How the UAE’s pregnancy healthcare may be different from your home country
The UAE is quite different from the pregnancy healthcare system in many other countries, in that you don’t come into contact with a midwife until you go into the labour ward, and all of your antenatal appointments will be with the same obstetrician (a doctor who specializes in obstetrics, the field of study concentrated on pregnancy, childbirth, and the postpartum period) who in all likelihood will deliver your baby.
“In the UAE, a pregnant woman chooses to see an obstetrician (OB) who will deliver the baby and will take her through her pregnancy, providing all the scans, blood tests and regular reviews that she needs,” says Dr Kiren Sahota, consultant family medicine, HealthBay Marina Branch. “The reviews are more frequent than in countries like the UK, often accompanied by scans, and the doctor will also attend the delivery. Whereas some countries have free healthcare services, all of the UAE's healthcare services for expats are provided at cost to the patient (or medical insurance company). Furthermore, some women in the UAE are able to choose the form of delivery that they wish to have. For example elective C sections are more common here due to maternal choice than in the UK.
“The benefit I have found to the system here,” continues Dr Kiren, “Is that you have the continuity of care with the same person taking you through the pregnancy. The fact that you are seen so regularly and scanned regularly can make it very reassuring during the pregnancy which can be an exciting but anxiety provoking time. This has been criticized as apparently it can lead to unnecessary interventions, but appears to make parents feel comfortable.”
Although it is possible to give birth in a government hospital in the UAE, most expats pick private hospitals to give birth in, and there are a huge number to choose from.
All hospitals have their own in-house staff, and it’s worth noting that the cost of using these in-house ob-gyns to deliver your baby will be less expensive than bringing in your own ‘community doctor’ from an external clinic; generally the hospital will charge you a slightly lower delivery fee, but then you will have your own obstetrician’s fees to pay on top of that, which varies from about Dh5,000 to Dh10,00 for a vaginal birth.
Read more about UAE childbirth costs: ‘Everything you need to know about maternity insurance in Dubai’
Nevertheless, the in-house doctors at popular birth hospitals can often be very busy, and some women may prefer a more personal-feeling service at a quieter external hospital or clinic. Additionally, you may have an insurance policy that allows for more expensive fees, or you may be willing to spend the extra on a community doctor for the sake of giving birth with a professional who you feel really comfortable with. The most important thing is that you feel happy with the doctor you choose.
What’s the first doctor appointment I should book?
Maybe your period is late, or maybe you’ve taken a home pregnancy test – the first step is to book a doctor’s appointment to confirm the pregnancy and get some advice about your prenatal health – but this doesn’t have to be with an obstetrician you’ve never met before. “I would recommend a visit to the regular family doctor as the first port of call,” says Dr Kiren. “They can provide information on everything that needs to be addressed at this time, including supplements, dietary modifications discussing any medical concerns or history which may require extra monitoring, as well any other concerns relating or not relating to the pregnancy. This can also be done with the chosen obstetrician, although I know many people haven’t had a chance of thinking who they would like at this early time.”
“You only really need to see someone specifically for antenatal care for the prenatal tests around 10 weeks,” continues Dr Kiren. “Of course you can see an obstetrician at an earlier date but the essential monitoring starts around then”.
How to choose the obstetrician who's right for you
From the moment you become pregnant, you’ll soon find out that in the UAE obstetricians are curiously like demi-celebrities; the word on a good new childbirth doctor travels fast, and these medical ‘rock stars’ can become popular very quickly.
Therefore, the first place most people start when picking a doctor is through word of mouth; recommendations from friends, from people you meet at Mum-to-be mornings or prenatal exercise class, or from comments on social groups such as Mums and Bumps Dubai, Real Mums Dubai or Dubai Marina Mums on Facebook (request to join the group and then use the search function under the Posts tab).
However, others’ recommendations may be rather meaningless to you; it’s amazing how personal the pregnancy journey is, and how someone who your best friend raves about because of their involved approach can end up jarring with you and make you feel stifled.
