Interesting article about birth in the Arab world. Some really interesting comments too.
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What countries, exactly, are included in "the Arab world"? Is this the same "Arab World" where women aren't allowed to drive cars or hold jobs without permission from a male guardian? And what are infant and maternal mortality rates like in that world?
And while it's great that Yemeni national Umm Hamada is totally chill with giving birth on her own (as are a number of women in other parts of the world who feel really confident about their bodies and their risk factors) I wonder how another Yemeni national - one who is, perhaps, much younger, having her first baby, and experiencing some bleeding in her 7th month, just to create a random hypothetical example - might feel about being in the same situation. I'm imagining my hypothetical 16 year-old with undiagnosed partial previa sitting home with her legs crossed and hoping that she'll be better off than the sheep. I don't know what she would want, but I'm guessing that giving birth all by herself and having a handy relative cut the cord with a sterile knife might not actually be all it takes to manage her needs. And how on earth is a mom supposed to ensure that her children are sufficiently well-timed to provide birth education to her daughters? What makes Umm Hamada think that everyone else is totally capable of giving birth Just Like She Does?
Sheep are quadripedal, and don't have the same pelvic anatomy that humans do, so the sheep example is biologically irrelevant. But I think it's worth pointing out that sheep are actually notorious for having difficulty lambing. They don't have great infant and maternal morbidity and mortality rates either. The veterinary axiom for sheep is SSSS - sick sheep seldom survive. It's a justification for shooting them rather than investing significant time and resources in treatment. There are much better medical options available to women.
I think access to care and to skilled attendants in labor are crucial to improving worldwide childbirth outcomes. If a woman wants to give birth without a skilled attendant, that's her choice, but it should be a choice that's made freely, and not because of fear of necessary medical intervention or concern about cost. The more I learn about birth, the more hostile I find I am to efforts to hype unassisted birth as an awesome option for women who live in poverty or under oppressive regimes.
Because let's face it, who makes birth choices for Saudi women? It's not like they can contact an MD and drive to an appointment on their own if their guardian is opposed no matter how crappy his reason for opposing care may be. UC in the US is often presented as a way that a woman can express her power and autonomy - but the same would obviously not be true of a woman who is UCing because she can't reach care, or whose guardian is making the decision for her.
ETA: Finally had time to look at the comments.
CJ wants to know how to get a birth certificate if his wife gives birth at home. Great to know that CJ is considering his options.
Chris points out that the hospital in Medina is crappy. Good to know. He thinks home birth is a good option for low income families. Nice to know he's thinking about the needs of economically under-privileged women. Not so much about the needs of women who suffer life-threatening complications in childbirth, but hey, hopefully they won't be poor.
Nadeem proposes a mobile health care service. Interesting idea. Would probably help a lot of people. Isn't advocating UC, but is looking for a low-cost way for women to access care.
Shu'aib is glad his (American) wife gave birth at home, because the hospital is just a business that scares women, and lots of women give birth at home in the West. I'm not sure what he's getting at here - does that make home birth more modern? more safe? Evidently, it's at least more relaxing. I'd love to know what his wife thinks.
Syed says home birth is dangerous, and families should use the 9 months of pregnancy to budget for the hospital. Interesting notion, but doesn't really address a number of problems families face.
S says if you can't afford a hospital birth, how can you afford to raise the child? Interesting expression of economic privilege, not very helpful.
Just Thinking is concerned about women's privacy. No one should have mentioned the thing about it being shameful or weak to cry out. It's intrusive.
Shu'aib is a single computer engineer. He thinks it can't be that hard to use sterilised equipment to cut an umbilical cord. He's right - it's not. Too bad that's not the entire extent of assistance a woman might need during or after childbirth. I wonder if he carries methergine or knows how to suture?
Imran says women should decide for themselves. I'm inclined to agree with her.
Aisha says we should all trust Allah's perfect design for childbirth. I'm glad Aisha's birth went well, and I think her criticism of Saudi birthing culture probably has more merit than Shu'aib's, but I also think she's enjoying the privileges of good health and a good birth, and forgetting that not everyone is so lucky.
Cynthia asks for stats on the risks of home birth and suggests low-cost birthing centers. Hi Cynthia! The stats really are on Syed's side, and much more so for women who give birth without a skilled attendant, which is what the article is proposing, though not what Cynthia seems to have in mind. She favors low-cost birth centers, which is a model that is being pursued in several parts of the world with nice results.
Yes, those were interesting. So is the article Aisha links in her last post, in which she notes that it's really hard to find a midwife in Saudi Arabia.
On the one hand, I think those that advocate for home births have a point...we have learned that interventions may lead to complications. I'm all sure we have a friend or sister where it is easy to make this assumption.
Yet this article and the very thorough reply above gave me pause. I LOVED my birth experience. I went without medicine-free and had the best delivery in a hospital with wonderful nurses and an OB who supported my decisions. I was excited and giddy, my husband was happy and relieved, my son was vital and breastfed immediately - it was awesome. I was on an emotional high for weeks...I would relive the birth in my thoughts over and over again. But. Thinking back...everything wasn't "natural" - I had a second degree tear that required stitching and I received local anaesthetic (sorry for the spelling). I'm really quite thankful I didn't have to deal with that at home without help!
Like the poster above...I think it's all up to the mom. If she's comfortable at home and has confidence in the skills of her caretakers, I say go for it. I'm glad I had the option of having a hospital birth according to my birth plan.
Blessed mom (11.10) and wife (5.01-met/12.07-married). HI!
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