In September, Abu Dhabi's Corniche Hospital celebrated 30 years of delivering babies.
Marking the anniversary, chief executive Linda Clark spoke of the significance the hospital holds after decades of delivering generations of the same families.
But two months later, management revealed that the 235-bed hospital was full and had been operating above capacity for years, causing increasing delays for patients.
The hospital advised women to turn to other providers.
But some expectant and existing mothers say there is only a limited choice when it comes to choosing maternity care. Abu Dhabi expatriate Victoria Bautista, 33, is one of them. She was unhappy with the way a private hospital handled the birth of her first baby, because she felt it was too focused on the medical side and not enough on the holistic.
“I was scared because it was my first baby,” Mrs Bautista says, recalling the birth of her son Diego. “I went with what the doctor suggested, without taking the time to research and question. I ended up with an induction that was too early and unnecessary.”
Despite her doctor signing off on her birthing plan, which was geared towards as natural a birth as possible, he encouraged her to be induced and have an epidural.
She spent 36 hours in labour.
“I’m glad I took the epidural but if I’d had a natural birth I wouldn’t have needed the epidural. My body would have progressed on its own,” she says.
Mrs Bautista, from Mexico, took hypnotherapy birthing classes and consulted a doula to better prepare for the birth of her second child.
The delivery could not have been more different from her previous experience. The couple decided to remain at home until labour had begun properly to minimise unnecessary medical intervention.
“It was a super, super-quick labour,” she says. “I wasn’t in a lot of pain. But then it all happened so quickly and I didn’t make it to the hospital.”
Luna, now three months old, was born at the couple’s home despite their best efforts to reach the hospital.
After the birth, she needed a minor procedure to fix what is known as tongue tie, where the baby’s tongue is attached to the floor of the mouth with a tight bit of skin.
It can affect the child’s ability to breastfeed but can be fixed easily, without anaesthetic if the baby is young enough.
Mrs Bautista’s son also had a tongue tie. She took him to Dubai for the procedure when he was six weeks old because she could not find anyone to do it in Abu Dhabi.
“Then I took Luna to Sharjah when she was four days old. It’s a really simple thing,” she says. “Midwives used to do this as standard, but you can’t find anyone in Abu Dhabi who will do it.
“Breastfeeding support here is very, very different. For some women it’s easy. For a lot of women – me included – it’s a big learning curve.
“You need a specialist who watches you feed and shows you how, and looks for things that you don’t even know can be the problem. I didn’t get this here.”
Mrs Bautista also could not find a place for a water birth or a hospital that would allow a doula to be present.
“I couldn’t find water births in Abu Dhabi,” she says. “Some hospitals are very hostile towards doulas. They have strict policies that only allow your partners in. “It’s all about having choice. Women should have options.”
While options are limited there is some light at the end of the tunnel. BrightPoint Women's Hospital, attached to Al Jazira Sports Club, is expected to be open by the end of the year. It has already registered 700 women since the outpatient clinic opened on July 1.
The New Medical Centre group, which operates the hospital, has been consulting with patients and focus groups for more than two years, and is waiting for final approval from authorities before opening.
The results of the focus groups were minor tweaks to room designs to include mirrors, small rugs, clothes hangers, valet parking and play areas.
On the medical side, there are four separate neo-natal intensive-care unit rooms and a level-3 Nicu ward, four gynaecology and labour theatres, an emergency caesarian-section room and two relaxation water baths.
The latest statistics from the Health Authority Abu Dhabi, or Haad, revealed that in 2012, bed occupancy at the Nicu at Corniche Hospital was consistently higher than 75 per cent, and less than 50 per cent at private hospitals.
That year there were only 29 Nicu beds in Abu Dhabi – 18 in Burjeel and Al Noor private hospitals, and the rest at Corniche Hospital.
“Maternity hospitals are difficult to operate,” says Dr Anselma Ferrao, the medical director of BrightPoint who used to work at Corniche Hospital. “You can’t have maternity without a neo-natal intensive-care unit.
“First you work out who you want to care for, then you decide where you want the hospital. It needs to be easily accessible for patients. Then you decide how many patients you’re going to look after. This takes time.”
Frontline maternity medical staff are women, with men allowed to work in neo-natology and paediatrics. There are lactation specialists and licensed midwives.
Dr Ferrao says women will be assigned a midwife who will remain with them throughout their stay at the hospital, but will not be able to deliver babies on their own.
Midwives working in Corniche Hospital are licensed by Haad.
The 80-bed BrightPoint Hospital will be open 24 hours a day and will have more than 500 staff.
With the news that Corniche Hospital is not accepting any new patients, the need is greater than ever.
Leah, 38, is five months pregnant with her second child. Her first, a girl, was delivered as a high-risk baby at 32 weeks at Corniche Hospital last year. Her private doctor recommended that she go there.
“Her advice was based on its years of experience in terms of the numbers of deliveries and having seen so many different things,” Leah says. “I was under the care of a consultant.”
But she says the lack of transparency with maternity care in Abu Dhabi makes it difficult for women to make informed decisions.
She now sees three different doctors because she wants to be confident of her care. One is at a private clinic, another at a private hospital and the third at Corniche Hospital. All of the care is covered by her health insurance.
“I’m fortunate and grateful to be able to continue at the Corniche because I feel it’s the right clinic for me to be delivering at,” Leah says.
“You have to be proactive and very resourceful to build your resources here and create a network. My network has improved whatever care I’ve got. There’s people to consult, there’s discussion boards, there’s mothers’ groups, but you have to piece it together.
“I believe in very holistic care. There’s a whole spectrum of other things that should be in place to support a mother’s needs. We are in the very early stages of this thinking here.”
Most of the women Leah knows also gave birth at Corniche Hospital, but some travelled further afield.
“Some people go to Dubai,” she says. “I couldn’t because it was too risky, but people do travel to Dubai to give birth.
“I don’t think there’s a shortage of care in Abu Dhabi, but there is a shortage of care at the Corniche. They are overwhelmed, which is an indication of people’s belief in their care.
“It’s great that they are midwife-led. That’s a major point for me. I’m happy that there’s that experience that we can have in Abu Dhabi. We need to see more of that.
“People need to have choice. It’s unfortunate if women aren’t going to have that choice in care.”
Leah and her husband discussed their options before registering at Corniche Hospital when she was 11 weeks pregnant.
“We are a family and we discussed it together,” she says. “I didn’t know what I would have done. The option would be to move all of us to Dubai at a certain point on a short-term basis.
“I would have had to explore that option. I didn’t want to go overseas.”
Because of her first delivery experience, Leah needs to give birth at a hospital with level-3 Nicu care. BrightPoint will offer that.
“They’re not open so how is that even an option for me? I’m not going to rock up in a high-risk and dangerous situation to somewhere that doesn’t have a track record.”
Leah also refers to a lack of transparency and says the hospital could have been more open about the changes earlier so “people could be prepared and not in a panic”.
“There are no other equivalent options. That’s where the problem comes in. It can be scary or frustrating for someone in medical need.”
munderwood@thenational.ae