Wednesday, April 27, 2011

KD130 Health Insurance Plan Worries Expats

Published 27/4/2011 in Arab Times
‘Price Hike, School Fees, Rent Enough Burden’
KUWAIT CITY, April 26: Expatriates are concerned over the proposed health insurance scheme through which they shall receive treatment in 3 separate hospitals and 15 clinics after paying KD 130 yearly instead of the current KD 50.

In the proposed scheme, families will receive discounts that will cover lab and X-ray examination, as well as medical checkup, reports Al-Rai daily.

Based on opinions sampled by Al-Rai daily, expatriates are worried about the financial implications of the health insurance scheme, considering the hike in prices of foodstuffs, fees at the private schools, rent and other miscellaneous expenses, while some urged a rethink of the proposal, in order not to complicate life for expatriates.

Tuesday, April 26, 2011

Evidence-based practice in providing care for the mothers and babies

Milbank Memorial Fund defines Evidence-based maternity practice as:
"Evidence-based maternity care uses the best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and to facilitate optimal outcomes in mothers and newborns. Although the field of pregnancy and childbirth pioneered evidence-based practice, resulting in a wealth of clear guidance for evidence-based maternity care, there remains a widespread and continuing underuse of beneficial practices, overuse of harmful or ineffective practices, and uncertainty about effects of inadequately assessed practices."

Evidence-based maternity practice is ongoing and developing model of practice which uses the latest scientific research to provide best possible up-to-date health care for mothers and babies. This initiative is based mainly in USA.
"In order to inform coverage and clinical policy decision making for maternity care, Childbirth Connection (CC), the Reforming States Group (RSG), and the Milbank Memorial Fund (MMF) collaborated to write, review, and publish this report. The report presents a discussion of current maternity care in the U.S. health care system and identifies key indicators that show the need for improvement. The report further summarizes results of the many systematic reviews that could be used to improve maternity care quality, identifies barriers to the use of evidence-based maternity care, and offers policy recommendations and other strategies that could lead to wider implementation of evidenced-based maternity care in the United States. These maternity care quality concerns and opportunities for improvement are not widely recognized at this time."

Monday, April 25, 2011

Hypnobirthing courses for practitioners by Mrs. Katharine Graves

Have you ever thought of becoming Hypnobirthing Teacher?  Helping mothers achieving a calm and natural birth by providing them support and empoverment? Would you like to explore hypnobirthing principles in a labour?

Mrs. Kathrina Graves of Hypnobirthing Center UK is coming to Kuwait to teach hypnobirthing classes from May 5th to May 8th.

Mrs. Katharina is looking forward to share her method and professional experiences with you. She is also keen to introduce hypnobirthing method in Kuwait and make it available for all interested. She is offering reduced price for those inteterested in taking the course. Do not hesistate to ask for details.

For more information on hypnobirthing method visit

Sincerely looking forward seeing you :)


Quality evaluation of maternity services in UK

In my previous post I was describing system of maternity services in UK provided by NHS (National Health Services). Services are provided in hospitals and community centers (which include also midwifery-led birth centers) . Deliveries being assisted by Obstetritian ( specialists for complicated labour) and / or Midwives (Specialists for normal labour).
NHS encouradges low-risk pregnant women to deliver in birth centers citing study which confirmed low rate of interventions:
"A recent report on an NHS-run Birth Centre shows that women booked with the unit have fewer interventions in labour (even if they are transferred to hospital in labour) than low-risk women booked for hospital birth.Saunders, D., Boulton, M., Chapple, J., Ratcliffe, J. and Levita, J. (2000) Evaluation of the Edgware Birth Centre North Thames Perinatal Public Health

This post will be try to explain quality evaluation of maternity health care provided within this system.
NHS supports full transparency  by publishing  data and making them available for mothers to be able to choose health care provider according their needs and wishes.
(Kindly open the links to see the statistics)

1. How to find nearest maternity unit
    a. By region
    b.By hospital

2.Basic maternity statistics for the region
     - with description of available care: Obstetritians, Midwives, GP
     - evaluated as:  national average, better or worse than average ( by colours)
     - UNICEF Baby Friendly Awards for breastfeeding ( level of accreditation)   

Sunday, April 24, 2011

More Interventions at Delivery Not Linked to Healthier Newborns

Medical Center of University of Rochester released press statement April 13, 2011 :
" High Rates of Induction, Primary C-Section Do Not Improve Infant Outcomes in Low-Risk Women at Community Hospitals" 
based on the result of the study which was funded by the University of Rochester Medical Center and the New York State Department of Health, conducted by Chriptopher Glanz, M.D., M.P.H.

The study was trying to determine connections between interventions during the labour and their effect on the health of the newborn baby.
" The finding that rates of intervention at delivery – whether high, low, or in the middle – had no bearing on the health of new babies brings into question the skyrocketing number of both inductions and cesarean deliveries in the United States."

