This week, the European Court of Human Rights (ECHR) rejected two applications of Czech mothers who were not allowed to give birth at home with assistance by midwives. The Court ruled that it was not in the position to evaluate legislation of individual states, as the practice is not unified within Europe. In its substantive reasoning the court nevertheless agreed with the complainants on many points. We have therefore decided to use their last resort – request for referral to the Grand Chamber of the Court.
According to the Court there is no unified view on home births and the system of care for the new-born within Council of Europe. It followed that home births are regulated by legislation only in half of the European countries. “The Court omitted Denmark and Norway. And when taking Slovenia and Estonia into account, where the legislation is just being prepared, and Spain and Finland where home births are tolerated, the look at the map of Europe becomes very telling”, says the bio-statistician Markéta Pavlíková.
On the contrary, the court did not disagree with the applicant’s position in substance. Conditions for free choice for birthing women in the current practice are not met. “The Court also agreed that the risks of out-of-hospital births are comparable to the hospital births, in respect to low risk pregnancies assisted by a qualified midwife and sufficient continuous care,” said lawyer Richard Hořejší.
According to the Court, the State should continuously reflect the medical and legal developments. Recommendation of British state institution NICE from the beginning of this December notes that for up to 45 % of women and their children it is beneficial to give birth out of the hospitals. “Statistics and studies as well show clearly that women and children in care of midwives have the least negative outcomes as injuries, operative births, episiotomies. These happen much more often in common hospital care,” says Ms. Pavlíková.
Belgian judge Lemmens has published a dissenting opinion, according to him the issue of home births seems to be the object of a form of power struggle between doctors and midwives, where Czech medical doctors do not hesitate to use pressure tactics. “He noticed that the working group on obstetric care at the Ministry of Health was “cleared” of any non-medical views too,” said Human Rights League lawyer Zuzana Candigliota.
League of Human Rights is dealing with the rights of women during childbirth on their website www.ferovanemocnice.cz. There, we will continue to publish information on further developments as well as advice for women on their rights and opportunities to engage in change.
Legend to the map:
Dark blue – home birth is expressly allowed under certain conditions.
Light blue – legislation allowing home births is being prepared.
Green – home births are tolerated but not regulated by law.
Source: Judgement in Dubska and Krejzova against the Czech Republic (pat 4, point 60 and 61) and the report European Perinatal Health Report 2010 by Europeristat
For more information contact:
Zuzana Candigliota, lawyer of the League of Human Rights, phone no. +420 607005043, e-mail:zcandigliota@llp.cz
David Záhumenský, advocate cooperating with the League of Human Rights, e-mail:advokat@davidzahumensky.cz
Adéla Hořejší, attorney at law, phone no. +420776696656, e-mail: adela.horejsi@horejsilegal.cz
Markéta Pavlíková, bio-statistician, phone no. +420603795125, e-mail: pavlikova@biostatisticka.cz, web: www.biostatisticka.cz
More information:
Description of the case of one of the women (in Czech): http://llp.cz/pripady/pravo-zeny-na-asistovany-domaci-porod-resi-soud-ve-strasburku/
Article by bio-statistician (in Czech), Markéta Pavlíková, on problematic practices in the Czech birth care including after birth stay in the hospital and so called ambulant birth here.