Birth & Midwifery in Saudi Arabia
Resources for parents and practitioners

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Birth Situation Room Report

Midwifery Today Country Contact*

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Aisha Alhajjar has been networking in Saudi Arabia since arriving in 2010 (she was previously in Egypt) and is pleased to have brought together about a dozen doulas from all around the country. She hosts monthly doula meetings. She also collaborates with Al Bidayyah Center to coordinate breastfeeding counselor trainings and participates in monthly breastfeeding meetings and mothers’ gatherings. She has begun her educational journey to midwifery and has brought several of her doula sisters along with her. The only midwives she has met work mostly as obstetric nurses in hospitals, as homebith is not legal, however she dreams of the day where Alternative Birth Centers and homebirth midwifery are the norm.

Aisha writes a blog (see below) as well as two weekly columns on Saudi Life that raise awareness about natural birth, breastfeeding, and parenting; other writing include freelance journalism for Arab News as well as some in Arabic for the Ministry of Health. She is the first instructor of the Bradley Method of Natural Childbirth® in her country and is excited to bring it to the Middle East. However, she is currently rolling out an Islamic childbirth and doula education program (AMANI Birth) and hopes to have it recognized by the Saudi Ministry of Health. She also hopes to open a string of AMANI Birth ABCs that would serve women as well as be a training grounds for aspiring midwives.

Birth/Midwifery

Parenting/Breastfeeding

What is the biggest challenge facing normal birth in your country and what is being done to address it? [September 2011]

Saudi Arabia is a unique mix of technology and tradition. Unfortunately, like in the United States, technology and obstetric dominance is the norm for birth. It’s said that out-of-hospital births are illegal. Although I haven’t checked the law personally, I can attest that there are no out-of-hospital birth centers, let alone professional midwives attending homebirths in the metropolitan areas.

There are some gems in the hospital birthing world, but finding them can take some dedicated detective work. In the local culture, seeking a second opinion is considered shameful, which often leaves women stuck with the first care provider they visit. In government hospitals it is not even allowed. This makes women extremely vulnerable to the protocols of their doctors.

Women are often naïve to this and simply visit the clinic nearest their home or the one included on their insurance provider’s list. Families who do this are especially subject to the hit or miss chance of exercising personal choice in their care plan. Sadly, “miss” seems to surface more than “hit.”

There are a mix of hospital rules, some of which still forbid anyone, even the father of the baby, to attend women in labor, let alone delivery. A contributing factor is the strict segregation of the sexes, with the maternity unit restricted to “women only” in some hospitals. Fortunately, some hospitals do allow and even encourage personal labor support, though it is usually limited to just one person at a time. Doulas are not known in the culture and hospital midwives are oftentimes just obstetric nurses who do not catch babies nor preside over care.

However, there is a growing expat community of women who are entering the doula and childbirth education fields. A handful of them are also embarking on distance education programs of midwifery from the United States, myself included. The public voice for natural birth on the Saudi Life motherhood column (saudilife.net/motherhood) has begun to raise awareness and draw together women who advocate for natural birth and choices in labor and delivery.

This expat community of “birthy sisters” are pioneers for expectant families. The dream is to open women-focused freestanding birth centers. Although we are not sure how we will overcome the cultural barriers and address current governmental structures, we are optimistic and moving forward in our personal education efforts to ensure that we are prepared and ready when the time comes.

There have been reports in Arabic news about the ministry of health’s vision for a more European model of women-centered care. This will take extensive infrastructure and planning and we hope that we can do our part to propel this vision and contribute from the ground floor.

— Aisha Al Hajjar
AMANI Birth
aisha_alhajjar@yahoo.com