Monday, 5 September 2016

Pregnancy in Oman: Part 1

Hesitantly, I label this part one. I have the very best of intentions to make this at least a two part post, but anyone who has read this blog even semi-regularly will know I can be a very lazy blogger.

I'm into the last stretch of my pregnancy, and I thought it would be nice for myself to document how its all been going as well as a little bit about how the process works in Oman.

I'll start with me...

I figured out I was pregnant pretty quickly, at about four weeks, and decided soon after that we would keep the news to ourselves until the traditional 12-week mark. I was excited, happy, and fearful all at the same time, which for baby number one I expect is entirely normal. My main fears were about being so far away from home: I still don't understand the health system or process here. More than anything, I was disappointed that I wouldn't get to share the pregnancy progress with my family. Having shared every major life milestone with them up to now this still seems like a huge one to be missing.

I didn't get any morning sickness, I did, however, hibernate for a good couple of weeks, feeling completely exhausted all the time. That wasn't helped by getting a cold that I had no idea how to treat, and I doubted my usual pop-Panadol-until-you-feel-normal strategy was a good one. This was also my first experience of the health centre, which I'll get to later. Pretty much on cue, at 12 weeks I felt better again, but from what I understand the tiredness will creep back in again soon.

Other random symptoms I had in the first trimester included having a metallic taste in my mouth, all the time. Eating helped, but eating non-stop isn't a solution. I had read about women suffering from this for the whole pregnancy, which I dreaded, but luckily it stopped. Disappointingly, I haven't had any cravings. The only difference is wanting my drinks extra cold because I always feel overheated, but considering the temperatures this summer I'm not sure that counts as a craving. I think I'll have to make up a craving and send my husband out for some random treat at a weird hour...just to say I've done that.

I felt the first "flutters" at around 13 weeks, but considering one of the "side-effects" of pregnancy are digestions issues (I'll say no more), I was never sure what was baby and what was digestion. As for the first official kicks, they were a couple of weeks later (I'm regretting not making more of a mental note of the date), and now the baby is very active at random points in the day and will stop when anyone wants to feel.

Ok, enough of me and now onto the baby and healthcare.

As I mentioned, my first experience of the local health centre was when I caught a cold, which made me feel even more tired and weak than I had been feeling. I took the day off work and spent most of it in bed, then went to the health centre to get a sick note and maybe some drugs. After waiting over half an hour, I was asked if I would mind seeing a male doctor and because I didn't, I could be seen sooner. I explained my symptoms and mentioned as a passing comment that I was six weeks pregnant. The horror that passed over the doctor's face was quite something, and he told me that if I was pregnant I really needed to see a female doctor. I told him I wasn't there about the pregnancy specifically that I just felt awful and needed him to bare that in mind if he thought I should take anything. He told me I needed bed-rest and then granted me a generous one-day leave from work (the day I had already called in sick). I let the sickness ride itself out, and slept a lot at my desk.

I started off at Starcare thinking that our insurance would cover me, I had a scan to get a rough idea of how far along I was and was advised that I would need to have a bookings appointment and get my green card. Since this would all be at a cost at Starcare, I went to my local health centre and decided to continue my care there.

What I didn't realise at the time is that you can register at any health centre, and some will have more facilities and different types of doctors available than others. I just went to the one closest to my home. They took blood to test my glucose levels, HIV status, and some other blood-related things, and a urine sample to test for infection. There are no appointments at the health centres, and you are seen first-come-first-serve. It took me a good half hour to figure that out. Even though you check-in at reception, you aren't called in by the doctor, and you need to walk into the doctor's office and leave your green card/ID on the table otherwise you'll just be hanging out in the waiting room. After a week I returned to get all the results and be officially registered as pregnant, which is when I got my green card, had a dating scan with a radiologist, and a brief visit with the doctor. The strangest part of the doctor's consultation was that as part of the chest exam I was given some advice about how I should breastfeed, which seemed utterly useless at that stage of the pregnancy especially since all the information I was given about my next appointment was "check-up".

At that same appointment, I was booked in for my 5-month scan, which would be at a local polyclinic since the health centre didn't have the facilities. I was also asked to come in for a glucose test since I have a family history of diabetes. Again no set times for either appointment, but showing up as soon as the clinic opens has been a good strategy for getting in and out as quickly as possible. I would say all my appointments and check-ups have averaged at two-hours. The polycentre where I had my 5-month scan is especially efficient, having my fasting blood sugar results processed within two hours. The only disappointing part of the experience was that my husband wasn't allowed to join me for the scan purely based on the radiologist being a bit miserable. Considering that our first view of the baby together was nothing but a small blob, we were both excited to see something a little more human and from speaking to the nurses it was at the radiologist's discretion if your husband could attend so to be told he couldn't come in with me was very upsetting. I was given some excuse about time, but I don't think him sitting in the corner would have affected anything; it's just a totally female environment, and she was being miserable. The scan reassured me that all was as well as they could tell growth-wise.

Having hit the third trimester now, check-ups will be monthly, and I have another scan booked in just over a month before the baby is due.

My overall feeling of the pregnancy is one of ignorance: I haven't really seen anyone or been told that much. There is no assigned midwife to call with any questions (which is the system in the UK), and I haven't seen the same doctor twice. While everyone has access to my notes, that is nowhere near the same as having a doctor or midwife who has seen and had regular conversations with you. Also, there is also no general care, and by this I mean general advice about the pregnancy and what to expect, how to stay comfortable, if certain symptoms are normal and how to deal with them. I've had to turn to the internet and books to get the answers. The doctors also ask questions without giving me the information to answer them properly. For example, "are the babies kicks good?" Based on me feeling kicks, they're great, but should they be more or less? That's something I would expect the doctor to tell me.

While I've tried not to think about the birth, being only 11 weeks away now, I would expect some advice or to be asked if I have any ideas or preferences about how it happens. I don't think there are any birthing or antenatal classes (although I have seen some advertised privately). I know every woman says that birth plans tend to go out of the window, but I have no idea if they encourage natural, drug-free births, if something like an episiotomy is routine, or if my preferences will be respected and taken into consideration. My biggest fear is them doing things without my consent.

There are times I wonder if using the government facilities was a wise move mostly because I know they will continue to tell me nothing without a lot of questioning and effort on my part. Having read blogs about other people's birth experiences in private facilities, I don't know if that would have been a better option and as I write and think more about this the temptation to jump on a plane back home is huge. Ultimately, I think I am just going to have to take the attitude that it will all come down to luck (keeping my fingers crossed that I have helpful and compassionate staff on the day, and the baby comes out without too much difficulty), and this would be the case wherever in the world I am.

I may post a blog about the books and resources I have found helpful but, otherwise, I will try to go back to regular postings and follow-up with my (hopefully) happy birth experience story sometime after November! 

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