x Abu Dhabi, UAETuesday 25 July 2017

Women say babies can wait until later in life

Customs are changing rapidly as more women pursue careers and put off motherhood, increasingly with their husbands' consent.

Dr Aruna Slvapurapu, a gynaecologist at Lifeline Hospital, has worked in Abu Dhabi for more than two decades.
Dr Aruna Slvapurapu, a gynaecologist at Lifeline Hospital, has worked in Abu Dhabi for more than two decades.

The adolescent birth rate in the UAE has almost halved over a decade, according to the latest report by the World Health Organisation. Experts attribute this to increased opportunities for women in education and the workplace.

Birth rates among teenagers aged 15 and above fell to 2.3 per cent in 2007 from 4.4 per cent in 1999, according to the WHO's World Health Statistics 2009 document, comparing favourably with other GCC and Middle East countries. In Yemen the latest rate is 8 per cent, compared with 2.8 per cent in Jordan and 2.7 per cent in Egypt. Both Kuwait (1.4 per cent) and Lebanon (1.8 per cent) had lower rates than the UAE.

Doctors say this is good news for the country because having too many babies too soon can lead to an increase in the mortality rates of mothers and children. Women previously tended to marry and have children in their teens, but the trend now is to leave motherhood and marriage until the early or middle 20s. "Social factors today are different," said Dr Suaad al Oraimi, assistant professor of sociology at UAE University. "The UAE is going through rapid sociological changes that help women to get an education, to go to work and support themselves economically.

"Now they drive cars, have their own bank accounts, and so they have more freedom than before." In the past women were educated at home, she said, to prepare them for being mothers and wives at 14. Now they study at school, and many go on to university and start careers. "What was their choice before? It was like a child getting married because her parents want her to be married, but today women have their own choice whether they want to marry or not. Society has allowed women to delay their reproduction."

Husbands are increasingly siding with their wives on delaying starting a family. "Of course, my career is important to me, but having a family is important to me too," said Dalia Chukri, a 26-year-old dietician from Lebanon who lives in Abu Dhabi. "I would eventually have one when the time is right. And at that time, I would continue to work after maternity leave, just as my mother did." Her husband agreed, she said. "It's just going to require more compromise and sacrifice, obviously. But of course I would never choose to have a family unless my husband and I were financially stable and happy in our careers, and unless we felt secure in our careers."

Hasan al Naboodah, a history professor at UAE University, said dramatic changes had taken place in the past decade. "There is no comparison between the old days and nowadays," he said. "You can't tell a young lady to do what her grandmother used to do." Dr Aruna Silvapurapu, a gynaecologist at Lifeline Hospital who has worked in Abu Dhabi for more than two decades, said teenage mothers were often not equipped physically and emotionally to cope with having numerous children.

"The problem is that they are also growing," Dr Silvapurapu said. "With the baby they are more susceptible to all kinds of nutritional deficiencies, pre-eclampsia and other complications. There are also more problems birthing the child and with lactation." Enclampsia is a condition in which convulsions occur in pregnant women with high blood pressure. Abdulla's mother married at 15, as was the custom of the time in her village. She had her first child a year later and by the age of 26 had given birth to nine children.

Her grandfather worked in palm gardens and gathered honey near the mountain village of Jerief, in Fujairah. Her parents arranged her marriage and, within a year, she was preparing for life as a young mother. "It's better to have children at 22 or 24," Abdulla said. "At 16 or 18, it's early. Your body is too weak." Her mother remembers feeling tired. But she had good family support and a nanny to help care for her many children.

In addition to the medical complications, there are also social challenges to being a teenage mother. Many do not continue with school and never work outside the home. "Especially among nationals, many quit their education when they become pregnant," Dr Silvapurapu said. "It is the end of their career. "Although they have a lot of family support, the demands are so high on the married women here that it becomes difficult for them to balance their careers and families. The majority of them end up in prolonged absenteeism, long-term leave, and finally end up quitting."

One woman, who married at 17, remembers the challenges of raising 12 children when she was in her 20s. "There was no school," she said. "My father and mother decided on marriage for me. Now women go to schools but before we worked in the house." Dr Kamini Naik, a gynaecologist at Al Zahra Private Hospital in Sharjah, said teenage mothers with many children might not be able to enjoy motherhood as much as they would like.

"If you have babies back to back then there will be issues with malnutrition," she said. "The babies often have a lot of abnormalities and delayed growth. "Many [women] end up having the second baby within one and a half years. She hasn't even recuperated from the trauma of delivery and lactation, which drains her reserves." While the complications of adolescent pregnancy are well known, some doctors disagree about whether those studies can be applied to the UAE.

"Most of these studies are done in the West where the situation is different," said Dr Saad Ghazal Aswad, the head of gynaecology at Tawam Hospital in Abu Dhabi. "In the UAE this is not the case, as the women who are pregnant when they are teenagers are married." Dr Aswad agreed, however, that there were unavoidable complications because of the way an adolescent body works. There are often nutritional problems, he said, where the mother and baby are not getting the right vitamins and minerals to support both their systems.

This can lead to a high chance of low weight for the baby and anaemia for the mother. There is also a higher likelihood of post-natal complications, including depression. "Mainly the issue is prematurity," he said. "Teenage mothers are not ready to look after a small baby." Abdulla's mother is grateful that she married young and had a large family, but she advises women today to wait. The best time for a woman to have a family is, "when she gets older, of course, after she is 20 and has completed her studies".

"Now people marry when they are 20 or 21," said Abdulla, 24, who married two years ago. "I want a small family, only four or five." @Email:amcmeans@thenational.ae azacharias@thenational.ae