A labour you'll love: What exactly are the birthing options for expectant mums in the UAE?

Giving birth could be a daunting prospect. With an increase of than 140 hospitals over the seven emirates, nearly all which are private, social media is the go-to resource women use to garner information and advice from other mothers. Which doctor would they recommend? Which hospitals provide best prenatal or postnatal care? What hospital or doctor will focus on more natural birth preferences?

American resident Samantha Warrayat has lived in the UAE since 2008. The mother of two became a doula after she had her first child.

“In 2015, when I had my eldest daughter, the only hospital claiming to permit water birth was in Al Ain and I could not look for a doula, showing their undersupply then. I gave birth at Al Zahra Hospital with the support of Dr Anni Engberg, and even though I was permitted to labour in the tub, ­unfortunately I was asked to escape the water for the birth. Significantly less than a month later, the first water birth happened at the same hospital. It’s incredibly positive to see that.”

Warrayat believes that the UAE is more complex than the US in terms of hospital deliveries. “Hospitals here are implementing evidence-based policies around breastfeeding and delayed cord clamping, whereas the US falls behind in these areas,” she says. “But birthing in the home or at a birth centre is still no option, and they are areas for growth.” In the UAE, midwives aren't permitted to work outside hospitals, so home births are legally not allowed, nor is there birthing centres, which are an alternative to hospitals for low-risk deliveries. Water births are facilitated by an increasing number of hospitals, however, and hypnobirthing is more prevalent.

Salma Ballal from HealthBay Polyclinic in Dubai says birthing options are progressing ­steadily in the UAE. Originally from the united kingdom, where home births are common, Dr Ballal, a consultant obstetrician and gynaecologist, says this won’t be a choice unless regulations changes to allow midwives to provide outside hospitals. Regulations also states a physician should be present at a birth.

“It’s more of a stigma when compared to a fact,” Ballal says of the perceived higher rate of Caesarean sections in the UAE. She says the private healthcare system does, generally, respect birth preferences. “There are fantastic doctors in the UAE and C-sections are only performed if they're required since it is major surgery … doctors often have a conservative option if problems arise during labour for concern with litigation action should something fail.”

The rate of C-section deliveries here isn’t as high as in some other countries such as for example Italy, Brazil and Egypt, she continues, and data varies in one hospital to the next, as there is absolutely no auditing system in the UAE, so it’s difficult to quantify.

Of private healthcare, she says it’s been wonderful to really have the possibility to develop relationships with families, from their first child to their third occasionally. “This wouldn’t happen in the united kingdom, where in fact the public healthcare system means as a health care provider, you may never start to see the same family again.”

For mothers considering a water birth, Clare Evans couldn’t recommend it more. The mother of two from the UK had a water birth at Al Zahra hospital in 2017. Evans laboured in water in a dedicated hypnobirthing room with dim lighting, music and candles. She had the support of her husband and a midwife. Her doctor came and went. Evans thought we would have capsules made from her placenta. She said she couldn’t fault her UAE birthing experience despite the fact that she would have chosen a home birth or birthing centre if she had been at home in the united kingdom.

Another consequence of the private healthcare system is the cost of health insurance. Giving birth in the UAE without insurance cover can incur a hefty bill. Private maternity packages in the UAE cover the fundamentals, but if a crisis arises, or a C-section is necessary, hidden labour costs can escalate rapidly.

C-section birth rates are rising in nearly every country on the globe and it’s a pricey procedure in the UAE, costing up to Dh30,000, with most insurers only covering up to Dh15,000 to Dh20,000. Hospitals often demand a deposit. It’s vital that you read the terms and conditions as some insurance providers are affiliated to certain hospitals rather than others. Svetlana Svetova from Russia researched heavily before deciding on a hospital in the UAE as she favoured an all natural birth without medical intervention. Then she faced another difficult decision a few months into her pregnancy: should she change doctor and stick with the same hospital - she had chosen Al Zahra - or follow her doctor who was simply moving to Saudi German Hospital.

She said could have preferred to provide in a birth centre as her pregnancy was low-risk: in her home country of Russia, homebirthing is not a choice either but birth centres are. Svetova discovered that few hospitals in the UAE ticked all of the boxes: there were no midwife-led birthing options, water birth was rare, some allowed doulas for the birth and others didn’t, and standards of neonatal intensive care unit units varied greatly in her opinion.

She would advise pregnant women to do a lot of research and to double check postnatal policies as she believes in the value of the crucial transitional area.

That's where doulas come in. Residents far from home or anxious in regards to a first baby will most likely hire a doula for support. What’s the cost? These doula, Warrayat, charges Dh975 for a 12-hour package, to be utilized three hours at the same time.

Doula Nicky Langley, also a hypnobirthing teacher and breastfeeding counsellor, will charge Dh4,500 outright and make herself available whenever she’s needed. Langley, who is British, is available through the Hippo Birthing Programme.

She sees her work as filling the role of an absent sister or mother and says she has seen considerable progress in 15 years of surviving in Dubai - eight as a doula. “Water birth is now a choice, which is fantastic,” she says. “There are lots of passionate OBs and midwives who would like to offer pregnant couples more choices in this area.”