New antenatal programme to boost care for mums-to-be

ABU DHABI //Guidelines that are to take effect by July require every hospital and clinic in Abu Dhabi that treats pregnant women to schedule a series of 10 appointments with first-time mothers, and seven with women who have already had children.

Health chiefs say the standardised antenatal programme will improve the quality of care in the emirate.

The Health Authority-Abu Dhabi (Haad) is giving hospitals and clinics six months to comply with the new system.

Doctors and midwives in the capital agree that the lack of a single, clear system has resulted in scores of pregnant women receiving inadequate treatment.

"Sadly, we do see a lot of referrals where the care has not been up to what it should be," said Dr Gowri Ramanathan, a foetal medicine specialist and consultant obstetric gynaecologist at Corniche Hospital.

The appointments, led by midwives or obstetricians, are meant to ensure that women are fully prepared to deliver, said Dr Jennifer Moore, the section head of family and school health at Haad.

It has not yet been determined whether the guidelines will require the hiring of additional staff.

There were 31,691 births in Abu Dhabi last year, up 8 per cent from last year's 29,327.

Dr Moore said that while most hospitals and clinics offer exemplary care, standardising the guidelines will iron out any weaknesses.

"A woman who is pregnant needs to be able to trust that the care she's getting at any healthcare facility is the best," she said. "We found that although many institutions are providing excellent antenatal care, this is not always the case. The standard is to ensure that all healthcare facilities that offer antenatal offer a best-practice approach."

Noreen Healy, the head of Al Ain Cromwell Hospital's nursing department, has seen her fair share of patients turn up to the hospital unprepared to give birth.

"Women should be seen every week in their last trimester, from 36 weeks to 41 weeks. Here, they tend not to. I find sometimes a woman might be seen at 36 weeks and next time she comes it is because she is due to give birth," Mrs Healy said.

She said that though a woman might think she is past the stage of developing complications in the last few weeks of gestation, that is not necessarily the case.

"Maybe the placenta isn't going to work as efficiently; maybe the growth isn't going to be as good as one would expect; maybe their blood pressure is going to go up. Something could be going wrong."

Another worry for mothers-to-be is that doctors might not be able to spend an adequate amount of time with them.

"The problem is, antenatal is so busy in every hospital and your appointment is so short and so rushed. They are more worried about whether your blood pressure is fine and whether the baby is fine than they are about giving you information," said one mother and midwife who asked to remain anonymous.

Each session with a doctor should last 20 to 30 minutes, said another mother-to-be, who is due to give birth in April.

Under the new regulations, Dr Moore said, specific topics should be discussed at certain stages of the pregnancy and no doctor-patient session should leave women with unanswered questions.

For other women, the worry lies with in whether one doctor will oversee their appointments and whether the midwife or obstetrician supporting them will be the one to deliver their child.

"Continuity of care is very important," Dr Moore said. "It is important for a doctor to know the results of a patient's previous antenatal visits. If a woman would like to have the same physician throughout the antenatal period, we encourage her to choose a healthcare facility that offers this service."

Mums-to-be who have their baby delivered by someone other than the obstetrician they see for their antenatal care will also have their cases handled efficiently, she added.

Mrs Healy said addressing problems with the current system will help to educate expectant mothers, in turn leading to a reduction in the number of complicated births.

"The biggest issue is education. Women need to know what happens to their body during pregnancy."

Many pregnant women in Abu Dhabi lack even the most basic information, said one mother.

"There are women here who have no idea at all. No idea of where to go, for a start, and no idea of what to ask for so they end up researching on the internet," one said.

Said another, "A standardised programme is a really good idea, because then you'll have faith that wherever you go the care will be the same. There's a big lack of antenatal care here and we are all for a new system."