Baby steps to better health for mothers and children
Umm Nasser Al Muhairbi was 12 when she married. A year later, she was pregnant with her first baby.
The teenager was lucky. In the absence of anything resembling modern medicine, she was able to turn to her mother, who had given birth to 12 children and knew what her daughter was about to face.
“My mother told me, take three meals every day. Breakfast at 6am or 7am, not at 9am, and don’t think about going to bring the water from the sea, and don’t take anything heavy or run.”
Umm Nasser’s father, a fisherman, also knew about traditional medicine and made her drink one small glass of halool every two weeks throughout her pregnancy. The herb, from the Cassia angustifolia plant, is used as a natural diuretic and laxative and is still popular today. It is recommended during pregnancy to help keep the digestive system clean and to promote a healthy appetite in expectant mothers.
That was the 1950s and 1960s, when health care was virtually nonexistent, and halool and other herbal drinks were the only things that qualified as medicine. Passed down through generations, many of them remain today.
Umm Nasser, who now has 10 children and whose eldest son is about 45, is from a generation of women who remember when they had no alternatives. There were no hospitals or ambulances; at best a foreign doctor somewhere in Abu Dhabi, usually from a Christian mission, who could help if contacted in time.
It was a time when mortality rates were high, with some reports that half of all babies died in birth, although collecting accurate statistics would have been difficult.
All of the country’s first hospitals were set up by Christian missions. Oasis Hospital in Al Ain, founded in 1960 by Dr Pat and Marian Kennedy, is still operating today.
In 1940s Sharjah, the American missionary Dr Sarah Hosmon was treating women at a small clinic in the building that is now the Sharjah Art Institute.
Before this, women relied solely on traditional healers, practising techniques such as maysam that involved heating metal rods over the fire and holding them on the skin for a few seconds. The location depended on where the pain or injury was.
When Umm Nasser had her first baby, her mother called for the help of Dr Mariam, an Indian doctor. She also remembers an Emirati woman known as Baksa, who had a particular knack for hurrying up labour.
“Some ladies, they can’t push the baby. When she has pain it can sometimes take two days or three days. After, if she can’t have the baby, another lady like a nurse comes. She uses her head to push the bump and push down the baby.
“She delivered the baby. I cut my own cord. Then my mother brought the salt and made it like a tablet. I needed seven tablets to put inside to heal.”
The salt was mixed with a little camel urine, which is thought to have healing properties, and moulded into fingertip-size tablets as a vaginal suppository.
“One tablet, one a day for seven days. After seven days, khalas, you can go back to a normal life, the woman is clean. Me, after four days, I go to cook and get the water.”
As well as the salt tablets, women were encouraged to clean themselves with salt and water as this was thought to speed up the healing process. While it worked well, Umm Nasser says, it caused “too much pain”.
Post-birth, women also wrapped wet salt in a shayla and wound this round their belly for seven days to help it return to its normal size. “After the baby the stomach is big, but it makes it strong.”
A healthy baby was fed date paste as well as breast milk. “We make a little dates with a little foam of the milk and give it to the baby to suck,” Umm Nasser says.
“Like a lollipop. It’s good for the stomach and it makes everything come out that is not good for the baby.
“After seven days, the baby gets hab al hamra. We make it with milk and paprika and give it to the mother. It’s good after the birth.” The drink is made from cress seeds boiled with turmeric, black pepper, ginger and cinnamon.
Women were expected to get back to their normal routines within days of giving birth. While other women helped with household chores and childcare, they could not afford to lose a pair of hands for long.
To speed up recovery, women came up with other rudimentary ways of dealing with the physical effects of having a baby.
“Before we didn’t have privacy after the baby,” recalls Umm Noora Al Muhairbi, a mother of one girl also born around 45 years ago.
“We just put the shayla around us. We had two shayla; one for use and one for wash. First we needed to tie around the waist after the baby; it keeps the stomach in, then down here.”
The shayla would be wrapped around the waist and then threaded between her legs as a sort of sanitary towel for one or two weeks after the birth.
“Now you need it for 40 days,” says Umm Noora, who champions the old-fashioned ways.
Never in short supply, the shayla had a number of critical uses in childbirth.
