Differences Between Middle Eastern and US Pregnancy Services

One Middle Eastern woman’s pregnancy experience in both countries.

It is a blessing being pregnant and having a little miracle growing inside of me. I can compare between the prenatal cares I received here in the US, and in a Middle Eastern or Arabic country. I gave birth to my daughter is Syria, whereas my son was born in California.

Middle Eastern Prenatal Care is Good but is Missing Something.

To begin with, pregnant women in the Middle East can get good medical care during the terms, but all the services are specific to the physiological health of the mom and the fetus. Little attention is paid to psychological and emotional changes of the mother. Because of the war and the lack of a peaceful environment in much of the Arabic countries, many of the families were forced to leave everything behind and flee to a safer country. For instance, I was in Syria with my husband. My parents were in Libya, and his parents were in Iraq.

Since we were far from our parents and siblings, I often felt lonely. I was talking to my baby in my tummy to get rid of the loneliness. I cried and prayed so many nights, yearning for the days when we would all be together in one place. It was because of the lacking emotional support during my first pregnancy, that I waited for 7 years to have my second baby. With family and friend’s support nearby during my second pregnancy, it was easier emotionally. On top of that, there are diverse emotional and psychological services to guide the mom for a healthy mind and emotions to cherish this blessing and watch it grow and grow.

The Law, Freedom and Government Makes Healthcare Different.

A great difference in pregnancy care between Middle East and United States is how the law protects the patient more than the doctor. Women also have more freedom here to decide for themselves what is best for medical care. I felt the doctors in Syria were more confident and reassuring than the medical providers here. Doctors in the US seem more concerned about their license and how to avoid getting sued, more than they care about their patients. I felt they were afraid of taking most of the decisions on behalf of their patients. They explain pros and cons of the situations and they leave the decision to you. However, in Arabic countries Drs are more clear in their intents and decisions. Fewer options are given.


For example, in my second pregnancy I had Braxton Hicks contractions. I thought they would mean a premature birth. My Dr recommended that I reduce or stop my working hours to be on the safe side. I was encouraged to be on bed rest 2 months before my due date, so I followed his concerns. I was severely anxious. To make matters worse, I was spreading my anxiety all around in my family.

When I went to deliver my first baby in the hospital they found me to be 7cm dilation, and my baby was delivered within 15 minutes. The midwife involvement was extraordinary in Syria! My second pregnancy, I felt the first contraction at 6 AM and I waited until the contraction was one minute apart. I went to the hospital at 9:30am. After being checked in, they checked the dilation, it was 7 cm. I was given antibiotics and an epidural, and pushed with the contractions. Then when I felt that I could not wait any more and the baby is about to come out with the third push at 12:30 PM.  The whole process at the labor and delivery room took two painful and prayer filled hours.

Midlevel providers can do more here in the US, and that means we see less of the ObGyn, so they seem more detached.  In the Middle East, pregnant women are only under the care of an Ob/Gyn. A midwife can only deliver if the Ob/Gyn would not arrive on time. In coming from the Middle Eastern perspective, it feels like the physicians’ time gets substituted by physician assistants, nurse practitioners and midwives. It was harder for me to trust them in place of an ObGyn.

The Family Responds to Pregnancy differently here

Being separated from my family was hard for my first pregnancy. Our family was spread around due to the wars, and I did not feel supported at all. In my second pregnancy I had my families  support and our Middle Eastern traditions. I did not cook during most of my pregnancy. My mom was feeding me and my family. After the delivery, my sister stayed at my house for more than two months, and she was helping out with everything for me, the baby, my daughter and husband. It was a big help when she prepared meals, changed diapers and responded to the crying baby in the middle of the night.

 
Fathers in most Arabic communities are left out of early parenting. Mothers can enjoy maternity leaves for up to two years in Middle Eastern countries, and women stay at their parents' house postpartum for 40 days. In the US the early role of the father is essential. Fathers can also get paternity leave for baby bonding and mom caring, but Mothers’ maternity leave ends after four months for most of the US companies.  

Customer Experience in Prenatal Care is the chief Concern in the US

We do not need referral or prior appointment to see the OBGYN in the Middle East. I did not know I was pregnant in my first pregnancy. I walked in to the clinic with pelvic and back pain. After waiting for 30 minutes, I saw the OBGYN who after doing an ultrasound said that the changes in the uterus seems to indicate I am pregnant. Then they confirmed that by a positive urine pregnancy test. In the Middle Eastern countries we don’t have nurse practitioners or physician assistant, so we only follow up with the OBGYN once monthly. We also do not have prenatal classes, parenting classes or vocational nurses. The only provider who is available to give a woman pregnancy related information is the OBGYN.

Customer service and a positive experience are emphasized in the US.

In the US, the customer service in most of the places is exceptional! There are lots of people involved, and everyone seems excited to make the pregnancy a good experience. When I first came to the Pregnancy Care clinic, I was scared and worried about how I would deal with the clinic staff? I had many questions, but how would I communicate with them. As soon as I entered the front door of the Pregnancy Care Clinic, the receptionist asked me with a smile, "How can I help you?" I said, "I read your services I think I am a pregnant, I need a pregnancy test" It was easy to talk to her because she spoke Arabic, and helped me fill out the required forms.  It felt like a mountain of difficulties melted down, and I became more confidant that I was in safe hands.

They told me that my test result is positive with a smile. Then they gave me a package containing a pregnancy developing guide and other booklets that deal with parenting. They offered some useful classes, a handmade blanket, and suggested I return for an ultrasound. The nurse gave me a list of local doctors that I could choose for my pregnancy.

I went back home so happy. Not only was I pregnant, but I also found a friendly place that took good care of me and my medical, mental and emotional health. They also addressed my concerns and answered all my questions.

Pregnancy Care Clinic Offers Something I Had Never Experienced.

On my second visit my husband was with me to see our baby's first picture. They welcomed him and offered to speak to him if he had any questions or concerns regarding parenting and whether he was psychologically prepared for it. This was beautiful because this pregnancy came 7 years after the first. We had many questions and inquiries especially because we are new to the US. We have benefited greatly from the valuable information they have given us. In our country back home, there are no such services provided, no one would care about parenting classes. We have Arabic proverb that say: "wise people learn from their mistakes." New parents have no choice but to learn parenting skills from their mistakes with the first child!

The clinic continued to follow up during all of my pregnancy to the postpartum when they contacted me to check on how healthy my baby was and to invite me to come to the clinic to celebrate the birth of my baby. The celebration was beautiful and elegant. They took a picture of my baby and gave him some gifts also asked me if he needs any food, clothes, and/or diapers.

That was my experience of the difference in pregnancy care between Middle East and United States. At Pregnancy care clinic, my husband baby, and I got the benefits of helpful services in a friendly environment. We are so blessed to have these two miracles in our life, and they spread the fragrance of their love, kindness and smiles to all of our family and friends!

Many of the themes and experiences shared by this client of Pregnancy Care Clinic echo the experience of women in Saudi Arabia. The feedback they provided in this short term study highlights some of the strengths of pregnancy care in the US. More study should be given to whether the differences identified here are a one or the other relationship, or if a perfect medium can be found. For more about different birth traditions around the world consider this blog story from AWHONN.