Birth

Abroad?

My Moroccan

Experience

 

We were into our second year in Tanger. I was about to finish my thesis when I got completely beaten out by pregnancy hormones. I didn’t function besides being this fine machinery vessel for a new human being. What an honor, Alhamdulillah! I had to ‘throw in the towel’ and leave my studies, and Allahu alem if I´ll manage to return. What I knew for sure, was that I wanted to give birth in Morocco. This is home. This is how it all went:

I’ve never had a pregnancy, birth, or a baby on my chest without being a student, research assistant, or a PhD fellow. Studies, exams, presentations, deadlines, lectures, and seminars occupied my thoughts and focus, and messed with my nerves while I was trying to be the supreme version of myself for my children. Maternal leave never managed to ‘pause’ the subconsciousness from analyzing and formulating arguments and I often found myself daydreaming about 'that day when I would free myself from this torture.' And there I was, having nothing but pregnancy, family, and home to work with. I was relieved and ready to see how extraordinary I could become as a homemaker! When I passed the first heavy months, and we were back home from an amazing vacation in Nairobi, I entered an intense nesting mode which led us to the most peaceful birth:

The Search for Birth and Baby Products

The nesting started with accumulating the necessary baby products an rearranging the home for making room for family member nr 8. I prefer to stick to what I’m used to! That has been a funny discovery. I wanted the simplistic Newbie-style of baby clothes, the same Philips pacifiers, Babybjorn babysitter, pregnancy and breastfeeding supplements, etc., so instead of trying something different, we brought some essentials from Norway with travelling family members and friends, in addition to getting similar baby clothes from a Hollandese sister in a local second-hand Whatsapp-group. There we also found a car seat for 300 dirhams.

Orchestra has a lot of comfortable cotton clothes, shoes, baby beds etc., of what seems to be of good quality, but the prizes are just extreme. The only thing I brought from here was some suitable hygiene articles for the first days after birth that were cheaper than what I found at para-pharmacies and pharmacies. The big sheets to protect the bed, floor and carpets during birth, I found at Locamed only, but to a very high price. Here I also found support stockings for longer flights. For the crib, babybed and changing table we had to go to IKEA in Tetouan due to the very high prices on this category of products at KITEA. Everything can be made at Casabarata though, but we only got the big hotel pillows here for 35 dirhams each, and a 180 cm headboard for the bed that we didn’t find anywhere else. An oldschool carpenter listened closely to what I wanted, and made a beautiful, simplistic headboard in natural, untreated wood. It smells so good, and with the pillows covered with linen that we also got made here, the countless nursing sessions became comfortable. I bought the smallest diapers from the brand Calin and Dala as they are OK and not perfumed. We finally bought a second hand car that made everyday life smooth again, as we had to sell our Norwegian car when we got residency permit. With my favorite dates brought from Sweden, licorice and mix of nuts and dried fruit in the kitchen closet, all important material matters were in place for birth.

Choosing a Doctor/Midwife and Place for Birth

I was told by a Belgic family doctor that here in Morocco, you either choose the birth institution or a doctor/midwife that stays with you through pregnancy and birth. This city has a lot of hospitals, mostly private ones. At the public hospital giving birth is free. At the private ones, the price varies between 2000 - 10 000 dirhams for a natural, unmedicated birth, and starts from 10 000 dirhams for a c-section. I used Google Maps to check out the hospitals. I began with those I was recommended and then checked out every single one. It took me hours to read the reviews and I ended up uncomfortable by all the negativity. I knew I had to go and see for myself, but chose to change tactics and check out the gynecologists instead. They have their cabinets where they receive pregnant for consultations and have specific clinics they collaborate with for birth. I was recommended four: Dr Sara, Dr. Houda, Dr. Oumaima, and Dr. Nazek. A consultation costs 3-400 dirhams, but I never managed to see any of them as I haven’t yet developed this amazing patience Moroccan women seem to have, may Allah bless them! I can’t recall exactly how many times I sat in fully packed waiting rooms before leaving. The way I understand it, many health facilitators have a system that relies on women coming early in the morning to get their number in the line and wait. You can choose to leave and be called by the receptionist. I tried that too, but when I returned, the gynecologist had just went out to attend a birth. To have the same person for pregnancy and birth is precious, but it’s impossible to be many places at once so imagine if doctors worked together and took eachothers' patients when they were called out to attend a birth.

