The maternity unit at the Government-run Al Wasl hospital in Dubai has a great reputation despite being considered a no-frills hospital.
The maternity unit at the Government-run Al Wasl hospital in Dubai has a great reputation despite being considered a no-frills hospital.

Eight steps for a cost effective and hassle free birth in the UAE



Having a baby in the UAE can be an expensive business. With prenatal care for the mother costing up to Dh6,000 and the birth costing as much as Dh25,000 depending on whether it's a natural or Caesarean delivery, it's not something parents to be can take lightly.

Once they've also factored in antenatal classes, postnatal care and the possibility their child may need neonatal care after birth, they're looking at a minimum bill of between Dh20,000 and Dh30,000. And that's without all the new furniture and equipment they need to buy for their precious bundle of joy, not to mention the cost of actually bringing up the child. With estimates of between Dh1.26 million and Dh2.52m to raise a child to the age of 18 in the UAE, dependent on the school they attend, that's a tall financial order.

"Unfortunately, there's no such thing as a good deal when it comes to having a baby in the UAE," says Cecile de Scally, a Dubai-based midwife educator. "And you can't really predict how much it is going to cost. Your insurance policy may not cover maternity at all or only cover a limited amount, so if you have a budget of Dh8,000 and the birth ends up costing Dh14,000, you've got to make up the shortfall."

But Annette Kirby, from the Abu Dhabi-based website, www.expatdoula.com, says doing your research will help you both financially and emotionally. "Fortunately, there are many choices for childbirth. People should 'shop around' until they find a health care provider they feel comfortable with," she says. "There is a lot of scientific evidence that once a woman feels that she is in good hands during childbirth, she is more likely to have a good outcome."

1. Pick a hospital

The most important part of the process is finding a hospital that you want to deliver in. But before you latch onto a doctor you like or choose a hospital because your best friend said it was great, compare prices first. There is a good choice of private and government-run hospitals in the UAE and the difference in cost can ease the burden for those on a tight budget.

A normal delivery at Dubai's City Hospital or Welcare Hospital with a two-day stay in a private room costs Dh11,000. But if your birth is an instrumental delivery (with forceps or vacuum), this can bump up your outlay to Dh13,400, while a Caesarean costs Dh22,500. Abu Dhabi's Corniche Hospital charges Dh10,000 for a normal delivery and from Dh10,000 to Dh14,000 for a Caesarean. At Sharjah's Al Zahra Hospital, prices start at Dh6,900 for a basic normal delivery package with a one-night stay. A three-night stay will set you back Dh10,350.

For some, it's not just the hospital that's important, but also the exclusivity of the room. At Dubai's City Hospital, for instance, a four-day stay in the Royal Suite following a Caesarean can set you back Dh95,000 compared with Dh22,500 for a standard private room.

Dubai's government-run Al Wasl Hospital is considered the "no frills" choice, but while you may not receive the upmarket feel of a private establishment, its maternity unit has a great reputation.

Charges for a normal delivery package with a two-night stay in a shared ward costs Dh7,000. This rises to Dh9,000 for a private room, Dh10,000 for a Caesarean delivery in a shared ward or Dh12,000 for a private room. If you do choose a government hospital, make sure you register at it before the birth and that you have a health card, which costs up to Dh310 for expatriates.

Also, remember to check for hidden extra costs: epidurals, which normally cost about Dh2,000, medication and blood transfusions are often not included in the package. Having twins, triplets or more will cost you more, too, with each baby setting you back an extra Dh3,500 for a normal delivery and Dh5,000 for a Caesarean.

And anything from the baby needing resuscitation after the birth to your husband choosing to stay overnight in the room with you will cost extra. Some hospitals also charge for the baby's nappies and wet wipes, so read the small print.

2. Choose an antenatal package

Once you've decided on the hospital, the next step is to book an antenatal package. These usually include up to 10 visits to your obstetrician of choice in the run up to the big day and most of the essential tests.

Dubai's Al Wasl charges Dh5,000 for up to 10 visits, City and Welcare Hospital charge Dh5,175 from week 12 and Dh3,350 from week 28, Sharjah's Al Zahra Hospital charges Dh4,000 for up to 12 visits and Abu Dhabi's Corniche Hospital charges Dh275 per consultation.

Some people also choose to have all their antenatal care at their local clinic and their consultant will deliver their child at their hospital. This can also make delivery cheaper. For example, a community physician normal delivery package at the American Hospital costs Dh8,250 as opposed to Dh11,590 if you use the hospital's own doctors.

You will often be asked to pay the antenatal package fee up front and remember, once again certain tests are not included in those packages, particularly specialised screening tests and blood tests and injections if your blood group is Rh Negative, so be prepared for extra costs.

3. Learn the ropes

Developing an understanding about the birth process is an important way to ensure the delivery is as smooth and pain free as possible, so book in for some antenatal classes.