Birth Story 1

Dear Readers,
I`d like to share with you a birth story sent to me by valued friend of mine. This birth story happened in Kingdom of Saudi Arabia. Women in the story is dedicated Mom, passionate about natural birth, breastfeeding and attachement parenting. Let`s see how her story unravels...
"My due date was still about 2 weeks away. My mum had just arrived from my home country to spend time with me. It was a new doctor again…she had a look at my file, asked how I felt and then said: "well then i'll see you in about 12 days time"

As I was leaving my mum insisted that she do an internal  exam as I was complaining about slight pain that felt like period pain…guess what…I was already 4 cm dilated!!! I was already in labour…

Saturday, April 23, 2011

Birth choices in UK

Maternity services in UK are mainly provided by NHS- National Health Services in hospitals and community units, depending on woman` s choices or presence of pregnancy complications.

1. Consultant units (available only in hospitals)
These units are mostly choosen by women who prefere "hi-tech" birth enviroment or women who have pregnancy complications and need active management of labour and interventions.
"A woman is usually booked under the care of a particular consultant, but may only see them rarely throughout her pregnancy. Most of her care will be given by midwives. If complications arise during pregnancy or labour, the doctors will become more involved. Interventions such as epidurals and Caesarean operations are usually available in the unit. "
         a.  Obstetrics consultants: specialists in birth where there are complications, like cesarian section
         b.  Midwifery consultants: specialists in normal births
"Hospital midwives work within a hospital. They run antenatal clinics, help women giving birth in the hospital, and look after women staying in the antenatal and postnatal wards of the hospital. Their work usually gives them experience of interventions such as induction, continuous monitoring and use of epidurals for pain relief. They often work closely with doctors.
2. Other Maternity Units ( available in hospitals and community centers )
"These types of maternity units provide maternity care for women who have chosen a "low-tech" birth environment. They include midwifery-led units, GP units and birth centres. They provide friendly, personal care from midwives. They can be grouped according to whether they are at a hospital which also has a consultant unit, or if they are situated away from a main obstetric hospital (community units)."

International Day of the Midwife is approaching ! 5/5/2011

To:  All my colleaugue and friends,

Congratulations on the occasion of the International Day of Midwife! You all have been of great support and help last year. Thank you for virtual discussions and advices. Thank you for sharing your knowledge and expiriences with me. YOU ALL ROCK! <3 you beautifull community.

Check out online conference where we can share our expiriences about last year.
" Virtual International Day of the Midwife May 5th 2011The World Needs Midwives Today More Than Ever

Welcome to the Virtual International Day of the Midwife (VIDM) which is a 24 hour FREE ONLINE CONFERENCE on the 5th May starting at 12pm New Zealand time - click here to see the time where you live. "

Wednesday, April 20, 2011

Definition of the Midwife

This is definition of  the Midwife by ICM: International Confederation of Midwives, which is the largest professional  midwifery organization.

Midwifery is specialised and independent branch of health care system, providing primary care for physiological (healthy) pregnant, labouring and women after delivery, including care of newborns.

Hypnobirthing classes in Kuwait

Couple and practitioner classes will be held from 6th-8th of May 2011 by Hypnobirthing specialist and Doula Katherine Graves from the UK. Please check for more information about hypnobirthing and Katherine  Course timings and location are yet to be determined. If you are interested please contact and we will get you in touch with the organizer.
Sneak peak:
"Hypnobirthing is a completely logical and extremely effective established method that lets you discover the joy and magic of birth, and is much more than just self-hypnosis or hypnotherapy.

 It is deeply relaxing and effective, and allows your mind and your body to work in harmony, the way nature intended.  Hypnobirthing is your ante-natal training of choice."

Tuesday, April 19, 2011

Waterbirth: Evaluating benefits and risks

" Benefits of water birth have been studied by various practitioners such as midwives, doctors and researches around the world. Water birth was highly rated by women in a recent study of 1,300 water births.  In contrast, a minority of them found it ineffective (Balaskas, 2004; p48-49). Overall it was found there were common physical and emotional benefits for both mother and infant.  Unfortunately, no one can assure women that water births are safer than normal births, because they have not been studied broadly.  However, according to Gilbert (1999) (as cited in Balaskas, 2004:p22) a study has found a decrease in the perinatal mortality rate (1.2 per 1000 of water birth)."

I am very pleased to inroduce an article by Ms. Roa Altaweli : Waterbirth. I thank her for kind approval with posting summary of the article. You can read full version in her blog on women`s health and midwifery . Roa is highly qualified Midwife currently finishing her postgradual studies in Midwifery in UK.

