Birth, from sand to state-of-the-art

Generations of mothers recall their experience giving birth in the UAE, a process that still involves ancient traditions as it modernises.

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As with every other aspect of society in this young country, giving birth in the UAE has seen tremendous changes: from being in labour in a tent on the sand to giving birth in a modern hospital. But, as Bushra Alkaff al Hashemi finds, the fundamentals remain the same.

"When I was in my early 20s, I helped my mother give birth to three of my brothers. At that time, my mother and I had no one but my father. We were living in the desert," remembers Mariam Meftah al Mansoori, a charismatic lady of around 50 years old (she does not know the exact date or year), who now lives in the Al Wathba area of Abu Dhabi. Over a long sufra (breakfast) of traditional dishes in her majlis, she reminisces about how much has changed in such a short time. "Unlike my mother, I gave birth to all my children in a hospital, apart from this one," she points to one of her daughters, then asks her when she was born. Fakhra answers, "Ummaya, in 1982", and smiles.

"Fakhra couldn't wait till I reached the hospital," continues al Mansoori. "She was born in the car. Ubo Mohammed, my husband, pulled over to a shady place by the side of the road, where I had her. Then he cut the umbilical cord, and we headed straight for the nearest hospital." Some people call it "the magic of life"; others, an "act of God", a "miracle" that allows life to continue. But more than that, an understanding of the traditions around giving birth in a society provides an insight into its culture, religion, environment and economy. What happens once the pregnancy is discovered? What preparations are made? What happens when a woman goes into labour? What are the beliefs, the fundamentals of raising children?

In the UAE it is a chain: giving birth is at the core of the family and family is a pillar of society. It takes women from one stage in life to another, where a girl becomes a mother and a mother, a grandmother. But to begin with it is kept hidden. "No one knows that a lady is pregnant until it shows," says al Mansoori, a mother of nine (all of whom work for Government departments) and a grandmother of five, who was born in Al Thafra, Baynoonah.

A busy woman with a constantly ringing mobile, she manages her farms and a construction company. "It was the custom to try and hide the news at first." A lack of labs or tests to confirm pregnancies, an expectant mother's natural shyness and her desire to protect the baby from "ayoon", or the evil eye, were among the reasons for secrecy. "There are still certain protocols that come with the news of a pregnancy. Until the mother is four months pregnant, nobody knows," says Om Mohammed, who preferred not to give her full name. A mother of four girls and a boy, she looked serene just a day after giving birth to her fifth baby, May Ahmed al Hamil, pictured on our cover, at Corniche Hospital in Abu Dhabi.

Om Mohammed, who is 31 and a Higher Colleges of Technology student, was born in Abu Dhabi but brought up in Liwa. She comes from a family of six brothers and sisters, all born in hospitals. She explains the protocol of whom to tell first. "In most cases, the young mother would first tell her mother, then her husband and then the husband would tell his mother." Husbands are always thrilled to know when their wife is pregnant, especially with the first child. This vibe of happiness is carried to the mother-in-law and the husband's sister as well. And they start helping the pregnant mother-to-be with the daily housework.

After nine months, prepared or not, labour time comes. Women can now choose between natural births, Caesarean sections or water births and have a choice of hospitals, but midwives or doctors had few options in the past. Al Mansoori explains the process: "There were no doctor's appointments and no vitamins that they gave to the pregnant woman except when she was eight months pregnant, a mother was given a little bit of sbr (or aloin, a bitter compound) covered with a date and made into a small tiny ball to be swallowed easily, which helps in labour.

"When the contractions began, two or three experienced women would assist and support her. And if there were any men around them, they would go to the other tent." Only the daya, who was the doctor/midwife, and two women would help. At this point most still did not know that the woman was giving birth. This was to avoid them feeling shy or distracted or having too many people around. Sometimes, brave women had babies completely alone, such as a lady now in her 80s, who told us the story of giving birth to her second child. "I was in my ninth month sitting in the majlis with my mother and the other women, and I felt it was time. I slowly took myself off and went to another room alone, had birth, tied the umbilical cord and cut it in one hour. Alhamdulillah, when my mother came to look for me, she found a crying baby beside me. And the matter was done."

Every child born comes with a story, and knowing your story brings you closer to your mother, God, and who you are, your very beginning, your very first moments in life. A memory of an arrival that you cannot remember is told by your mother or another relative. Was it a difficult arrival or not? Who chose your name? What was happening during those days with your parents? Where? Were there tears of happiness shed when they first held you?