Prices range from as low as Dh600 to Dh1,800, depending on how many sessions there are and whether it's a group or individual class. They usually start 24 to 28 weeks into the pregnancy to give you enough time to complete the programme before you give birth. The classes cover every eventuality of delivery, pain relief, understanding your newborn and feeding.

"Knowledge is empowerment when it comes to antenatal education. The more a couple is prepared for what to expect during labour, delivery and the postnatal period, the more likely they will be able to cope successfully with the challenges of parenthood," says Ms Kirby, who offers antenatal classes through her website.

Ms de Scally, who runs weekly three-hour sessions at Little Wonders Nursery in Dubai, charges Dh1,500 for four group classes and one individual session. "Insurance companies don't generally pay for antenatal classes, so it is another expense for new parents. But it's also essential, especially for first-time parents," she says.

4. Decide on your support system

Some mothers prefer to have the help of a doula - a woman with no medical experience who has been trained to help provide emotional support and physical comfort during labour.

"This is particularly important in the Middle East, where women are often far away from home and therefore in an unfamiliar medical environment or their husbands are working outside the UAE and may not be available on the day," says Elizabeth Bains, of www.dubaidoulas.com.

A doula will usually be on hand for two to three consultations before the birth and then stay with you for the duration of the labour, whether it is two hours or 36 hours.

"The hourly rate for a doula varies from Dh100 to Dh600, depending on the level of education and experience she has," says Ms Kirby. "Some doulas have attended a three-day workshop, others have worked for many years with mothers and babies, have attended hundreds of births and may even be lactation consultants. It all varies."

5. Check your insurance

How much maternity cover you have depends on whether you arrange the policy yourself or if it's a corporate policy with your employer. The amount of cover varies from company to company and what people are willing to pay for.

"In most cases, the normal pregnancy and childbirth benefits is up to US$10,000 [Dh36,730], but some plans offer full cover for complications, while others limit this," says Keren Bobker, a financial adviser with Holborn Assets and the On Your Side columnist for Personal Finance.

"If you are arranging your own cover, choose a plan from an insurance company, select a level of cover and purchase an add-on maternity plan that offers a specific level of cover. The difference with corporate policies is that you usually have to accept the terms offered, which the employer has negotiated. Anyone on an Abu Dhabi visa must have medical insurance provided for them by their employer and for most people, this must include maternity cover. This is not the case in the other emirates."

For those wanting to upgrade their corporate plans, they need to check if the scheme or employers will allow this. Alternatively, if a company-sponsored scheme does not include maternity cover, you can pay for this additional plan yourself. But remember, selecting maternity as a policy add on does not ensure it is activated immediately.

"In most cases, you have to have been covered for between nine and 12 months before any maternity-related claims can be made," says Ms Bobker.

Also note that the issue of insurance is not only a concern for you, but also your unborn child, who is not automatically covered by your policy. To get cover, the insurance company needs to be notified of the child's existence and, while some companies back date that cover to the birth, others don't unless you notify them within a certain time period.

6. Register the birth

Registering your baby's birth may not set you back financially because it should cost no more than Dh300, depending on the hospital and emirate you deliver in. But you will need to set aside a chunk of time to get all the paperwork done. As well as the Arabic birth certificate issued by the hospital, you may need an English copy, which requires getting it translated and attested by your emirate's health and foreign affairs ministries.

You have 30 days to complete this process before the next step: getting your child a passport, another cost to factor in, and then a residence visa, which must be done within 120 days of your child's birth and will cost about Dh100 for each year of residence plus Dh115.

7. Get help after the birth

In the UAE, the first contact a new mother has with a doctor is six weeks after the birth at a routine appointment with her obstetrician. But a lot can happen in six weeks and issues such as feeding difficulties and postnatal depression can be missed. Although many other countries offer free in-home support for new mothers, in the UAE you need to pay for this service.

"After the birth, postnatal support is equally important and many mums cannot afford that extra cost, particularly if all the money they've put aside has been used up in the birth," says Ms de Scally, who advises putting some cash aside to help you with your needs when you get home.

Thankfully, more UAE hospitals and clinics are now offering postnatal support services with qualified midwives that include home visits, lactation consultations and baby-care classes to make the transition into parenthood as smooth as possible.

8. Buy second-hand

When it comes to decorating the nursery, the urge to buy everything new, particularly for a first child, can be overwhelming. But there's no shame in buying second-hand. Friends with older children will have cupboards full of used cots, baby baths and changing mats they're only too pleased to get rid of. And websites such as www.dubizzle.com, www.souq.com and www.expatwoman.com are bursting with used baby products for sale. Another useful tip is to keep an eye out for garage sales or car-boot sales. You will nearly always find a host of baby products at giveaway prices - sometimes barely used. And even if you do buy second-hand, there's nothing stopping you adding some signature touches to your purchases to make them your own. Paint the frame of your second-hand cot to match the decor of the room or buy your own bedding to spruce it up.

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”