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By Kate Minogue

Imagine you land yourself a great job in Libya, but by the time you arrive here, you find you’re pregnant. What do you do? Whilst Libya is very close to Europe, the standard of health care in public hospitals tends to be low, as shown by the huge number of Libyans who regularly travel to Tunisian clinics. Look Out Libya quizzed five recent mothers of British, Dutch, Moroccan and South African nationality, some of whom decided to give birth in Libya, whereas others decided to go back ‘home’. None of them were at any special risk and the oldest were in their early to mid thirties.

None of our respondents were particularly keen to give birth in Libya: ‘I did not want to risk anything by delivering here.’   Even medical staff would ask where they were going to deliver, which perhaps did not inspire the required confidence to do it in Libya. But delivering elsewhere is not an easy option if you have a job here or don’t have your own house in your home country. Even if you do have your own house elsewhere it means a long separation from your partner as well as potential disruption for your other children. Clearly if a mother shows any risk factors or had a difficult first birth, she is unlikely to want to risk delivering in Libya where good neonatal care is not assured. But for those expecting a second child, it may feel better to keep the family together and deliver in Libya.

The women we interviewed had all visited several private hospitals here and found it very off-putting, especially when dirty toilets are encountered: ‘as an eight-month pregnant hormonal woman to see a ‘dirty’ hospital with water all over the dirty bathroom floors I was shocked!’. Hospitals may reduce a pregnant woman to tears, but the prospect of splitting up the family is not a happy one: ‘I spent a lot of time going to different clinics/hospitals here and meeting different doctors and was almost certain I did NOT want to give birth in Libya … and there were a lot of tears, but after much thought we decided it was best for us as a family if we all stayed in Libya.’

We have heard of birthing clinics in Tripoli, but have no reports from them.

The most frequently recommended gynaecologist was Dr Raeda Basheen at the Libyan-British (used to be Libyan-Swiss) clinic, who also visits Medilink, a private clinic in Janzour, and the Razi clinic in Ben Ashour. Dr Jose Muscat at St James’s was also recommended for pre-natal checks and scans. The doctor-patient relationship is paramount in Libya because the nursing support leaves a lot to be desired. There tends to be the assumption that the doctor knows better than you and as a patient you are expected to be quiet and not ask questions. Our respondents managed to find gynaecologists who were NOT like this! It is vital you can communicate with your doctor and that they answer your questions. This is not just a language issue! Our Arabic speaker said: ‘I speak Arabic but communication was very difficult!’

It seems that in Libya scans and blood tests are regularly available, perhaps more so than elsewhere. But no tests are offered for abnormalities such as Down’s Syndrome,  because abortions are illegal. Find out what scans and tests are necessary and make sure they are done. Keep your own records of test results, blood pressure, and weight, especially if you plan to deliver abroad. It is important to always see the same doctor so that they get to know your personality and health profile.

If you stay in Libya you may feel a lack of support with your extended family far away and your friends being relatively new. On the other hand you are quite likely to come across other women in a similar position. On the plus side you may have a bigger house and more help to look after it.

During the birth process, gas and air is not available, but pethidine and epidurals are available on request. If you are having an elective c-section you will have the choice between a spinal block/ epidural and a general anaesthetic. One gynaecologist recommended not risking spinal injections in Libya, but one of our respondents chose this option with no ill effects. One woman who was told she needed to have an emergency c-section said that when her husband saw the theatre: ‘he saw them switching on the air-conditioner, which for sure wasn’t clean and full of dust! He saw rusty tools and equipment … getting sterilized manually … He was going crazy, but couldn’t do anything …’

And at another emergency c-section: ‘Everyone was rushing round talking in Arabic and me and my husband didn’t know what was going on … I was then just left on the bed for 30 minutes while everyone went to get scrubbed up for the operation. It was the most frightening (and painful) half hour of my life.’ As in any country, those who had planned c-sections fared much better and mentioned how kind their doctors were, and that their scars healed quickly. Most likely the husband won’t be allowed to attend, even at a natural birth, although you may be lucky if the hospital is quiet. Anyone planning to deliver in Libya  would be wise to find a potential blood donor and if they are planning a c-section they should get them to donate a pint of blood.

Generally there is no special after care, but mothers have the mobile number of their doctor and our respondents felt sure they could have called if necessary. Nursing staff will have limited English and may want to do things differently from you, for example by bottle-feeding the baby. You need to be firm about what you want - which may be difficult - and it would certainly be helpful to have a partner, friend, or relative around if possible. One new mother reported having to ask to get the baby changed and to get help to reach the bathroom. Once in the bathroom  there were no railings and only a hand-held shower. Another mother reported that her baby’s navel became infected in hospital because it was never cleaned there.

If the baby is born outside Libya there are certain formalities to be completed before you can bring him or her home. Don’t rely on what we say here because the requirements can change suddenly. Obviously the baby needs a passport, although at the time of writing an Arabic translation is no longer required. The birth certificate needs to be legalized by Libyan and local authorities. Each parent needs to supply a copy of their Libyan residency, and then a visa may be applied for. All of this can take anything from three to eleven weeks, which must seem like an awfully long time if you are keen to reunite the family and get back to normality!

As with anything in Libya, baby necessities are generally available but you may not always be able to find what you want when you want it, so if you see it, buy it!

Things to bring from outside are:

  1. BulletJars of baby food with vegetables and meat, fish, poultry (limited here)

  2. BulletSwim nappies

  3. BulletScented nappy bags

  4. BulletLaundry soap and softener for sensitive skin or perfume-free

Out of our three respondents who had actually given birth in Libya, one said ‘never again’, one said ‘yes’ (with certain qualifications), and the third has already done it twice!  It very much depends on the health of the mother, previous pregnancies, the family situation, and not least how comfortable the mother feels with the idea. If it’s going to cause extra stress and worry, then clearly it is better to go elsewhere! On the other hand, it’s obviously good to be able to keep the family together, although under some circumstances it may be better to be born in the country of one’s nationality. Clearly anyone who is considering giving birth in Libya needs to do lots of research and get as many first-hand accounts as possible. Remember that there comes a point when the airlines don’t take pregnant women, so the decision has to be taken well before this moment. Once decided, enjoy this very special time.

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Published Oct 2010