Prague court delivers landmark ruling in home births advocates’ battle with the state

27-01-2012

A ruling on Thursday by a Prague court might lead to a breakthrough in the ongoing Czech debate about home births. While state officials and health care providers have consistently opposed the practice over safety concerns, the court decided that mothers indeed have the right to choose the place of their child’s delivery, and the state has to provide all necessary assistance.

What has been described as a breakthrough ruling was delivered in the case of a Prague woman who sued one of the country’s largest hospitals for refusing to provide a midwife for the home birth of her third child.

The court rejected the woman’s plea because it was filed too late – the verdict was in fact issued on the day the child was born. However, referring to a recent ruling of the European Court of Human Rights in a similar case in Hungary, the judge said women indeed have the right to choose the place where they give birth to their children.

The court also said that the woman was entitled to all necessary assistance from the hospital because the state had so far denied the registration of private midwives who would otherwise do the job.

Zuzana CandigliotaZuzana Candigliota Lawyer Zuzana Candigliota represents the woman in this particular case as well as dozens of other women in similar situations. She believes the court’s ruling could force the authorities’ to change negative approach to home births.

“In the justification of its decision, the court expressed some far-reaching conclusions that might be adopted by other courts, too. In practice, this means that women who wish to give birth at home can approach their hospital, demanding a midwife to assist in the birth.”

The ruling has received little applause from the Czech medical community. The head of the Czech Gynaecological and Obstetrical Society, Vladimír Dvořák, called the ruling an empty gesture.

“Out attitude has not changed at all. Our utmost concern is to ensure maximum safety for the mother and the newborn, and we still maintain that home births are non legae artis. This means that doctors planning to deliver the baby in the mother’s home would not be following the latest medical standards.”

Ondřej DostálOndřej Dostál Hospitals argue that they do not have enough staff that could assist at home births, or the means to train them, a view upheld by a leading Czech expert in medical law, Ondřej Dostál. He believes the government should allow independent midwives to render their services to mothers who want to deliver their babies at home.

“I think [the Health Ministry] should act in the sense that it should allow the registration of home birth assistants. This I believe is also necessary from the point of view of international law. Recently, there has been a ruling against Hungary which said the authorities wrongly prohibited the providers to assist at home births, and I think every country should rectify their practices accordingly”.

Meanwhile, it seems that the Czech Health Ministry will at long last answer the calls to sanction home births. On Thursday, ministry officials announced a working group would be formed to prepare new legislation which will determine conditions under which home births will be allowed and covered by public health insurance.

27-01-2012