“For the cord,” Umm Nasser says, “we used to cut a little shayla and use it to tie the cord tight after, four fingers from the stomach. You measured with your fingers. Before we cut it longer, but when the baby was playing it was not good, so four fingers was cut and tied.”
In some traditional houses, called chandal, there were wooden beams on the ceiling. The shayla would be thrown over the beam and used as a pulley for the mother-to-be to pull herself up on to give the baby room to emerge in labour.
“If someone thinks ‘this time the baby will come’ they will make a balance to pull,” Umm Afra says. “My mother did this. When she had too much pain she pulled up and pushed the baby out. Women pushed down on her knees to help.”
In the absence of husbands, fathers and brothers, women would be responsible for everything from cooking to raising children, and any household repairs. They also formed the main support system for other women in the community.
“When men go to sea, the women do what men do. They bring the water from the well, bring the wood, we carry it on our heads.” Umm Noora says. “The men farm or fish for business and family. Sometimes when they go to the sea, they go for three months.”
The women could estimate the time the men had been away by looking at the progress of the dates growing in the trees and also by looking at the stars.
Pearl diving, once the Gulf’s main source of wealth, was a gruelling and dangerous business. The divers worked from sunrise to sunset and were under water for many minutes at a time, wearing a nose plug and leather finger protectors.
“Sometimes men did not come back,” Umm Nasser says. In cases like these, other women stepped in to help care for the family, sharing food and supplies when needed.
It was also an anxious time for the men leaving their pregnant wives. With entire male populations out at sea, the women developed a clever way of letting their husbands know the fate of their babies.
“When my husband goes fishing and I deliver the baby he doesn’t know about me,” says Umm Nasser. “But when you have other friends who go to the sea, he takes my baby’s dress to give to my husband. He knows I had the baby and he can smell it.”
It was virtually impossible for women to know exactly when their babies were due. Because of this, some families were caught out. “Before, we didn’t know which time we would deliver the baby,” says Umm Nasser. “My mother went to Delma Island with family, she took four days to go. After 20 minutes, she said: ‘Now I deliver the baby’.
“Women gave shaylas and men gave kaffiyeh to create privacy. I know how to swim because I was born on the sea.”
If a baby was born early, mothers developed a simple incubation system to try to keep it safe until it reached full term.
The cord of the baby was kept long and the thread of the shayla was tied more loosely than normal. The child was placed on a blanket in a box or a large cooking pot and covered with a dark shayla. To breastfeed, the women would bend over the box rather than removing the baby.
“It must be not too hot or not too cold,” says Umm Noora. “And feed in the box. Keep it safe and dark until nine months.”
If women lost a lot of blood during birth, they were encouraged to avoid standing up and told to eat and drink lying down because “it stopped the blood”. If the bleeding continued, they turned to other methods such as massage and maysam.
“Take metal from the fire and put on the lower back,” Umm Nasser says. “It stops the blood from coming outside. Sometimes it left a mark.”
Women neighbours would be called for help, if needed.
“Just go outside and say ‘Umm Nasser’, and she would come. Doors were not closed. Now if you are sick, no one knows. Before people will say, ‘Where is this lady’ or ‘where is that lady?’”
Umm Abdulla Al Shehhi, a mother of two, gave birth to her first child in the 1950s in Fujairah. She was staying in the family’s clay kareen winter house when her labour started. She gave birth lying on a blanket on a floor.
“My mother is a nurse. When I had the baby my mother delivered the child. After, she put a stone in the fire and made it hot. Then put it in the shayla, on the stomach. It helps pain. When I had a baby the weather was cold. In winter, I lived in a different house.”
Umm Abdulla’s second son, Ali, arrived the following year but died at seven months from an unknown illness.
Eight more years passed before she became pregnant with her third child. By that time she was living in Ajman, where her husband was working.
“When I had Abdulla in Fujairah it took two hours. But Fatima was born in a hospital. I went there at 9am and Fatima came at 7pm. For me, it was different in the hospital. It was better at home.”
The relative security of having trained doctors and nurses on hand is not enough to convince Umm Abdulla that giving birth in a hospital is the better option.
“When I had a baby with my mother, we cleaned him and she gave me the baby. But in hospital the nurse took the baby and cleaned.
“And at home I can return to a normal life after three or fours days, but in hospital I needed to stay too long.
“I like the old ways, not the new ways. The traditional is better.”