Rabat – What should I take to the clinic when I give birth? Will I get my own room? What discussions should I have with my doctor ahead of time? Women preparing to give birth in Morocco doubtless have many questions.
As part of a series on giving birth in Morocco, with focuses on both c-section and vaginal delivery, Morocco World News reached out to 21 mothers from 10 different countries who have delivered in Morocco.
Veterans of c-section and vaginal birth who delivered both at home and at clinics, the women offered valuable advice to prospective mothers, especially foreign women.
Choose your doctor well
Time and again, women said choosing a doctor you trust is of the utmost importance.
“Your doctor is number one,” said Erika, an American who gave birth at a Rabat clinic last year. “He or she is the one who is going to call the shots the entire way.” Because of this, she said, it is essential to “really really trust your doctor.”
In fact, Erika and her husband met three other doctors before finding a doctor they felt comfortable with.
Beyond discussing preferences, such as having your spouse present or holding your baby skin-to-skin immediately, Erika said mothers must “make sure your doctor understands and knows how important [the wishes] are to you and that they agree with you and that they give you verbal confirmation that these things either can be done or can’t be done.”
Katie, a British woman who gave birth in Rabat last year, echoed Erika. She advised pregnant women to repeatedly discuss their birth plans with their doctor.
British mother Amal said, “I was advised to always ask a doctor what their c-section to vaginal birth ratio was.”
Canadian doula Genevieve Lepage said women should be firm: “Know your rights. Write a birth plan. Stand your ground.”
Going into more specifics, Lepage suggested moms “discuss mobility [during labor] and not having episiotomy.” Episiotomies, which doctors used to perform indiscriminately, are cuts at the vaginal opening. Research has proven episiotomies to more often cause severe tears than prevent them.
Many women emphasized the importance of thorough research. When studies prove certain birth practices to be harmful or beneficial, it is well known that even in advanced countries, familiar methods persist for a decade or two after the new evidence comes to light. Even if their doctors are knowledgeable and experienced, women should educate themselves.
Bring everything you will need
Pack everything when going to give birth, advises Charissa, an American maternity nurse who works with a Moroccan obstetrician in Marrakech. “You have to bring pretty much everything you need: Diapers, wipes, pads, toilet paper, towels, soap.”
New mothers are often surprised by the amount of bleeding they experience after birth. To prepare for heavy bleeding in the immediate postpartum, a South African mom recommended women bring adult diapers to the clinic.
Other moms suggest having relatives bring food to the clinic or packing some yourself. Especially if you have a c-section, clinic staff may not offer much food. Amal said that after her c-section, the “hospital only provided tea, soup, and yogurts.”
Sarah, an American who unexpectedly gave birth at home in Rabat when her baby came quickly, said that when she went to the clinic immediately after the birth, they gave her a basic meal of a croissant and coffee. She asked for more, and the clinic obliged, bringing her eggs.
In contrast, a German who gave birth in Marrakech last year said she received three “healthy and good meals” at her clinic.
Comparatively low cost
Especially for anyone familiar with American medical bills, the cost of giving birth in Morocco can be a relief.
One American who gave birth in Casablanca last year, Brooke, said she was happy with the price. “It was a fraction of what we paid in the US when we had insurance and here we don’t have any insurance so we paid full price,” she said.
There are a few particularities about paying for a birth in Morocco, however. Some doctors and clinics will charge extra under the table. Women should address the issue with their care providers to avoid unexpected costs.
Pregnant women should be aware that if they want a private room after delivery, they may need to pay extra.
Charissa advises women to make sure someone is staying with them, whether a husband or friend, to help take care of themselves and the baby, although it can cost more. “Expect actually to pay extra for someone to sleep with you at the clinic,” she said.
If you do not pay for a private room, the number of people in your recovery room can vary. Respondents to MWN’s survey who shared rooms had 1-10 roommates.
Sharing a recovery room can be challenging because you cannot control the number of visitors coming to see other women.
Naturally, the birth of a child is a joyous event, and Moroccans are known to love and welcome little ones. One British woman who gave birth in Marrakech in 2014 said she personally received 94 visitors in 48 hours.
Issues of consent
Several mothers noted that after they gave birth, staff began feeding their baby formula without asking.
For mothers who wish to breastfeed, giving an infant formula can unnecessarily complicate the start of breastfeeding. Babies who eat formula are less interested in suckling and thus do not signal their mother’s body to produce milk.
For this reason, women who intend to breastfeed often try to nurse their newborns immediately and insist they get no formula. This is especially important in the first days after birth before they have “established” a milk supply.
A Russian mom who gave birth in Fez in 2013, whom I will call Maria, said she only saw her baby briefly before staff took him away. He stayed in the nursery, Maria said, and staff “gave him formula without my consent.”
Claire, a British mom who gave birth in Marrakech in 2017, had discussed her wish that her baby not receive formula with both her doctor and clinic, who agreed. Despite “specifically asking them not to,” she said, the staff fed her baby formula after separating Claire from her daughter immediately after birth.
The issue of consent goes far beyond formula feeding for infants. As pregnant women demand dignity during birth, consent is becoming a focal point for women’s rights in labor and childbirth.
For Sarah, the idea her care providers may not ask her permission was concerning. “I felt nervous about the clinics because I had heard so many stories about nurses taking action without the consent of the women or trying to push for unnecessary interventions.”
A German woman who gave birth in Marrakech last year and wished to remain anonymous found out her care provider administered “Spasfon” through her IV to help her labor progress—an intervention she did not want.
An intimate experience
Several moms spoke of giving birth in Morocco as a positive experience. Some explained that although they are foreigners, they consider Morocco to be home and naturally gave birth in the country.
South African mother Janine said her experience in Morocco was absolutely better than births in her country.
A Moroccan-American mother who wished to remain anonymous said giving birth to her second child in Rabat “was more intimate and comfortable” than her first in the US.
Although she felt her birth was unnecessarily traumatizing, Claire spoke of the love from her Marrakech neighbors. “When we arrived home from the clinic, our neighborhood was so welcoming and even to this day our little Marrakchia feels the love from everyone in the community.”
‘My doctor was truly amazing’
Most of the women who shared their stories with MWN had something positive to say about medical staff.
Charissa, who works with a Moroccan doctor, spoke highly of the education Moroccan doctors receive. “The doctors here are well-educated, they’re smart, they know what they’re doing,” she said. Unfortunately, she continued, “There are parts of the medical systems which don’t work well. They don’t always have the resources they need.”
Maria’s doctor impressed her by jumping into action when her baby’s heartbeat dropped too low during labor, and she needed an emergency c-section. “Me and my baby were in danger and she knew what to do right away.”
Private clinics, reputed to offer better care than public hospitals, operate under financial pressures, and in some ways, incentives align to point towards more c-sections or speeding up labor. Charissa underlined Moroccan doctors “are good people; they work hard; they have really good education, most of them.”
Rachel, an American who gave birth in Casablanca by c-section in 2017, described her doctor as “truly amazing.” Rachel also said she received “wonderful care” from the hospital staff.
Of course, doctors are only part of the system. Charissa also had praise for nurses’ memory, especially in a system that relies less on documentation than the West. “There are some nurses who are incredibly smart, and they remember everything. But their educations vary greatly and they don’t get paid very well.”
After her c-section birth, Amal said her “nurses were amazing and supportive.” They gave advice and helped her breastfeed her newborn in the middle of the night.
At the same time, some women say they believe their doctors pressured them unnecessarily towards interventions they did not want. The varied experiences only confirm Erika’s words to choose a doctor you trust.