and sometimes they are the safest option.

But women deserve informed consent, respectful care and an understanding of their options.

Birth should not be something that merely happens to a woman while everybody else makes decisions around her.

Nomazizi and I discussed how traditional practices once prepared not only women but also men for conception and parenthood.

She emphasised that reproductive preparation was never intended to be exclusively a woman’s responsibility.

And that is another conversation we need to have.

Why does the burden of fertility so often fall on women?

Why are women expected to investigate, regulate and prepare their bodies while the reproductive health of their partners sometimes receives considerably less attention?

Fertility is not exclusively a woman’s responsibility.

Neither is parenting.

The Birthing Room Was Never Meant to Be a Lonely Place

One of the most beautiful aspects of my work as a doula is witnessing what happens when a woman feels supported.

I have seen partners hold women through contractions, grandmothers pray, mothers offer reassurance and entire families emotionally prepare to welcome a child.

There are moments in the birthing room that feel profoundly spiritual to those experiencing them.

During our conversation, Nomazizi and I exchanged stories about births where prayer, humming, familiar voices and physical closeness brought comfort during frightening moments.

She recalled attending a birth involving a mother who had previously experienced pregnancy losses. She described a moment of distress after delivery and the emotional significance of encouraging the mother to hum a familiar sound while medical professionals attended to the baby.

For Nomazizi, this represented the spiritual connection between mother and child.

For me, it reinforced the importance of emotional presence during birth.

Such experiences are meaningful, even though we cannot assume a spiritual intervention caused a particular medical outcome. A newborn experiencing distress requires immediate skilled medical care.

But spiritual support and medical care need not be opposing forces.

I am particularly interested in the importance of the environment into which a child is born.

The voices.

The touch.

The atmosphere.

The mother’s sense of safety.

In appropriate circumstances, practices such as immediate skin-to-skin contact, delayed cord clamping and continuous labour support can improve the birth experience and support maternal and newborn wellbeing.

Surely, we can create spaces that accommodate both clinical excellence and emotional care.

What Would a Birthing Space Designed by Women Look Like?

Another fascinating part of our conversation centred on architecture.

Nomazizi told me about discussions with a researcher exploring birthing spaces informed by indigenous African practices.

It made me think about how many conventional birthing environments are designed around institutional efficiency.

The bed. The lighting. The equipment. The limited room for movement.

And then I thought about historical communal spaces, where women could be surrounded by familiar people and supported through birth.

What would happen if we designed maternity facilities around women’s physical and emotional needs first?

Spaces where women could move freely when clinically appropriate.

Where birthing positions were not unnecessarily restricted.

Where privacy, dignity, family involvement and cultural practices were thoughtfully accommodated.

Where the mother was not simply a patient occupying a bed but an active participant in her own birth.

Nomazizi raised an important point about the difference between designing spaces for maximum commercial return and designing them for maximum value to women.

The two are not necessarily incompatible, but the priorities can produce very different environments.

We should be able to imagine maternal healthcare that is safe, evidence-informed, culturally respectful and deeply humane.

These things are not mutually exclusive.

Reclaiming the Wisdom Without Rejecting the Science

I am deeply interested in indigenous healing practices, particularly where they intersect with women’s health.

But reclaiming ancestral wisdom requires discernment.

We must be able to investigate traditional medicines, question harmful practices, recognise the value of cultural rituals and acknowledge the enormous contributions of modern medicine.

We cannot replace one unquestionable authority with another.

A woman with infertility deserves appropriate investigations and access to fertility treatment.

A woman with fibroids deserves an accurate diagnosis and evidence-based options.

A woman with reproductive trauma deserves compassionate psychological support.

She should also have the freedom to explore safe spiritual and cultural practices that hold meaning for her.

The point is not to choose between being African and being medically informed.

The point is to refuse the suggestion that these identities cannot coexist.

And perhaps conversations like the one I had with Nomazizi are where we begin to bridge that divide.

Not by agreeing on everything, but by remaining curious enough to listen.

The Future of Womanhood Must Include Our Past

Toward the end of our conversation, Nomazizi described her dream of creating a larger healing and educational space for women.

A place that would accompany women through menstruation, conception, pregnancy, postpartum recovery, perimenopause and menopause.

I recognised something of myself in that dream.

For years, I have imagined creating a space where women can come to heal.

Not because every problem begins in the womb, but because so many experiences of womanhood remain misunderstood, dismissed or insufficiently supported.

I want women to have access to knowledge that makes them confident participants in their healthcare.

I want girls to grow up understanding their bodies without shame.

I want mothers to experience childbirth without feeling that their voices have disappeared.

I want postpartum women to be cared for with the same intention with which we care for their babies.

And I want us to recover the value of women gathering, sharing knowledge and supporting one another.

Perhaps the most important thing I took from my conversation with Nomazizi Sihlahla was not a particular ritual or healing practice.

It was the reminder that women’s knowledge has always mattered.

Our bodies deserve science. Our experiences deserve respect. Our cultures deserve thoughtful examination. And our voices deserve to be heard.

We do not have to romanticise the past to recognise what we have lost.

We simply have to be brave enough to ask what is worth bringing forward.

Because perhaps reclaiming womanhood is not about returning to who we once were.

Perhaps it is about becoming women who finally have access to everything we need to be whole.

And perhaps, this time, we can build a world where women no longer have to wait until everyone is asleep before they are allowed to fall apart.