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Doha Doula
27-01-11, 06:43 AM
Hi all, I am new to the forum and have just read the "doula posts' and thought I would share my experience (limited) of working as a doula in Abu Dhabi, UAE (for 18 months-12 births) and now Doha, Qatar (1st client booked).
My 12 births in Abu Dhabi were in either a government midwife (western usually) led hospital, or a private consultant (Arab usually) led hospital.
A quick description:
Govt. hosp. - old, busy, disorganised at AN checks, no private rooms, no baths on delivery ward, no birth pools, 12,000 births a year......
Private hosp. - sparkly, new, private rooms for all with en-suite bathrrom, large delivery room, no birth pools
Homebirth is illegal.
So reading the above, which would you choose???? Most expats chose the private hospital, it looks cleaner, they like the idea of a private room and the ante-natal appointments don't take too long.
Where would I choose???? The government hosp., absolutely hands down, you couldn't PAY me to go to the private hosp.Why? The gov. hosp. is MIDWIFE led, so although the ante-natal care is somewhat chaotic (which puts so many people off giving birth there) the 'upstairs' (delivery wards) is calm, quiet, safe....what women need to birth. The Dr only comes if indicated and the labour and birth can progress with a midwife alone.
These are my statistics on the births I have attended:
Govt. hosp: 7 births total, comprising of:
3 x vaginal births, primips
2 x vaginal births, multips (2nd baby and 4th baby)
2 x CS's, primips (no labour had started, one for pre-eclampsia, one for post-dates and unfavourable cervix for induction...mum chose section)

Private hosp: 4 births total, comprising of:
2 x emergency CS's, primips (same consultant, who had told BOTH mums that they had VERY large babies from 6 months pregnant and would struggle to birth them, neither baby was over 8lbs....both women laboured to 10cm and then got section.....)
1 x vaginal birth, primip (1st contraction to birth=1 hour, 40 minutes!!, in hosp. for 40 mins before birth, arrived fully dilated)
1 x vaginal birth, multip (4th baby)

I also had a birth in Dubai, vaginal, primip, private hosp but with midwives until delivery, then doctor came to 'assist'.
From what I have seen, the private hosp. uses scare tactics into letting them intervene, and this starts way before the labour does! Big babies, small pelvices, short mothers, Basically they don't TRUST birth, or women to be able to birth without their help. There were a couple of Dr's who weren't as bad, but they still didn't really go for the completely hands off approach, they liked the woman on the bed, wearing the gown, being monitored, having an IV set up "just in case", no eating or drinking etc.
So that was Abu Dhabi, now I am in Doha......yet to witness a birth myself, but have heard from a local doula (10 years here) and it sounds even worse than AD!!!
Govt. hosp.- EVERY woman gets an episiotomy, NO-ONE is allowed a physiological 3rd stage, on the bed, strapped to a monitor, stirrups.....but very pro breastfeeding (formula on prescription)
Priv, hosp.- More likely to look at a birth plan, but all primips bet an episiotomy and not keen on physiological 3rd stage.....not supportive of breastfeeding, most babies leave hosp. having had at least one bottle of formula (due to low glucose, they test all babies before a breastfeed!)

In my opinion this is EXACTLY why women need a doula here.....they are not getting evidence-based information, they are not getting appropriate support and they are not made to feel like they can birth their babies....however, I do realise and understand that I am not medically trained and cannot go against what the HCP say, this is why I work very hard ante-natally to try and inform the parents and help them to feel empowered and strong enough to question the HCP's decisions (ie. there is alot of synto use for the old favourite 'failure to progress', and in the 'rest and be thankful' stage....not enough time is given, or patience, or belief)

OK, rant over!!!!! Apologies for being so dull....but needed to get it down on paper!!
Sending doula love from Doha x

MrsBanks
27-01-11, 06:49 AM
Wow, what an interesting post. Thank you so much. The private/public hospital system sounds similar to Australia (in that people percieve private to be better because the rooms are all shiny and new, but in fact public lends a higher chance of having a normal birth).

I don't know the geography of where you are, is Doha a big city? Are there lots of hospitals? What are the breastfeeding rates like with formula on prescription?

Sorry for all the questions, welcome to the site :)

Delilah
27-01-11, 07:21 AM
Wow, what an amazing post! Is formula prescription payable then? I imagine it's better as you need a 'medical reason' to have it?

Welcome to the site too ;)

Doha Doula
27-01-11, 07:21 AM
Hi Mrs Banks and Star! Thank you for the welcome.
Doha is not a big city, and it is also fairly 'new', but this confuses me even more. The women, until recently, birthed in tents in the desert with no doctors or midwives (probably with a tribal 'midwife') or synto or C-sections or beds or IV's or gowns or epidurals....so why, now, can women suddenly not birth?
I am afraid I don't know for certain about the BF'ing rates, I would presume that they are very high, thankfully, but this is only at the govt. hosp. where the rest of the birth process sounds very medicated and regulated (I should also add that at the govt. hosp. NO men are allowed at the birth, and also that it definitely has the best NICU and would be the best hosp. to go to in an emergency situation) Iwould think that the rates of BF'ing at the priv. hosp would be lower, giventhat most babies are given formula whilst there, also keen to have babies in nursery rather than rooming in.....parents are not allowed in the nursery!!!!)
I believe that there are only 3 or 4 hosps. for maternity, 1 govt. and 2/3 private......I am sure I will know more over the next few months.
xx

Delilah
27-01-11, 07:23 AM
It would be utterly amazing, if you could start a blog? Or a post on here to update us on your experiences? You are such an inspiration!

Doha Doula
27-01-11, 07:58 AM
:o Oh Star,I really don't think I'm an inspiration!Just doing a job I love.But thank you! :o

A blog? Hmm, interesting idea, I may try.....I am not very computer literate although I have just amazed myself by creating my very own website. (I also managed to keep hair on my head, not break the screen and stay married whilst doing so!!!)
xx

Mama
27-01-11, 09:07 AM
WOW! WHat a post!

I have to say, any women that hire you are very lucky! As those conditions and rules sound horrendous! WHY every woman needs a epi' is beyond me!??!?!

Keep us updated! SOunds very very interesting! x

And Star is right, you are a inspiration! x

Raven
27-01-11, 10:49 AM
Really interesting perspective. It makes me thankful for the UK system despite its flaws and problems.

For me, what happens to birthing women in the Middle East and the USA is the result of midwives no longer being the primary health professionals in maternity care.