Up the Duff: Natural Birthing Classes in Dar

Most of the ex-pat women I know who have children have given birth in their home countries for their first child. The one woman I do know who gave birth here in Dar es Salaam is an American who’s entire family lives here, and they moved here from Zimbabwe. I suppose if my entire family lived here and I had no contacts in the USA, that would make a lot of sense. The one lesson that is most important in childbirth is to have a support system. If you can’t get it where you are, go somewhere else. That’s why for our first child we are returning to the USA instead of going closer to home.

Our doctor made it clear that she would not deliver a first-born, and we would need to go to the Agha Khan hospital because they have better equipment to care for the mother. However, she stressed that no wear in Tanzania is adequately prepared to deal with taking care of a newborn in distress (oxygen, etc.) Because of that issue, she recommended that we consider returning to the USA, Europe, Nairobi, or Johannesburg for the birth of Kidogo.

Agha Khan has great technical resources (the Agha Khan foundation is fantastically wealthy), but they are somewhat behind the times in patient care. I did meet with a doctor there………. It didn’t work out. There was a total disconnect between my western sensibilities and her Afro/Eastern mentality. I wanted information, and I came with a list of questions. She was overwhelmed by my questions and responded sort of like a limp wrist. Clearly, she came from that all-too-common African/Indian medical culture of the doctor simply proceeding with a check-up then telling you when your next appointment will be. She didn’t share anything to me about the state of my own health or that of my baby, but simply dismissed me. When I asked her where I could get information on pregnancy, she told me look on the internet. The next day I learned that there are English-language bookstores all over Dar es Salaam (in coffee shops serving iced lattes no less) with a large variety of pregnancy manuals, mostly from the UK.

I decided to take my prenatal care at the European clinic, in conjunction with a pediatrician clinic that is run by Tanzanians all trained in Europe, even though it does not have the super tech equipment of the Agha Khan hospital. The decision was an easy one: I didn’t even have to pull out my list of questions, my doctors, Western trained or European, know intrinsically what I needed to hear and dispensed information rapidly. They then directed me to appropriate resources for further investigation. Since then, I’ve been very happy with my care, and each issue has been attended to efficiently and immediately. To date I haven’t had any major issues, but I know that if I do they will be spotted quickly.

Since I’ve had more time to know Tanzania, I’ve learned that there are a host of skilled midwives, African, Indian, European, American, and many doulas and yoga instructors that assist with natural birth. Epidurals, unfortunately, are out of the 1970’s spinal tap era, and drugs are not to be trifled with. The hospitals are well equipped to handle cesareans if necessary – in fact the gossip is that they will give you an unnecessary cesarean if they think you can pay for it.


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