Labour & Delivery @ Women’s Hospital, Qatar

To date, most readers who end up on these pages are those looking for information on the birthing process here in Qatar. A large share of the very large and diverse expatriate population here is mostly the younger demographic. Families that are still expanding. Women getting pregnant and delivering their babies in an alien land, away from the comforting support of extended family and friends.

Three and a half years ago, I was clueless about labour and delivery (the reality I mean, not the theory). I was also clueless about how things would pan out once I went into labour. The state funded healthcare system here is great but it is not without pitfalls. Considering how over burdened it is, it shouldn’t come as a surprise. It can be chaotic, very crowded and sometimes a bit too “clinical”. But they try hard and I appreciate that. I know how it is to be overworked in the healthcare sector. The labour and delivery service at the largest women’s hospital in the country is probably one of the busiest in the world. No kidding.

Let us start with my pre- natal appointments. Unlike the last time, where I was primarily followed up at the primary health centre, this time all my appointments were at the main hospital. Due to complications that Lil Z had, apart from regular OB visits, I also had regular appointments and ultrasound scans at the high risk unit- aka the feto-maternal unit.

The difference in patient satisfaction this time is incomparable. If I felt helpless and frustrated with my care the last time, this time I looked forward to meeting my doctors. I also went home after each appointment, a happy and optimistic woman. Content, grateful for the excellent care. I was even afforded some flexibility with the appointment times and was regularly given dates every month initially, and then every two weeks at the end. Compare this to three years ago, all I had was two appointments at the health centre and one at Women’s. All different doctors, and me a first time mum!

As far as the birth went, it was almost as good as it could get. I worked full time till the very end. On the day The Little Man was born, I woke up early with some discomfort. This was nothing new. I was in perennial discomfort by this stage. And had been barely able to stand for procedures the previous day. But I was about 38 weeks and I had a feeling that this was it . I’m more of a 38 weeks kinda gal.

I woke up, freshened up and walked around the house. Pottered around doing this and that. I bounced on the exercise ball, checked the patient list for the day, watched the news. Had some tea. Tried to not wake the other inhabitants in the house.

The discomfort turned to pain pretty soon. The pain was rhythmic and regular, and I knew by this time that the day had come. I felt eerily calm. Oddly, I did not feel hurried or anxious. I felt truly ready.

When things started to get a bit serious, woke the Mister up. We sipped tea, chatting about inane matters. It was entirely up to me, when to leave for hospital. It was about 0500 am and thankfully traffic wouldn’t be a problem for another hour or so. We got dressed, got the bag out and were ready to leave, whenever I felt like it.

By 0530 hours, the contractions were a little over a minute apart. We decided to leave, mainly due to the fear of impending traffic and also because we anticipated another quick one again. During the ten minute ride to the hospital, things hastened. There was a sense of deja vu, with me clutching the seat of the car, and huffing.

We parked at the far off parking lot and walked to the emergency room, stopping every minute till the contraction/ pain passed. I went up to the reception and offered my health card. I was clutching the railings and wall every minute by then. I sucked in and dealt with the pain as and when it came. Nobody took me seriously (why would they- screaming is the norm and I wasn’t even close to screaming), but I knew I was quite far along.

By the time I was triaged by the nurses and checked in it was 0630. And when the doctor checked me, it was about 0645. It was only then that the nurses and orderlies stared scrambling- I was 7 cm dilated, fully effaced (childbirth speak- the Mamas will get it). I was in a labour suite by 0654.

All this while, I was chatting up the nurse, telling her which was my best vein, calling my department secretary to tell her to find someone to cover my clinic for the day and get me off the roster from the next day. As I was disrobing and getting poked and prodded at by the nurses and midwife, a resident came by to take a quick history and offer me the option of an epidural. We said hello and made small talk for a bit. It was 0700 by then and I was 8 cm or more she said. I asked her to quickly break my waters and get things rolling, and stop brandishing the epidural candy. I’m not against epidurals, and honestly I was very, very close to taking up on her offer. But I also knew that I had already suffered through the worse, I was in “transition” as they call it and if all went well, the pushing stage would commence as soon as the waters were broken. I might even deliver before the anaesthetist could set things up or even if I managed to get one, I might deliver before it acts. Therefore, pointless.

