x Abu Dhabi, UAESunday 21 January 2018

How to get the birth you want

There's no way to accurately predict when a baby will come, but things under our control can be planned. Here's how.

Future mother waiting (istockphoto.com)
Future mother waiting (istockphoto.com)

A baby was recently born on a plane toilet while Filipino nurses on board assisted the mid-air delivery and kept the newborn warm using LED reading lamps attached to passenger seats. Although the mother, who was flying from Dubai to Manila, decided to name her son "EK" (after the Emirates Airline code), I suspect it wasn't quite the birth she'd wished for.

After giving birth on the kitchen floor, next to the dog bowl, I feel great empathy for women whose labours don't turn out as expected. Mine certainly didn't go to plan. While women can't control when their baby makes an appearance, you can make plans to increase the chances of getting the labour you'd like - Mother Nature permitting. Here's a 10-step guide to making delivery day go your way.


1. Write a birth plan

Make the time to put pen to paper. "It is a good idea to write a birth plan as it is a legal document," says the Dubai-based parent educator and midwife Cecile de Scally. "It helps both partners understand what the other expects from the birth. You should keep it quite simple and not put yourself under pressure to achieve the impossible." De Scally suggests you write things such as: "I would like my husband with me all the time" and "I do not want to be offered pain relief, please talk to my husband first."

Many doctors support the idea of a birth plan. "It provides the means of building and improving the relationship between the doctor, midwife and the mother," says Dr George Michailidis, an obstetrician and gynaecologist at the N9ne Medical Institute, Dubai. "It highlights the areas of agreement but, more importantly, identifies the areas of disagreement. By doing so, it allows time to resolve misconceptions and find a common ground, reducing the risk of conflict at the time of labour."


2. Swot up

This is the one time in your life when it's definitely worth doing your homework. "To avoid unnecessary intervention, I would advise people to take a good prenatal class," says De Scally. Knowledge is empowering and Jasmine Sneyd, a parent educator and senior midwife at the Corniche Hospital, Abu Dhabi (www.cornichehospital.ae) agrees preparation is everything. The Corniche Hospital offers Parent Education sessions to introduce prospective parents to coping techniques for birth, empowering women to have confidence in themselves to give birth naturally. "We also discuss the special situations such as unexpected complications - this is when a caesarean birth or other interventions may be needed; even in these circumstances women need to know what to do to ensure they are aware of all their options so that birth is still a positive experience even if events are unexpected," explains Sneyd.

3. Don't believe the rumours

Yes, you do need to be married to give birth in the UAE, unless you're happy to get to grips with breastfeeding in a prison cell. However you shouldn't believe everything you hear. "While you might need your passports and marriage certificates to get the birth notification, it is a myth that you need your husband's signature to have an epidural," says De Scally.


4. Shop around

Just because your best friend recommended a hospital, don't rule out all others, especially since they have different policies. For example, hospitals put a limit on numbers in the labour room and who they allow in is dependent on the particular hospital. Normally, only the husband is allowed in, but sometimes a mother is allowed in, too.

5. Consider hiring a doula

A doula can help you stick to your birth plan when you may feel like deviating and provide another voice in the room when you have to make a decision. Elizabeth Bain, a doula in Dubai (www.dubaidoulas.com), believes the presence of a doula in a labour room is important in the UAE because the birth process here is often very medicalised and a doula can encourage women to labour more naturally. Research has shown that having a doula present at birth decreases the chance of caesarean section by 50 per cent and decreases the need for pain medication.


6. Be healthy

Labour is literally that - hard work. And for it to go smoothly, you need to be reasonably fit and healthy. It helps if you can get into shape before you fall pregnant, although it's never too late. "Optimal health prior to pregnancy is a key factor in helping to prevent pregnancy complications. The importance of nutrition, exercise, folic acid supplementation and screening tests should not be overlooked," says Sneyd.

7. Know all your options

Although you're not allowed to give birth at home, it is possible to have a water birth. Last year, the Al Ain Cromwell Women and Children Hospital began offering water births and now a number of other hospitals have followed suit. Sandi Blankenship, the head midwife at the hospital, says: "Labouring in water can shorten the length of labour and reduce the pain between 60 to 70 per cent, due to the warm water temperature (35-37.5°C) which has a soothing effect."


8. Stay at home as long as possible

It's natural to want to rush to hospital at the first twinge, but it's better to hold fire because labour often slows down when you arrive in an unfamiliar environment. "Most doctors want the mums in hospital if their waters break," explains De Scally. "And most mothers in the UAE tend to go into hospital much earlier than they need to. The lack of support and ability to prepare mothers, as not all attend antenatal classes, makes them inclined to do as they are told."


9. Ask questions

Most of us are naturally subservient towards a doctor, but remember that this is your body and your baby. "Question … and be part of the choice," advises De Scally. "Do not be frightened into a choice you are not comfortable with." If you read up beforehand, you will be better equipped to make informed decisions.


10. Think carefully

"Is the birth you want necessarily the right birth for you and your baby?" asks Sneyd. "Many women I meet perceive caesarean birth as an easy alternative to natural birth, possibly because of their 'fear' of natural birth. Families are often unaware of the potential adverse effects of caesarean birth, such as a longer recovery period, possible breastfeeding difficulties and implications for future births."