I took it as a sign that none of these were the right for me. Some sisters chose midwife-led birthhouses/dar ul wiladah/ maison d’accouchement that promotes natural births only, so I wanted to check them out. I looked at the one closest to us first, then another one that I completely fell in love with. At these birthhouses a consultation costs 150, and birth 2000 dirhams. I connected right away with the midwife, and after a careful consultation of me and the baby, including earlier pregnancies and births, I was thrilled to hear that she could attend a homebirth. She was also experienced regarding breech births that I had to prepare for in case the baby didn’t turn. Alhamdulillaah, he turned head down in week 38.

Pregnancy Consultations

My experience was that all birth controls are consentrated around an ultrasound check. That was surprising as in Norway we only do one between week 18-20 if there’s not any reason to do it more often, like twin births in third trimester. I tried to skip as many as I could, but ended up accepting more ultrasounds than I was comfortable with. Like the first one in week 8 that a doctor told was very important in case it was outside the uterus. I kind of tried to find a middle path where I “do what is normal here” meanwhile holding onto what feels right for me. Here the medical ultrasound is done around week 22 by a gynaecologist. At that time we were in Kenya, so we went to the Somali hospital. I brought with me back to Morocco the written report I got here, and added it to my health-book many doctors expect you to have with you for every consultation.

Mothers are recommended to do bloodtests three times; around week 8, 24 and then some weeks before birth if I remember correctly. They´re done at the laboratories where you just stop by and wait for tour turn. You can choose to pick up the results the same day or the day after, or to Get them on WhatsApp. I added a check of vitamine D. Tests are pretty expensive so that’s an encouragement to be consistent in taking supplements if needed, and to be exposed to the sun at least 20 minutes daily. It’s not normal to take a urine test at every consultation like I’m used to, only if there’s a reason, but if one prefers to do a full screening there is no need for a doctor's requisition: Every test can be done by going directly to the lab. The testing for gestational diabetes is done during the second round of blood-tests. They screen for toxoplasmosis all three times, but again, as I learn from sisters here: It’s all up to you. Your body, your pregnancy, your baby. No one will haunt you with concern. This type of freedom to really experience adulthood, to be in charge, and to claim total responsibility for oneself and one's family is one of the biggest blessings with Hijrah.

The Mental and Spiritual Preparation

With everything settled I could relax the last two months with litterature to both refresh and increase my knowledge to prepare mentally and spiritually for birth. I started with ‘Freebirth’ mentioned in the last text, which sparked a fire of excitement, renewed joy and thankfulness for experiencing another birth. I continued with the following books:

I can’t describe how awakening and beneficial these books have been. They present a new, but so familiar(!) way to see- and experience birth, and enabled me to be much more present in myself, and more connected to my baby during birth. Many of the authors write about spirituality and its manifestations in birth. Our spirituality differs but we are closer to each other than the mechanical, material ‘God-and soul-less-ness’ I’ve been exposed to in my country of origin through conventional maternity care, welfare rationality and Scandinavian culture in general. How come I didn't stumble upon this universe earlier? I go through a phase of reading and researching during every pregnancy, but the closest I got was the book “Painless birth” written by a Danish author recommended to me by a sister during my third pregnancy. The same periode I read ‘Amani Birth, Assistint Mothers for Active, Natural, Instinctive Birth which has a Muslim perspective. They also provide courses on this topic for newly married couples, a great way to familiarise parents on the topic of natural birth. A part of getting familiarised with natural, unmedicated births, is to attend some, or more accessible, to read what women share. Readers who doesn´t find any interest in birth stories can jump to the next part “A Birth´s Paperwork.”