There was gas and air of course, if I wanted it. Honestly though, I was past the point of any sort of pain control. And the thing with having no pain relief, is that I felt totally in it. In control. In the moment. Head, as clear as it could be. My own hormones and adrenaline doing what needed to be done. I knew exactly what to do and how. I even called my husband between two pushes as he was supposed to go and wait in the male waiting area. I told him, “Give me ten minutes, okay”.

Husbands/ men are technically not allowed in the clinical areas, female relatives can stay with the patient, but are not allowed in the actual delivery/ labour room/ suite. But the husband can be called in for a moment or two to the delivery room before they whisk you off to recovery once things are cleaned up (you, the baby and the room)- to say hello to the new entrant.

In short, by 0730 things were done and dusted, literally. Mr H got to meet The Little Man a few mins after and then we said our byes for a bit. Skin to skin is practised and they are quite good about that. You could also ask for delayed cord clamping if you want to. The midwives delivered the baby, and I have no problems with that, considering I was a low risk case. But the baby was considered high risk, thanks to his sister’s credentials and therefore the paediatrician was on stand by and a neonatologist also came by and ordered tests in less than a couple of hours.

I spent very little time in recovery. I had an IV line inserted as per protocol, but since I was eating and drinking throughout, I wanted it out as soon as possible. The nurses are more than happy to oblige as soon as your have your first wee in recovery. Again, I am aware of the protocols, and the reasons for them so I don’t feel the need to fight these things.

The hospital is pro- breastfeeding and even though the nurses are ever busy, they are happy to help you with any issues that you may have in this department.

As soon as a room is available (and after you have wee’ed), you are taken to the wards upstairs. You most likely will have to share a room with another patient. But there is adequate privacy, in lieu of curtains. The on suite bathrooms are clean and sufficient.

The nurses are efficient and the meals arrive like clockwork. I ain’t fussy with food, and therefore I enjoyed all my meals. Three meals, with snacks in between. You do have some choice in regard to you meal preferences. No complaints there.

You are expected to be in hospital garb during delivery/ surgery. But are encouraged to get into your own clothes in the ward. The uber useful giant pads and super comfortable mesh underpants are provided upon request. Diapers too are provided, but it does no harm to take some your own. Blankets and pillows are provided, even for the female attender who can stay with you overnight. Male visitors(including husbands), are encouraged to leave past 10/ 11 PM.

If all goes well, you will be discharged the next day (for vaginal births). As per the cultural norms of this part of the world, circumcision is offered for all male babies. You can take it or leave it. It involves a signed consent, some EMLA cream and a short 20 mins or so separation of you and the baby. This may prolong your discharge by a day or so.

We had to stay longer at the hospital as The Little Man too ended up having ABO incompatibility. We were better prepared this time, and I will not write about it in detail except that it all ended alright and we are doing well now.

In summary, things went as smooth as they possibly could. My labour in hospital was less than an hour in duration- half an hour maybe. It was my decision to labour at home for as long as possible. I had several reasons for it. But if you are less confident about it, or have other issues that make you high risk, I’d suggest you get to the hospital earlier. Also, ask for an epidural whenever you feel the need to. Request it early, as the anaesthesiologists in the unit are insanely busy.

I have been both the patient and doctor. And therefore my perspectives on things may be different. I get why doctors may sometimes seem rushed, or why the nurses many not immediately respond when I push the button. I also know that medication can sometimes be ordered “PRN” and therefore I will have to ask for it. Only you can feel your pain, so don’t be shy about it. I also know that it is good to be wary of unnecessary intervention and be aware of patient rights, but that doesn’t mean I kick and fight everything and doubt the highly trained staff at every corner just because Dr Google (or some internet “expert”) said something. Having a relaxed attitude, made my hospital stay easier, no doubt.

My final piece of advice, do your research but know when to stop. Don’t fall prey to the scaremongering and only base your decisions on the horror stories. Yes, you don’t want to be “that unfortunate case” but you need to understand that people usually come online to vent about their bad experiences. There are hundreds of “average”, mundane, regular stories that never get told online.

All the very best to all the soon- to- be Mamas. Am happy to answer any questions you may have about my experience (two in three years).

Till next time.

J.

Would love to hear from you folks! Do comment (email optional)

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: