photo 2 (3)Smooth indie pop mixed with the din of morning breakfasters — masking the Arabic and English conversations and adding a warm buzz to the many clinking tea cups. It was a cold morning and the wind off Kuwait’s Marina drove patio-goers indoors to the trendy cafés lining the water.

I was enjoying a Moroccan mint tea and nursing Ivy to sleep when I heard a testing, “Hello?”

Expecting guests, I looked up with a bright smile and instantly recognized Heba al-Ali, co-founder of BirthKuwait. Her colleague, a birth doula, gave a quick nudge and joked at me, “When I saw you breastfeeding, I knew you were one of us.”

The three of us had never met before — but a chance tweet and a couple of email exchanges later, there we were, talking all things maternal over poached eggs and organic bread.

BirthKuwait was created to better support mothers by advocating for healthy and natural birth, and to improve maternity services by making resources and information available to women. One and a half years ago, doula Sarah Paksima and midwife Zuzana Nadova spearheaded a plan to get professionals who were interested in maternal care — breastfeeding and natural birth — all together in one room. Health professionals, doulas, pediatricians, and members from the Ministry of Health’s Breastfeeding Promotion and Support Team entered into a discussion to move beyond just breastfeeding support and answer the question, what else was there to offer women in Kuwait?

Heba explained:

We wanted to offer monthly meetings to give out free information, and educate women so they can demand the changes in maternal health. We didn’t want to lecture the government or the hospitals to change — but to empower women to demand the change for themselves.

BirthKuwait is essentially helping to fill education gaps in breastfeeding support, prenatal care, unnecessary medical interventions during delivery and postnatal care that women in Kuwait might not receive from private or government hospitals. Unless someone actively seeks out information from their doctor or government clinics, it’s unlikely they will be made aware of  lactation consultants, childbirth preparation classes, or that the birth experience doesn’t have to include an episiotomy — a standard procedure in Kuwait.

I had read online that birth in Kuwait is a highly medicalized, hospital event and that midwifery isn’t a recognized profession. But I was still shocked to hear the opinion that doctors don’t know how to birth a child without an episiotomy and that women simply expect to receive one.

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Eryn seconds old I’ve been thinking about getting pregnant.

Pregnant bellies have started looking really good to me and I’ve actually felt some jealousy when shopping for baby items and bumping into random bumps. I loved being pregnant and alhamdulilah I had a great birth experience. And of course it’s something that I’d like to experience again.

Naturally, there were definitely some things about my birth experience that I’d like done differently a second time around.

The hospital we chose was AMAZING. Apparently the labour help is  top-notch, allowing labouring mothers to walk around and not to be tied down to an IV; no invasive baby monitoring; a low use of invasive delivery techniques such as forceps or episiotomies; and a dedicated nurse to coach you through labour (I wouldn’t really know first hand though, since we essentially walked in and delivered on the spot).

They don’t routinely suction newborns and will hold off administering any injections or clean-up if you request it. And the first place baby goes after being born is directly onto mama’s chest. There baby is left to calm down, breathe, and get some help latching on from lactation consultants if necessary. The aftercare is also brilliant — with daily group breastfeeding help sessions with one-on-one help available.  I ended up using their breastfeeding clinic’s helpline almost weekly until Eryn was about 2 months old.  They’ve also gone through extensive renovations and now have birthing units so that you deliver and recover in the same room. Each birthing unit is also equipped with a specially designed tub for water birth — which would be really neat in my mind.

Now, there were some things that I could have gone without. We were admitted at 7cm dilation. But within the time it took me to get changed and walk to the birthing unit (oh, about 10 minutes), I had hit the 10cm mark. When I walked into the delivery room I immediately said, “I have to push.” That’s when the nurse gave me a rigorous internal exam.

She swirled her hand around like she was washing rice and I quickly sat up and shouted, “woah! Not so fast!!” To this day I wonder if she was attempting to strip my membranes or trying to get my water to break.  Once she determined I was 10cm, she lifted my legs, told me to grip behind my knees and push.

I was overwhelmed, confused and shocked. First I asked about the Hubby and if we should wait for him to come. He was SUPPOSED to be there. He was my voice and my support network. She said push. I then asked about my position — was it alright being flat on my back? In my head spun the unspoken options that we learned about in prenatal class: side lying, squatting, sitting. My crazy, hippy prenatal instructor was repeating over and over again, “avoid giving birth on your back.”

But instead the nurse said, push.

So I pushed. And a cheering purple push squad came into the room. After 10 minutes when her head crowned and the delivering OB came in he said, “stop pushing so hard. Ease into the push like you’re saying ‘house’. The slower the push, the less you’ll tear.” Great advice, but too late. Recovery had some interesting challenges outside of the broken blood vessels in my face.

So now that I’m wiser about how to deliver and I’ve been able to revisit my birth experience mentally and on film (God bless my techno-Hubby), I have a pretty good idea not only how I want to deliver, but how I’ll have the strength of mind to say, “I want to be side-lying or squatting. I’ll have none of the stirrups thank you very much.”

I also have been thinking about having a midwife instead of my OB. But I really have no idea about what the practical differences would be between a supportive OB (like mine was.. late, but better late than never), and a midwife. I could have my awesome OB throughout the pregnancy and end up with a dud on call for the actual delivery — which is what happened with Eryn. I had a dud throughout the pregnancy only to be delivered by Dr. Wonderful.

Delivering in a hospital setting is something I still would like to do, but to have more control over the actual delivery, which is what a midwife could potentially offer.  There’s also the continuity of care provided by a midwife that the one 8-week OB appointment just can’t compare to. Instead of running to clinics, calling helplines, making specialist appointments during recovery, a midwife would coordinate all of that, or avoid the issues that would require extended aftercare. In fact, from what I understand, a midwife would also be able to mitigate purple push squad nurses and slow the delivery down to avoid a natural episiotomy (or as Dr. Wonderful told me to watch out for in future: prolapse 😦 )

What do you think? Anyone with practical experience willing to share?

We haven’t exactly started trying yet, or even really talked about it, but I’m starting to think the Hubby and I should start doing some research and have a couple of numbers on hand in case of a happy chance.