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Bringing Birth Choices to the GCC: An Arab Midwife’s Perspective

Pregnancy and birth are two of the most life changing experiences in a woman’s life.

Being trained as an Arab nurse midwife in the United States, and coming to practice in the Arab Gulf States, has given me the rare opportunity to experience both the traditional Eastern and modern Western perspectives. This article aims to share some of my experiences, to empower women with some of the key tools they have at their disposal to realize the birth experience of their choice.

Birth choices have changed in the Arab world. Many of today’s young Arab women probably have at least a mother or a grandmother who has given birth at home with the help of a local midwife, aka. “Daya.”  My own grandmother gave birth in the comfort of her own home, recovered effortlessly, calling in a physician only when needed. 

However, with industrialization and the migration of families from rural areas to cities, home births were not seen as safe anymore, due to a lack of sterile and hygienic practices and a lack of standards, guidelines, and certified practitioners. So in the last 30 years, the process of giving birth was moved away from the intimacy, comfort and warmth of the home and into the safety of a hospital setting, but that was sometimes seen as impersonal.

That being said, today’s hospitals can feel more like five star hotels. In most large GCC cities such as Dubai, Manama, Riyadh, and Muscat, there are dedicated large maternity hospitals and private hospitals with all kinds of maternity units. Most private hospitals and even government hospitals offer private rooms as well as individual labor rooms, staffed with well-trained physicians, midwives, and nursing teams.

But what was missing on many occasions is the option to have a birth of your choice with your active participation and informed decision.

For example, in many countries women now have the choice of a midwifery led birth, or midwifery modeled births. This means the hospitals, physicians, and midwives support the women’s choice of birth delivery while providing the support needed to do so.

The model views pregnancy as a normal and healthy process, and provides resources for the mother and her family. These include: prenatal classes, breastfeeding preparation courses, and options for labor such as water, hydrotherapy, and different birthing positions. It also allows allied health practitioners, such as acupuncturists and doulas, in the labor room to support the women.  Doula’s/one-on-one midwifery care is associated with a 50% reduction or more in cesarean sections, shorter labors, reduced use of analgesics, and higher rates of breastfeeding.

Most importantly, a qualified health practitioner provides these services in a safe and comfortable environment.As a result, countries like the U.S. are witnessing increases in midwifery led birth, as much as 10% increase over the last 5years, and birthing centers are opening around the country to offer women these choices. The increase is accompanied by data that confirms that “midwifery births are associated with fewer episiotomies, fewer instrumental births, and fewer use of analgesics”* .

The great news is that this choice has now come to the GCC. The UAE has just passed a mutual agreement between the regulating health bodies to allow midwives to practice birth independently, in conjunction with a physician.

 

Having The Birth Of Your Choice

To help ensure that you achieve the birth of your choice, below are five tools for moms to be:

  • Attend a prenatal course to empower yourself with the knowledge and information to be able to discuss things with your medical practitioner comfortably and confidently. It also helps you to be prepared physically.  You also learn how to care for your baby and prepare for breastfeeding.
  • Create a birth plan that works for you. Discuss it with your doctor, midwife, husband, and family. Keep it simple, and take it with you to the hospital, so you can communicate your wishes to the staff in writing.
  • Hire a doula.: This is recommended when a woman might be alone, or would like a non-medicated, natural and spontaneous birth.
  • Use hydrotherapy for pain relief and relaxation. Many people associate birth pools or baths with water birth. However, the use of warm water helps mothers through labor, and allows for uterine and perineal muscles to relax during contractions. Now you know why they always ask for warm water and towels in the movies. Ask your hospitals to make this available for you
  • Know your community resources.  Lactation consultants, baby massage classes, home visits by a nurse midwife, and joining a mommy group will help ease your recovery. Make sure you sign up with a reputable group who will give you sound advice. If in doubt, ask your doctor or midwife or call your local lactation consultant.

 

Remember, the journey of parenthood is an exciting excursion. You want to be prepared with all the knowledge and tools you need to be able to make informed decisions regarding the choice of birth you would like to have and beyond. Ultimately, you want to make sure to enjoy each memory created during and after birth.   

 


References

*Hatem et. Al. 2000

Photograph Credit: Inspiratus Loving Care

 

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Contributed by Sahar Al Husseini RN CNM IBCLC

Sahar is a mother and baby educator, who works for Inspiratus Loving Care in the UAE. Sahar is a US trained Certified Nurse and Midwife with over 8 years of experience in the United States, Saudi Arabia and the United Arab Emirates. Sahar has worked in internationally accredited hospitals, and attended to over 1,200 births. Sahar can be contacted at Lovingcare@inspiratus.us .

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