Hello friends! I’m back with Part 2 of the Pregnancy Abroad series to share about pregnancy in Senegal so far. Even though we’ve lived here for just two months there is already so many interesting things to share! If you missed it and want to read about what the start of this pregnancy was like in France or know more about my background with my two pregnancies before this, be sure to check out “Pregnancy Abroad Part 1” on the website.
When we arrived in Dakar I was about 24 weeks along. I am so thankful that our big move and international travel could take place during the second trimester! Thank You God for that timing. I am also thankful that we had gotten connected to our doctor here, Dr. Zayat, before we had even left France. With Dakar being as big of a city as it is (3+ million people) there are many options for healthcare. Though I used midwives in the States I opted for this doctor in order to have a provider who spoke English. This is also the doctor my teammates used when they had their baby here a couple years ago.
So far I’ve had two appointments with Dr. Zayat. For our first appointment Adam came with me and we had a really great encounter. Though we had an appointment set up we ended up waiting about two hours in the waiting room before being seen. We had heard that this would be the case with his office though so we made sure to eat a hearty lunch beforehand. When we did make it back we were warmly greeted and welcomed, he looked through all the labs, documentation and ultrasound findings we had brought with us from France and we got to have an ultrasound. This is one of the nicest things here. At each appointment Dr. Zayat himself does an ultrasound to check in on baby. In the States I only ever had two ultrasounds throughout the whole pregnancy so this was a welcome difference.
One of the other biggest differences that we’ve found is that they don’t keep much as far as records on patients. Instead it is expected that the patient brings all their paperwork to each visit. This includes previous ultrasounds, lab work and anything else pertinent. This was something I learned the importance of at my second appointment.
For the second appointment I went alone as Adam was with a sick kid. I had opted to not bring any of the paperwork from my previous ultrasounds since Dr. Zayat had looked through all of it the last time. I was used to America and even France where there is some electronic record kept. I also only had electronic results on my phone of the bloodwork and urinalysis that I had done between appointments. I had the first appointment of the day and so was able to get in much faster, however Dr. Zayat was not afraid to clearly express his dissatisfaction that I had not brought back all of my paperwork from France and that I had not made sure to get a printed copy of my lab results. While I understood that his emphasis on this was coming from a place of wanting me to receive the best care, which is made possible when all information on me is available (ie. when I carry all of that information with me), I was still caught off guard by the repeated reprimand. Add in pregnancy hormones and the fact that I was alone and you can be certain I cried after the appointment (and quickly sent a message to my previous midwife in the States to thank her for the gentle, personal practice they run!).
Thankfully all was well besides this and baby looked good on the ultrasound, albeit large. As Dr. Zayat did the ultrasound and noted that baby was measuring big, he and I did have a nice laugh that he could easily recall my last baby had been 9lbs (4 kg) at birth. I told him I was surprised he could remember that given how many patients he must see and he said, “You always remember a 4kg baby.”
One other notable thing to share from this appointment is that my hemoglobin had dropped. While it was not a concerningly low level it was a fairly significant drop. He explained that this is most likely due to the poor quality of food here. Even the meat, which should be a good source of iron, is not great, so it is very common for pregnant women’s hemoglobin to drop. I am on an iron supplement (not uncommon for pregnancy) and have been trying to increase the amount of iron rich things I eat such as lentils, which are plentiful here. With how much access we have to different types of food here in Dakar it made me appreciate how challenging diet would be in general, but especially in pregnancy, in a more rural setting.
Besides these appointments most of my experiences here related to pregnancy have more to do with stories I’m hearing from people I meet which has painted a picture for me of how very different my labor and delivery will most likely be compared to what I experienced in the States.
Unfortunately we have heard time and time again how poor the nursing care is here and how important it is to advocate for yourself. There are also many cultural differences and standards of practice that we are not comfortable with which will require some firmness on. For example, it is culturally normal here for the nurses to pierce the ears of baby girls shortly after birth and if we do not want this then we will need to be very explicit with those desires.
The setting for laboring is also very different. In the States I was able to walk the halls of the OB unit, I had a tub to labor in as well as many other resources like a birthing ball and great nurses who helped me go through labor. From what we’ve heard you are not allowed to leave the labor room once you’re there and it is small. There are no extra perks such as a tub or birthing ball. The general attitude of staff is much less warm as well which may have something to do with the fact that the birth rate in Senegal is so much higher than the States (4.45 births per women in Senegal versus 1.64 in the U.S. according to a 2020 study). We have also heard that the general amount of time spent training nursing staff is typically very short, especially when compared to the type of training nurses (especially those in specialized settings like obstetrics) receive in the States. Take all of these things and add in the stories people share in person or on FB pages regarding the poor care they received plus the number of times people have been shocked to hear that I’m giving birth here and it makes for a less than exciting view of the upcoming labor process.
I share all of this to give a picture of what I’ve heard and anticipate which, admittedly, has caused me a fair amount of anxiety. This has been a really good opportunity to daily surrender my fear to Jesus and to meditate on the truths of who God is, even amidst situations that seem overwhelming or worrisome.
God has been so faithful to meet me in each and every concern I’ve had and to remind me of His strength and presence always, as well as His provision. I will share one really tangible example of this in the next pregnancy blog post!
Thanks for reading!
-Selina