Roa Altaweli, MSc (Midwifery), BSc (Nursing), RM, RGN
MPhil/PhD. student in Midwifery
City University London
United Kingdom

BENEFITS of waterbirth according to the article:
1. The comfort and mobility the water allows during delivery, as changing position under the water is easier than on the land especially in the case of overweight mothers or those carrying large babies.  It is almost certain that reduction of abdominal pressure causes efficient uterine contraction and better blood circulation therefore better oxygenation to uterine muscle and for the baby, which indicates less fetal distress.  As a result, changing position during labor is highly beneficial for mother and baby.  Balaskas and Gordon (1992; p34)

Monday, April 18, 2011

Recomendations for OB in Kuwait

Dear Friends,

I` ve got a question from reader and would like to ask for your recomendations for good Obstetritian in Kuwait.
"I am curious to find out which hospitals here in Kuwait will promote Natural Childbirth (following C-Section) and which Dr.’s are also “onboard” ? "
OB should support natural birth: that is hands off policy- minimum exams, alternative birthing positions, no medication, early initiation of breastfeeding.

Looking forward to hear your opinions.

Thank you very much!

Hope for Change in Kuwait Childbirth!

I am reposting this article written by my dear friend Mrs. Sarah Paksima, Doula and Chilbirth Educator, originaly posted on her blog
"Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has." - Margaret Mead
Newly elected parliamentary members celebrate the passing of the new law allowing women to get passports without prior consent from their husbands. (GulfNews) Living proof that working together we can achieve great change!

Every brushfire starts from a single spark. That’s how change happens too. First the spark ignites within the individual, and as it burns brighter, it spreads to your friends, your neighbors, your community, your country, your region, and eventually the whole world. But first, it has to start with you.

If you look at birth advocacy groups around the world, that’s how change has always started. Inspired by their dreams yet surrounded by a different reality, a conflicting image begins to emerge. The descriptions of physiological normal birth- uninterrupted by unnecessary technology, with an empowered mother making the decisions about where, how and who she births with—begin to contrast sharply with the Birth Story or the stories she hears from sisters about the “complications” in her birth that gave rise to numerous medical interventions. That conflict between what should be and what is, is the spark that ignites change.

Saturday, April 16, 2011


I am excited to hear about following project published in Arab Times 16/4/2011
" Kuwait launches largest health development firm Private sector to play vital role in operation
KUWAIT CITY, March 9: Kuwait recently inaugurated a comprehensive health development company — the first of its kind in the country — with a capital of KD318 million, reports Al-Seyassah daily quoting sources.
Sources revealed the government will distribute 50 percent of the company’s shares to the citizens through public subscription free of charge, 26 percent for Kuwaiti companies and 24 percent for the Kuwait Investment Authority (KIA).

Sources added the company will build the largest health insurance and medical services hospital in the Middle East to provide a wide array of medical services to citizens and expatriates.

Sources confirmed Deputy Premier for Economic Affairs and State Minister for Housing and Development Affairs Sheikh Ahmad Al-Fahad Al-Sabah launched the company on Monday in the presence of Health Minister Dr Hilal Al-Sayer, Finance Minister Mustafa Al-Shemali, the company’s Founding Committee Chairperson Mohammad Al-Munaifi and Health Ministry Undersecretary Dr Ibrahim Al-Abdulhadi.


Do you want to help improve Maternity Services in Kuwait? Are you looking for more readily available resources, information, and support? Do you want more options? Come help us create the first ever NGO dedicated to improving maternity services in Kuwait.

Restrictions on Human Rights Organizations in Kuwait

Following article published in Arab Times 16/4/2011 describes new decision of Ministry of Information of the State of Kuwait about dealing with International Human Rights Organizations:
"  ‘Restrict dealing with rights units’ - MoI issues rules
KUWAIT CITY, April 15: The Ministry of Interior (MoI) has instructed its departments and units not to deal with international human rights organizations and authorities, unless it is done  through its foreign affairs counterpart, reports Al-Rai daily quoting sources.
Sources revealed MoI Undersecretary Lieutenant General Ghazi Al-Omar issued decision number 45/2011 on the guidelines in dealing with international human rights organizations according to the directives of the Secretariat General of the Gulf Cooperation Council (GCC) as follows:
  •  The human rights organization and bodies should deal with the member nations through their ministries of foreign affairs.
  •  The language used in dealing with the organizations should be Arabic since it is one of the six formal languages in the United Nations (UN).
  •  The member nations should immediately provide the Secretariat (Security Affairs Sector) with a report on the experiences and standards in dealing with the organizations.
  •  The guidelines must not contravene the laws and bylaws of the member nations.
Meanwhile, the Interior Ministry also announced that the  Nuwaiseeb land border post, which underwent several renovations, is now ready to handle all arriving and departing travelers, reports Al-Rai daily.

