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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Up the Duff (3): My anger towards pregnancy manuals

We found out we were pregnant immediately after moving to a foreign country where we don’t know anyone and don’t speak the language. We found a great doctor and health care, but support groups and classes are non-existent here. So until we become integrated enough to have a circle of acquaintances/friends, I’m desperately looking for books on pregnancy and going into online chat rooms looking to share worries, discuss issues, and get reassurance from other women.

But pregnancy, I’ve discovered, is a big business, and one that is based more around an idealized myth of what it’s supposed to be like rather than on honest and practical realism. This is why I usually shy away from the self-help section of the bookstore: it seems to perpetuate some pop-media created ideal of what type of humans we are supposed to be. Not climbing the corporate ladder fast enough? Here’s what you’re doing wrong. Can’t communicate with your parents? Here’s why your family is messed up. Having problems conceiving? Here’s why it’s your fault.

Because of pop culture, I’ve always believed pregnancy was this beautiful time of graceful womanhood, and a time when your body is beautiful and glowing. Celebrity twits keep this up by proclaiming how “empowered” they feel. I understand that they need the public to see that they are happy to be pregnant, but let’s call a spade a spade. For most women, pregnancy is not empowering. Actually, it’s the pits. To say one is in a “delicate condition” is far more accurate. Delicate is exactly what I would call myself these days, in every sense.

At the bookstore, the first manual I picked up was Dr. Spock because it’s sort of a requirement. It was too thick, small print, and not at all something my ADD hormone addled mind is capable of focusing on. No humor, no real discussions about the “discomfort” of pregnancy. Discomfort? Discomfort?! It’s a non-stop migraine popping puke fest. Bloody men. In the first section, Dr. Spock wants to know my goals for my child. What goals, I don’t have any goals? A healthy baby is about it, the rest is up to the kid. Then he asks what my aim is. You’ve got to be kidding me. This book goes back on the shelf. I don’t want some stupid manual making me feel badly because I don’t have colleges picked out, and I don’t want a manual that gives me homework.

Next up, I pick up The Rough Guide to Pregnancy, which claims to give the lowdown on “blokes, bosoms, and busybodies.” Yep, this is more up my ally. Into the basket.

Next to that is Deepak Chopra, which I just put in the basket because, well, it’s Deepak and I usually fall for his whole mind/body medicine, plus the cover looks peaceful and text type inside is nice and big. Big mistake. I get home and really look at the title: Magical Beginnings. Chapter Six is actually called “partners in love” and the conclusion is titled “healing the world one child at a time.” I don’t want to sound like a big hater, but given my whole anger at the world for misrepresenting the truth about pregnancy, Deepak can take his lovey-dovey outlook and shove it you know where.

The fourth book, beautifully entitled “Wiped: Life with a pint-size dictator” is actually more about the third trimester and life after birth, but I love it. The first line of the preface says “here’s the thing: you could say I didn’t exactly enjoy being pregnant.” Bingo! The author goes on to admit she can’t figure out the diaper genie and ponders why, if she hasn’t had a drink in nearly a year, she still looks worse than she ever did with a hangover. I want to know exactly the same thing! And Spock doesn’t even cover it. Doesn’t he know what’s important?

I find it interesting that the horrible “pregnancy is a time of graceful empowerment and the opportunity to better yourself” kind of books are written by men. As if they would know! The totally realistic, filled with love and practicality books, are written by women who have actually been pregnant. It’s like, if I have an issue, I can always go to my doctor for an answer. But when I go into the chatrooms and find 100’s of other women wondering about the same thing, I feel so much better. These books do the same thing. Reassurance is all I’m really looking for, along with humor and realism. Deepak and Dr. Spock just doesn’t compare.

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