A Homebirth

All my five births have been similar, and I was right about feeling sure that this one wouldn’t be any different: This is the way my body gives birth if left alone to do its work. Like the earlier births, this one started several days before the due date, some hours before salatul fajr, with a constant tense feeling in my lower back that gradually turned into weak and irregular contractions. They got stronger as the dawn turned into day, and when I vomited, I told my husband that this is the day no doubt. We felt excited and calm as we wouldn't leave our home to welcome our baby into this world, but stay home.

I sent an SMS to my midwife informing her about the beginning phase. Shortly after she answered that she was out of town for Eid, and therefore not able to attend any birth. I remember I reacted with a laugh. This was surely qadr Allah, a challenge we took with confidence. We reflected on the options we had during the gradually increasing contractions. I couldn’t stay in bed anymore, and knew one thing for sure, I wanted to confirm the baby’s position. The night of Eid I felt that he had turned back to the breech position he had stayed in until week 38. As I have never experienced a breech birth, I didn't feel comfortable about having a breech birth at home without an experienced midwife attending. My husband meant he hadn’t turned, but I just had to get it confirmed so to eliminate that little insecurity. With the invaluable help of a sister neighbour, we called around to see where we could go for an Ultrasound. Eid vacation made it difficult, so the solution became one of the big private clinics where a gynaecologist welcomed us for a check-up. Before ten o’clock we were in the car. The contractions during that car ride were strong and lovely, as I felt my body open at least two centimetres. I was completely engaged in my contractions, and I welcomed them with dhikr. I visionalized how they one after another brought my baby closer to me. I hadn’t in advance decided upon a specific vision to delve into during contractions, but what I saw when I closed my eyes, was surprisingly strong and mighty eagles with huge wingspans who took off from the ground.

When we entered the clinic, sobhanAllah, the contractions stopped like I was hitting a light switch. The hall was huge, cold and empty. My friend talked with the lady at the reception who followed us to the right area where we were welcomed by the gynecologist on duty. I was surprised that my husband couldn’t come with us. She was exhausted after a long shift miskina, and I was thankful for her having us on short notice. She asked me if I had any contractions, and I said I had some the same morning, and that I had control over them. I hesitated to say that I felt I was getting close to the active phase, in case she would insist on keeping me there. She asked me which doctor I went to, and I told her I only went to a midwife. ‘A midwife,’ she repeated and rolled her eyes, before she observed my tummy and said ‘Oh this must be a big baby.’ ‘Oh, ok, maybe’, I said, but I didn’t believe that. I’ve never had a smaller tummy when pregnant, so I felt the two midwives who confirmed that the baby was around 3 kilos were right. I layed down and the doctor felt my tummy and said ‘There is no contraction here.’ Like, nothing is going on here yet my dear, so I was wrong when I said I felt the birth was in a beginning phase. She could confirm that Alhamdulillah, the baby’s head was down and that it was his hip that we felt on the top. I asked if the baby was down in the pelvis, and she could confirm he had a good position for a natural birth. She looked confused for some seconds before she said it was already 6 cm opening. ‘You can give birth any time, do you want to stay or what is the plan?’ We told her that we wanted to talk through it and then decide (which I think surprised her.) Suddenly she disappeared with the other lady lying in a hospital bed at the other side of the room I updated my husband on the phone and we agreed on heading home.

Before we entered the car, we had to cross the entire hospital to pay for the check-up. On our way there with my slow, slow motion, I had to vomit twice and Alhamdulillah I brought with me a bag, and Alhamdulillah no one else but us were in that corridor. We found a garbage bin to throw it, I payed, waited for the receipt, and then Alhamdulillah, we were out!!!! The sun hit me, and in the same second the contractions started again, Allahu akbar. They were powerful on the whole way to pick up a lovely sister doula with a lot of home birth experience, and they increased even more in strength up each stairway to 4th floor. For sure this trip was good in so many ways! The clock had passed 11, and from here we stayed in our bedroom and the bathroom where I fell asleep between contractions.

