Text and Photos: Laura Wando
Many expats in Kampala who become pregnant find themselves facing some big decisions: what are the best hospitals? Is it safe to deliver here? Should I go home to deliver? What are my birthing options? What if my baby or I have a medical emergency?
Birth Preparation, Support Groups and Labor Support
Kampala has a fair range of childbirth education, antenatal care and delivery options for expectant mothers. Some hospitals offer antenatal classes to help prepare you or you can access private childbirth preparation classes or support groups. The Positive Birth Movement- Kampala is a support group that meets monthly, bringing together both experienced and new moms to discuss a different birth or postpartum-related topic each month in a non-judgemental atmosphere.
You can also hire a birth doula to help you navigate the prospect of birthing in an unfamiliar health system. Doulas provide emotional, physical, relational support to birthing families and facilitate communication between you and your provider. Support from doulas has been shown to reduce the rate of medical interventions and lead to more positive feelings about your birth experience.
Some of the larger private hospitals in Kampala, staffed by OB/GYNs and Midwives, that are recommended by fellow moms include Nakasero Hospital, International Hospital Kampala (IHK) in Muyenga, Paragon Hospital in Bugolobi, Women's Hospital and Fertility Center in Bukoto, Kibuli Muslim Hospital in Makindye, Kampala Hospital in Kololo, and TMR International Hospital in Naalya.
Most private hospitals offer a choice of private or shared labor and post-partum rooms. It isn’t as common to find a hospital that has an “all in one” labor, delivery and postpartum suite. You may have to labor in one room, deliver in another, and recover in yet another room! Some of the hospitals have private baths where you can use water (shower, tub) for pain relief, but none of the hospitals offer water birth.Access to gas and air (entonox) or other short-term narcotic pain relief is limited and not routinely administered. Some hospitals offer epidural pain relief if arranged in advance with an anesthesiologist. Emergency C-sections can be performed if needed. Neonatal intensive care units (NICUs) are available at the larger hospitals -- Nakasero, IHK and St. Thomas Nsambya are just a few that have the ability to care for very premature infants.
If you,d rather give birth in the comfort of your own home, a private registered midwife, Diane Lockhart, offers antenatal care, lactation support, and home birth services (including access to a birthing pool!) to low-risk women in Kampala.This gives you the opportunity to experience physiological birth. Transfer to a hospital is arranged in case of any complications.
Experiences of moms who stayed
Moms who stay in Kampala to give birth do so formany reasons: in order to remain with their spouse and older children, for work reasons, or for financial, or health insurance reasons. Some feel more comfortable birthing here, and want their child to be born here, or want to birth at comfort of their own home. Staying here requires trust and confidence in your chosen care provider or hospital and a having a great relationship and communication with the provider is key.
Some moms share their experiences
Lynne, delivered at home in Kampala:
So when I first got pregnant the whole thought of finding a hospital here was overwhelming because I don't like hospitals. Once I found out about Diane Lockhart (homebirth midwife) and met with her, Diane encouraged me that a home birth was more doable for me.
I recommend home birth if cleared by a doctor and if you have no complications; don't be scared of this idea in Kampala.
I'd advise new moms not to be scared out of the idea of home birth, if that is what you want. I felt really confident that if any complications were to arise that my midwife would catch them early enough to get me to a well-established hospital.”
Arianna delivered at Nakasero Hospital:
I stayed because health care here seemed good enough and traveling back, buying plane tickets and giving birth in US without insurance is costly.
My friends here had good experiences, and I felt confident that I'd be well taken care of here.
Generally I was happy with staying here but would urge communication with the provider and finding a provider that is both a good listener and open minded. Nakasero Hospital wait times are quite long to see the OB and get lab tests done could take all day.”
Stephanie delivered at IHK with an epidural:
I had the best delivery and no pain for my 1st baby (in the US), so I felt brave enough to give birth here. I know a lot of muzungus have babies here all the time and it seems like the majority stay here.
I decided to have my 2nd child at IHK, with Dr. Alex the Russian doctor. I had a great relationship with the doctors and midwives there and really got to know them. My insurance also covered my birth there and we were already going there for primary care.
I wanted an epidural because of my pain intolerance but I was skeptical at first. I had a great experience, in spite of the epidural headache. They were very set up to monitor me and they were amazing and told me all about the procedure. It helped that the anesthesiologist is the brother to one of the teachers at my school.
I had a wonderful midwife. My husband stayed with me and I had a private room and he was able to take a nap in the room and then staff went and got him when it was time to push. They even asked if my husband wanted to cut the cord.
When giving birth in Kampala, you just have to know what to expect and have a good attitude, and ask questions. It's definitely about the relationship you have with the medical people. At IHK, you can request to have a specific midwife to attend your birth and pay extra to stay with you for 24 hours. There is always a doctor on duty and they call your doctor when it is time to deliver.
The decision is yours
Staying in Kampala to give birth will be based on your own personal intuition, comfort and situation. Your birthing options may be more limited and you may have to take extra care to prepare for birth, and make more effort to develop a close and open provider-client relationship and advocate for the birth you want; things that you may take for granted at home. Although birth outcomes are sometimes out of our control, birthing in Kampala can often be a very positive experience!