Once you have an idea of a few doctors’ names and clinics or hospitals, get googling. The doctor’s bio is often written by them, and can give you a good sense of their credentials, where their interest lies and what their style of care may be like.
Some women find that they feel most comfortable with a doctor from a similar cultural background to them, as there are a lot of cultural norms around pregnancy and childbirth that we absorb subconsciously and it can be comforting to have that reaffirmed by your doctor. However, this is by no means always the case; Dubai is a cultural melting pot and doctors of every culture can be of a very high standard.
A key factor in deciding which doctor to choose is working out what kind of birth and pregnancy you want. Does it feel normal to you that your obstetrician (OB) should be very involved in your pregnancy, or would you rather a more hands-off approach? Would you like an OB who embraces natural or alternative approaches to birth, or would you feel more comfortable with one who focuses on safety above all else?
Dr Kiren expands: “Go with someone you feel comfortable with and who will be able to manage you as the patient you are. For example if you are a no-nonsense type of person and want that from your doctor, then go for someone who fits that specification. In the same way if you want someone who will hold your hand throughout, then go for them. Don’t simply rely on what your best friend says or recommendations on Facebook groups. If need be, shop around until you find someone who makes you feel comfortable and that you trust. You should also look into how their practice will complement what you want from your birth. For example if you want a vaginal delivery, do they support you through this or ask you to book for your section in nine months' time? Conversely if you want a waterbirth is this something they are willing to do? If not, even if they fit every other specification you have, they won’t be suitable for you.”
It’s an interesting balancing act and it’s largely personal preference, as OB appointments can range from scans at every session and minute weight-monitoring, to laidback, belly-measurements-only, and a doctor who will leave the majority of the delivery to the midwives.
When you have shortlisted your doctors, make an appointment with the one you like best and see how it goes.
At the first appointment with your OB, come ready with the date of the first day of your last menstrual period (the day you started bleeding). The doctor will use this to work out how pregnant you are likely to be (the first week of ‘pregnancy’ is counted from the first day of your last period, even though this was before you had conceived). The doctor should give you either an ultrasound scan on your tummy, or an internal transvaginal scan, depending on how far along in the pregnancy you are likely to be. Take note of how gentle they are – do they keep you informed of everything they are doing? How did they make you feel?
Then, you should have a little chat. The doctor should inform you of the important blood tests that you will need to have done now that you are pregnant, and asses your lifestyle and give you some advice on nutrition and supplements you may need to take.
This is also the chance to interview them. Here’s a checklist of things to consider asking at your first appointment:
Checklist: what to ask your potential doctor
- Which hospitals in Dubai do you deliver at (assuming they are not in-house)? If you have a strong desire to deliver at a particular hospital, obviously ensure they will deliver there.
- What is your delivery fee (assuming they will be a community doctor)?
- Do you have any plans to move clinics or countries any time soon (like all expats, doctors can be transient too)?
- Are you likely to have any travel plans around my due date?
- What is your C-section/ induction rate?
- What is your attitude to birth plans/ preferences? Read how to write your perfect birth plan here.
- What are your views on pain medication during birth? Read more about pain medication for childbirth in the UAE.
- Will you be happy for me to travel throughout my pregnancy? And if so what will you require?
- How often will you scan me?
- How often will we have appointments together, especially towards the end?
- What are the after-hours provisions; if I have a question or concern at the weekend or in the evening, what should I do?
- How long past my due date will you allow me to wait before inducing?
- In the instance that you weren’t able to make it to my birth, who would come instead?
- What sort of after-care do you offer after I have had the baby?
Remember; you are a paying customer, you are going through the most important journey of your life, and you deserve for your doctor to respect your concerns and make you feel valued, while they should also be comfortable with your preferences and attitude to pregnancy and childbirth. If they didn’t seem to listen to you, take you seriously, or seemed distracted, then it might be that they aren’t the doc for you. “If you can get the same person to take you through the pregnancy it may make things easier as they know you and vice versa, but do not worry if you do need to change at any time,” says Dr Kiren. “Even just before your due date! In countries like the UK you don’t even meet the staff who deliver your baby and outcomes remain very good.”