Wednesday, April 13, 2011

A plea for natural birth in Kuwait

How much are we aware of consequences of inductions of labours, unnecessary cesarian sections and frequent use of epidurals? I highly recommend every pregnant woman to read following article to be aware of risks of following procedures.
In modern societies most childbirths occur in hospitals with the assistance of the latest technologies. Protocols are being carried out and policies followed. But what about mothers and their wishes or decisions? What do we really know about  the consequences of such approaches to pregnancy and childbirth, the beginning of a journey of a new human being? Can we comprehend the effect it will have and what we will face in the future?
Currently, a lot of births are conducted as follows:
  • Induction (forcing labor to start) by the administration of drugs (oxytocin and prostaglandins)
  • Augmentation (speeding spontaneously occurring labor) by administrating drugs (oxytocin)
  • Use of analgesics and epidural anesthesia (pain medications)
  • Cesarean sections (surgical removal of baby) and even elective Cesarean section
  • Deliveries in an unfamiliar environment (hospital)
Birth is a unique hormonal process activated by the body`s own production of oxytocin.  This serves the purpose of safe delivery of the baby, the onset of lactation (milk in the breast), and creating a bond between the mother and child. During the birth many cascading neuro-hormonal reactions (prostaglandins, prolactin, endorphines) take place which ensure progress and coping with labor.
Oxytocin is hormone which produced in brain. It stimulates:
  • Peripheral action 
    • uterine contractions 
    • let down reflex of lactation
  • Central effect 
    • decreases fear 
    • increases trust 
    • encourages bonding  
    • stimulates maternal behavior
Synthetic oxytocin, which is routinely administered during induction and augmentation of labor, does not cross the blood brain barrier like natural oxytocin.  Therefore it provides only peripheral actions which have effects on the uterus and breasts. It cannot affect the mother's feelings or behaviors, thus depriving her of natural releases of stress and anxiety. Also administrating synthetic oxytocin may interfere with the natural progress of birth.
Prostaglandins regulate contractions and are directly responsible for contraction of the uterus during labor. Synthetic prostaglandins, which are administered during induction of labor,  suppress prolactin secretion , the hormone responsible for milk production, and thus cause difficulties with breastfeeding.
Endorphines are produced in brain during pain and prolonged workouts like childbirth.  They resemble opiates and produce analgesia (natural relief from the pain). They also cross the placental barrier and help the baby coping with labor.  Administering medical analgetics and opiates during labor may disturbe the natural opioid system and decrese the production of natural endorphins, thus decreasing the natural supply to the baby.
Delivering by Cesarean section disturbs hormonal balance and processes that are meant to take place during childbirth.
Childbirth in an unfamiliar environment may produce anxiety and stress. During stressful situations the body releases adrenalin to cope with emergencies. Adrenalin acts as an antagonist to oxytocin, so a stressful birthing environment can slow the progress of birth and endanger its results.
Clearly, interventions and the use of medications during labor have immediate effects on the mother and baby in terms of the spontaneous progress of labor.  Interventions also create need for more interventions.  Notably, many interventions result in difficulties with breastfeeding.

Some scientists are examining the long-term effects of such labors, hypothesing about possible conseqences after interfering with the natural hormonal system.  They are studying the possible links between hormonal interference during labor and the baby's stress reactions, human bonding, anxiety disorders, depression, and even autism.
" 80% of the blood reaching the fetus via the umbilical vein goes directly to the inferior vena cava via the ductus venosus, bypassing the liver, and therefore immediately reaching the brain: it is all the more direct since the shunts (foramen ovale and ductus arteriosus) are not yet closed. . . . Furthermore, it appears that the permeability of the blood-brain barrier can increase in situations of oxidative stress—a situation that is common when drips of synthetic oxytocin are used during labor. We have, therefore, serious reasons to be concerned if we take into account the widely documented concept of “oxytocin-induced desensitization of the oxytocin receptors.” In other words, it is probable that, at a quasi-global level, we routinely interfere with the development of the oxytocin system of human beings at a critical phase for gene-environment interaction."  M. Odent


S Jordan1, S Emery2, A Watkins3, JD Evans4, M Storey5, G Morgan6: Associations of drugs routinely given in labour with breastfeeding at 48 hours: analysis of the Cardiff Births Survey

CG70:Induction of labour:NICE guidline

Begley C. The effect of Ergometrine on breast feeding. Midwifery 1990;6:60–72.

Winberg J. Mother and newborn baby: mutual regulation of physiology and behavior – a selective review. Dev Psychobiol 2005;47:217–29.

Dunne C, Da Silva O, Schmidt G, Natale R.:Outcomes of elective labour induction and elective caesarean section in low-risk pregnancies between 37 and 41 weeks' gestation.

Alfirevic Z, Kelly AJ, Dowswell T.:Intravenous oxytocin alone for cervical ripening and induction of labour.