| Dubai, United Arab Emirates

Caesareans in Dubai

Caesarean or natural birth: the choice is not always yours. Time Out looks at your maternity options in Dubai

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Fear, vanity, Victoria Beckham – blame what or who you like, but elective Caesarean sections are more popular now than ever before. Sceptics would have us condemn this as a selfish – and unnecessary – threat to the baby’s health, but is this really the case? There are dangers in all types of childbirth, be it vaginal or through surgery, but it’s now got to the point where there’s so much scaremongering out there, it can be difficult to see the wood for the trees.

‘I’ve been doing this job for 18 years and the amount of Caesareans being performed has undoubtedly gone up,’ says Dr Ibrahim Abd Elrahman, a specialist in obstetrics and gynaecology at The City Hospital. ‘I’d say we’re heading towards about 25 to 30 per cent of births in the UAE being done by Caesarean section.’ To set this in context, the rate in the US is almost one in three, while some regions of Italy report a Caesarean rate of 90 per cent. The World Health Organisation (WHO) recommends that the rate should not exceed 15 per cent in any country.

Other than in extreme cases like Italy, most C-sections are performed for health reasons. Often, these do not become apparent until labour has started, in which case an emergency operation is performed. However, there are also non-emergency medical circumstances under which a Caesarean is generally recommended by obstetricians: when the baby is breech (ie set to come out feet, rather than head, first), if there’s a family history of problematic childbirth, or if the mother has had previous birth or post-birth complications. But although medical factors account for the greatest proportion of Caesareans, around a tenth of Caesareans in the UAE are part of a well-documented trend emerging for women to choose not to give birth naturally for non-medical reasons.

Upon hearing this, most of us probably picture a bimbo scheduling in her hospital appointment between lunches and manicures. The media have dubbed this stereotype ‘too posh to push’ – perhaps unsurprisingly, given that celebrities such as Victoria ‘Posh Spice’ Beckham have played a part in popularising the practice (although Beckham’s Caesareans are actually said to have been for medical reasons). However, most women considering having an elective C-section would argue that it has nothing to do with how posh they are; the real reason is far simpler than that: fear.

Despite the fact that women have been giving birth since, well, the beginning of the human race, pushing a baby through a hole which seems so very, very small still seems pretty unnatural to many (apparently, size-wise, it’s the equivalent of a man pushing a tennis ball through his urethra – ouch). OK, so women have a handy elasticity which men lack, but that still doesn’t go far in assuaging the absolute terror many of us feel when considering the concept. Horror stories from friends who are ‘only trying to help’ just make matters worse.

The anti-C-section brigade would have us believe a natural childbirth is the only safe option, and the prevailing discourse is that Caesareans should be viewed as a last resort rather than a lifestyle choice, but vaginal deliveries are not without their risks either. Dr Ibrahim says these can be split into those to mother and those to baby. ‘Some of the biggest risks – and these are still rare – are tearing of the uterus during delivery, infection, and heavy bleeding,’ he explains. ‘There are also problems that can occur after the birth: if there is tearing of the perineum during labour, this can sometimes heal improperly, resulting in possible later problems with intercourse. Women can also suffer prolapse, whereby the uterus drops.

One of the side-effects of this can be urinary incontinence, but prolapse can often be helped with physiotherapy or, if that doesn’t work, surgery.’ Dr Ibrahim goes on to explain that prolapse is actually possible with any pregnancy; natural childbirth merely increases the risk, but it is not a life-threatening problem and, as such, many women just get on with things and never report it to their doctor.

By Ele Cooper
Time Out Dubai,

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