My neighbour gave me a big cup of zam-zam water and after every taste with dua, the contractions became stronger. The clock had passed one, and I realized this could be the transition. The doula made dhikr and massaged my back with an oil that smelled wonderful. The water hadn’t broken so maybe I should take it myself? It was then I realized that I was fully open as the head was just there. That meant that I actually was ready for the next phase, his entrance into this world. I didn’t feel the urge to push, but at the same time I told myself that when everything is ready, my body will send signals to push. I then instinctively moved into different positions, and click, suddenly my body pushed by itself one strong contraction after the other. I guess the movements had helped the baby into the optimal position and touched a specific point. Some few contractions later the doula got prepared with a clean towel. The baby took a breath when he met the air, and some amniotic water ran out of his mouth. On the next contraction, his shoulder and the rest of his body came into the Doula’s hands. He was quiet but awake, and only made a small cry, like a ‘Salam guys.’ She gave him to me and I went up into my bed, kissing my baby with tears flowing. My husband said the iqama and adhan in his ears, and put a small piece of dates in his mouth. After ten minutes or so I felt a contraction and some blood, so I pushed a little and the placenta was born. The doula put it in a bowl beside us, and I was beyond grateful for the midwife who sent her lovely assistant to cut the cord, and to check me and the baby.

Our children and the neighbours’ children came with fruits and cake to greet the newborn. I was so so so happy, so relieved, so proud, so thankful, so in peace! I can’t recall one moment of this birth that I felt pain, fear or frustration, and the baby got the most peaceful and undisturbed start of his existence on earth.

A Birth’s Paperwork

Three days later we went to our midwife who had returned from vacation. Since I went to her during pregnancy, and her assistant separated the baby from me after birth, she could write me the confirmation of birth despite not being there physically. We talked about this scenario in our first consultation as I wanted to make sure we didn’t risk ending up in a situation where it would be hard to prove the birth. With this paper, including the following papers, we went to the muqata'a our neighbour belongs to, to get the birth certificate:

As neither me or my husband are Moroccan citizens, the baby doesn’t become a Moroccan citizen either despite being born here. Moroccans have a “family book,” but we only got a birth certificate for immigrants. We didn't get a sheet to fill out, but we were asked what our profession was, what we wanted to name the child, and the name of our parents. After one week we returned to pick up the birth certificate. Be sure to get both the “extracte act de neissance” and the one called “full act de neissance.” It is the last one the Norwegian embassy calls “copie integrale.”

The next step was to prepare the documents for applying for a person-number and passport at the Norwegian Embassy. Both parents need to go, and if that’s not possible, the absent parent must consent either in advance at the embassy, or at a police station in Norway. This is the list of what we needed to bring:

It can take up to ten weeks to finish this phase, but when the baby has his passport, the time has come to apply for his Résidence permit, a process that will be the topic in a later post bi idhnillah. Giving birth in Morocco was a truly blessed experience, Alhamdulillaah. For me the key was to prioritise a phase of holistic preparation, so to feel safe, relaxed and grounded. If I was asked my top three “tools” for birth, (nb, not as a birth professional, but as a mother who has given birth multiple times), I would answer:

Salatul istikhara for deciding the birth´s place and attendance. Visualising time and time over how you want the birth to unfold while practicing deep breaths. Walking at least 40 minutes daily and taking advantage of every stairway in your way.

Tooootal Relaxation during contractions beginning with saying Allaahu akbar, and ending them with Alhamdulillaah, while truly realising that very every good contraction brings your baby closer!

Moving between contractions, choosing an upright position that makes gravity helpful and to have dates, water and nuts close by.

The hormone flow that comes with the milk production makes me super-melancholic every time. I tell myself that these are just some chemical connections, and I say it out loud to my husband and friends. I do my best to have a comfortable and relaxed post-birth period without stress or worries. I eat, sleep and drink well, and I have the baby skin to skin as much as possible. These weeks are so precious,

and we never get them back.