However, not all stories are happy memories, as al Mansoori recalls: "My paternal grandmother died giving birth to her second child. He was never born. There weren't any doctors to deliver him even after the mother's death. It is amazing that they could cope with such harsh conditions; the dryness and extreme temperatures with no air conditioning, few resources, no health care and mothers dying in labour. It is clear that in this society, safety was not a matter for high-tech tools or doctors, but simply belief. Quranic phrases have been read to the mother, and by the mother to reduce the pain.

"When a mother is in pain, she can't really think what to say, but her mother would remind her - 'Ethkery Allah: call for Allah', she would say, reminding her to pray for people. While in labour your prayers are heard because a mother is nearer to Allah and in his mercy. I always read the last phrases of al Baqara and fak el karb prayer," says Om Mohammed. Many feel that while it is a blessing that we now have more medical facilities and knowledge to save mothers, it is a shame that they are sometimes misused. Instead of saving Caesarean sections or epidurals (or back injections as Om Mohammed refers to them) for emergencies, some mothers use them simply to avoid the pain of normal childbirth.

Although Om Mohammed has just recovered from a natural (rather painful) birth, she does not regret it. "I think that the pain of childbirth strengthens the relationship between me and my mother. I have more appreciation for her and what she went through to bring me into the world. It also strengthens the bond between me and Allah. I know that I am at this moment under his eye, never mind all the medical equipment around me. Finally, the relationship between my daughter and I benefits from the bond.

"Most local mothers I know don't opt for Caesareans or epidurals," she continues. "Even though they tell you the epidural is safe, it can be dangerous. So why take the risk if I can bear the pain? Once my baby is delivered and placed on my chest, I smell her and she smells me, I forget all the pain as if it was never there." In the same hospital, 25-year-old S al Mazroui, born in Abu Dhabi and a student at Abu Dhabi University, gives birth to twins, a boy and a girl, by Caesarean section, as advised by her doctor. "I knew that I was going to give birth this way because the doctor decided it was the best option. I thought I would be awake while it happened but my husband heard it was dangerous and preferred for me to be sedated, and I agreed."

Even these kinds of births come with pain: "After I woke, there was pain but I bore it and followed the nurse's directions and it was better." Al Mazroui is in her room with her boy. His twin sister is in intensive care but is expected to make a full recovery. Her mother, Hamama, was pregnant 14 times; some died before birth and the others she had naturally. At that time there was the famous Hamda Hospital in Qatar. "In the past we used to go to Qatar gabel hekm Zayed: before Zayed ruled. There weren't any Caesareans as there are now. They would operate by cutting in vertically and then sew."

Before the Corniche Hospital opened in 1984, where most residents are now born, expectant mothers would go to the Al Mafraq Hospital and some others in Al Ain and Dubai. "For my births, I used to go to a Pakistani doctor called Baraksy who was well-known," says al Mazroui's mother-in-law. In the past, after a baby was born a woman would go to the men's tent to convey the good news. Al Mansoori says: "He would be taken to the hands of his father or his uncle and he would recite 'al than' in the right ear and the 'egama' in the left ear as learnt from the Prophet. The father would name him. Then they would put a small amount of honey mixed with water and a tiny tip of a date in his mouth." Following this, the father of the baby would fire bullets into the air to announce the arrival of the baby.

"With no phones or e-mails, women in the next freej [neighbouring area] would only know of a baby's arrival by hearing the sound of the bullets fired. They would all come carrying gahwa and fuwala, and would walk to the mother to congratulate her," says al Mansoori. A woman's safe delivery is always happy news, but sadly some fathers have not always been there to hear it. "Some women would be pregnant when the man left to go pearl fishing. They stayed for six months and would inform someone back home what to name a baby when it was born, and an uncle would take over. Sometimes by the time they came back, the baby was already crawling."

Elderly women tell stories and young mothers listen: "Through our grandmothers, we knew everything about the past and as much as possible as mothers we try to go back to our origins," says Om Mohammed. "Allah says in the Holy Quran, 'And We have enjoined on man (to be good) to his parents: in travail upon travail did his mother bear him, and in years twain was his weaning: Show gratitude to Me and to thy parents: to Me is (thy final) goal. Surah Luqman, 31:14'.

"From the very first day of her pregnancy a mother is being tested until the time of the labour. A mother should know that God knows the internal feelings and thoughts in her mind. If she wanted a boy and was upset that she got a girl or vice versa, that is wrong. Allah knows best. And you have to have retha: a satisfaction with what is given to you." Al Mazroui plans to stay at home with her baby after giving birth. "I am going to stay, insha'allah, in the house for 40 days, a tradition from the past; some girls now really understand how important this is. And my husband is going to name my children. He will name them on the seventh day of their birth."

Even in these modern times, the old traditions flourish and mothers are proud to continue them, even though most now prefer the Corniche Hospital to a tent.