Giving Birth in Qatar

By Shabina S. Khatri

Not alone | In Good Hands | Finding a Doctor | Picking a Hospital | Self Advocating

In the first of a series of articles journalist Shabina S. Khatri looks at giving birth in Qatar, from finding the right doctor to making sure you get what you want during delivery.

Also see: Qatar Hospitals | Qatar Dentists | Giving Birth in Qatar

Not Alone

Doha expats who are feeling pregnant and overwhelmed, take heart - you are not alone.

Whether you're expecting your first child or your fifth, it can be challenging to deliver in another country, without the support of family and friends and the comfort of a familiar health care system.

"Every woman has her own perceptions about how birth should be experienced," says Sarah Hannibal, an internationally certified doula who has been attending births in Doha for five years. "These ideas come from her personal experience, her culture, the stories she hears from family and friends and can also be shaped by the media."

"There are two basic models of managing childbirth, the medical model and the midwifery model," adds Hannibal, who also teaches childbirth education. "Women should have the freedom of choice to decide which model of care they feel more comfortable with and have flexibility within each."

Though some doctors are willing to work with moms who want to deliver naturally, Qatar's hospitals overwhelmingly follow a medical model, and home births are not permitted.

That leaves pregnant women no choice but to navigate Doha's health care system, which can seem daunting to someone who doesn't speak Arabic, the native language.

But there are also advantages to delivering in Qatar, Hannibal says, the biggest being "the postpartum care that is available since is it common to have household help."

She adds that the Gulf country also has better outcomes in terms of fetal and maternal death when compared to her home country, the United States.

In Good Hands

Though Qatar is tiny, it sees almost 16,000 births a year, at a rate much higher than many Western countries, according to the World Health Organization. With an extremely low maternal mortality rate - on par with much of the developed world - you may find it reassuring that the quality of care one receives here is not in question. Every place you go will follow the same procedures, running all the appropriate tests (and then some, if you have a generous insurance plan). Bottom line - whatever you decide, you will be in good hands, medically speaking.

With an extremely low maternal mortality rate - on par with much of the developed world - you may find it reassuring that the quality of care one receives here is not in question.

Still, Doha has a lot of doctors and a lot of hospitals - and hence a lot of choices in terms of where to give birth. And as any pregnant woman will tell you, considerations like cost, bedside manner and the ability to establish clear lines of communication with the medical staff are not insignificant.

"Medically, the care is good here," says Natalie Papagiorcopulo, an expat midwife who teaches prenatal classes in Doha. "But I think from a satisfaction point of view it's not very good. You can still have good medical care and patient satisfaction at the same time."

Finding a Doctor

Though your priorities may change as your pregnancy progresses, evaluating which factors are the most important to you is a great way to narrow down the mountain of choices that you face.

Are you adamant about having a natural childbirth, or having your husband accompany you in the delivery room? Is sharing a recovery room with a few other patients who have also just delivered not a problem? Are you counting on your health card or insurance to cover your medical costs, or will you be paying out of pocket for certain fees?

In Doha, most women receive prenatal care from doctors who work in the local hospitals and clinics, which are open to patients during certain hours or by appointment. That means that it's rare for a woman to see the same doctor throughout her pregnancy and in the delivery room, as is expected with private obstetric practices in other countries.

The upshot of this is that once you pick a doctor, you don't have to stick with him or her.

"Shop around," Papagiorcopulo advises. "I think the hospitals should live up to your expectations (but) you've got to go into labor with an open mind."

Picking a Hospital

The Hamad Medical Corporation's Women's Hospital is where most women in Doha give birth. The government-subsidized facility, in which 40 babies were delivered a day in 2008, has state-of-the-art facilities and some of the country's most experienced physicians. This is where, if severe complications arise during your delivery, other hospitals will send you.

"As far as medical services for a high-risk pregnancy, I always encourage women to go to Hamad," Hannibal says. "They have all the best technology, the best (neonatal intensive care unit) and a large blood bank."

With a health card, there is no charge for delivering a baby at the Hamad hospital. The stay will cost 100QR a day, or 800QR for a private room. Most women are discharged within 24 hours.

But there are pitfalls to going to the public hospital. Because Hamad is so inexpensive, it is often busy. Establishing a rapport with the harried nurses may be difficult, and securing one of the handful of private recovery rooms is considered nearly impossible. Husbands are not allowed in the delivery room, but a female friend or relative is permitted.

Other private hospitals that do deliveries include Al Emadi Hospital and Doha Clinic, which are smaller in size but popular alternatives for women who want more personal attention during and after their deliveries.

On the very opposite end of the cost spectrum is Al Ahli Hospital. One of Doha's newest hospitals, Ahli has been gaining in popularity among western expats because of its flexibility in accommodating birth plans and its luxurious recovery rooms.

The cost of delivering a baby, however, is significant. A vaginal delivery and three-day stay will run you anywhere from 13,000 to 14,000 QR, with an extra 1,200 QR for an epidural. A caesarian section and four-day stay costs about 18,800 QR.

Al Ahli has been gaining in popularity among western expats because of its flexibility in accommodating birth plans and its luxurious recovery rooms.

Despite the steep fees, the hospital seemed like a sensible choice to Kelly Allen, a 21-year-old rescue coordinator for Qatar Animal Welfare Society who gave birth to her first child in October.

"It had been highly recommended by family and friends and they allowed my husband to be present at the birth," says the British expat, who has lived in Doha for seven years. "After paying a visit to look at the facilities and meet some of the staff, I decided that Al Ahli was the best place for me personally."

For Allen, the deciding factors proved to be the friendliness and thoroughness of the medical staff, who showed a willingness to answer her many questions and helped teach her how to bath and breast feed her son after birth.

Self Advocating

But she adds that at Ahli, "you really have to tell them what you want and when you want it. If you want pain relief you have to tell them as they don't offer it automatically and then you need to let them know when you want it given. If you want things to be done in a specific way then you do need to tell them a few times to make sure it's done how you want it done."

That advice should hold true for everyone, Hannibal says.

"Informed consent is not always valued here the way most patients would like," she says. "I would just like to encourage every woman to be a self advocate. Take charge of your own health and the well being of your unborn child. You shouldn't be afraid to ask questions or ask for explanations before a procedure is done. By doing these things a woman has a much better chance of having the birth experience they want."

Image of pregnant lady by Mahalie

Shabina S. Khatri is an American journalist freelancing in Doha, Qatar. She has previously written articles for Al Jazeera English, the Detroit Free Press and the Wall Street Journal. E-mail her at shabina.khatri[at]gmail[dot]com.