Anna Ternovszky’s speech at HRiC Conference 2012

I would like to welcome all conference participants, as well as every attendee who is following this invaluable event from different corners of the world. I would also like to take this opportunity to thank the organizers for the tremendous effort they have put into making this milestone event possible. It is a great honor to be part of this conference and meet the most respected experts of the different fields, while also learning more about their work. I’m a bit nervous not only because this is my first time giving a speech at a conference in a language other than my mother tongue, but also because this topic is extremely important to me and I want to make sure I can convey my message to you as clearly as possible.

First of all, I would like to give you an insight into the situation that I was facing when I was expecting my second child, so you can better understand the significance of all that I will be sharing with you. It happened 3 years ago, and at that time it became very clear to me that the legal circumstances in Hungary prohibited me from taking advantage of the midwifery expertise that existed and should have been available to me. You see midwifery was not a recognized profession in Hungary then despite the fact that my own midwife Ágnes Geréb had spent the previous two decades trying to obtain the necessary permit from the authorities, which would have allowed her to assist homebirths. In the absence of these permits Ágnes and other midwives were exposed to and experienced criminal prosecution whenever an adverse birth incident arose. Out of fear that my second home birth could trigger another case against my midwife, and understanding that other independent midwives had similar fears, I turned to the European Court of Human Rights to seek legal remedy with the help of the Hungarian Civil Liberties Union. We accused the Hungarian state of violating two articles of the European Convention of Human Rights; one dealing with one’s right to privacy and the other concerning its anti-discrimination regulation. The ECHR ruling was made within a year and found that both my rights had been violated.

I won. But it wasn’t just me. It was all other women, who would wish to exercise such right. But now I begin to wonder have I really won?

In some ways yes, as the new

Do from looked I. Great regulation governing home births in my country was created within a year and for this I thank the Hungarian government and all experts who were involved, as many other pressing economic issues were also in need of their attention at that time. But in other ways we lost as the regulations which came into force were very restrictive on both birthing mothers and independent midwives. Though doctors and midwives can now legally assist home births, if any complication arises, it is the midwife who can still face automatic criminal investigation and likely prosecution. As long as our new legislation fails to address this very important discrimination then I feel we must continue to fight for equality of treatment between doctors and independent midwives in the matter of investigating adverse home birth incidents. In addition, we are concerned that the regulations failed to establish a midwifery board of enquiry and while we understand that Hungary may not have enough midwifery experts at the moment, advice and support could have been sought from international midwifery experts to help solve this issue.

If I were to have a baby now, I feel I would not be in a position to opt for a home birth. Why do I feel this way? Because even though the legislation permits midwives to seek a licence the underlying philosophy of the regulations is to limit the role and influence that midwives can play in the pregnancy period, to excessively restrict the number of women who are eligible for homebirth and to give the obstetricians and gynecologists the ultimate power of control in the birthing process.

One of the basic problems I see with this approach is that it views mothers and their babies separately, and assumes that what moms want is less than the best for their babies. It assumes that we wouldn’t inquire and know well enough about the process of birth, which is certainly not the case. There is no argument made about the fact that we can care for our children after birth all the way until they turn 18. Then why wouldn’t we be able to make informed decisions about the baby we carry under our heart, with whom we even share our breath?

 Anna Ternovszky giving birth to her first child with Agnes Gereb

Anna Ternovszky giving birth to her first child with Agnes Gereb

At the time when my two sons were born, home birth was available to everyone regardless of finances. This is no longer the case. Because of the huge costs involved in midwives securing a licence it means that home births will not only be expensive but parents will not be able to claim these costs back through the social insurance system. This is clearly both wrong and unjust when parents who have hospital births can access social insurance support. Also, there are excessive and unnecessary restrictions determined by obstetricians and gynecologists that put unreasonable constraints on the work of midwives and which reveal that these medical professionals view home birth as an extreme and inherently dangerous activity. They believe this by disregarding important international statistics, which clearly shows that low risk pregnancies lead to births at home that are just as safe as in hospitals.

If birthing is our basic human right, and if we have the right to choose the best birth place and conditions for our baby, then how is it possible that parents who wish to give birth at home, and the midwives providing service to help them fulfill this wish, are excluded from some of the most basic supports offered by the state through the social insurance system? Why is it that a home birth mother whose blood type is Rh negative, like me, is expected to pay for her baby’s medical examination to determine his or her blood type and then cover the expenses of the antibody given to the mother when hospital birth mothers do not? Is it only in the mother’s interest to make sure her next baby is born healthy? Isn’t it also in the interest of a country to make sure that all babies are born healthy?

Since the introduction of the new legislation midwifery has been recognized as a profession separate from that of the obstetricians and gynecologists, yet our midwives remain subservient to the obstetrician team for many reasons. OB Gynecologists continue to control prenatal care, making continuous and consistent primary care impossible to receive for people giving birth at home. This in turn creates tremendous obstacles for our midwives when they try to make an expert decision about whose home birth they are able to assist with utmost safety and whom they should refer to hospitals. Both the birth process itself and our midwives remain in the hands of OB Gynecologists as has been the case in Hungary for decades. It is the doctors, not me or the midwives, who make the final decision at month eight as to whether or not I am eligible for a home birth. Surely, this violates my rights as a mother.

I do not feel that our rights as birthing mothers are properly respected and I believe discrimination will continue as long as our rights are not reflected in the governing home birth regulations. All these things put mothers and professionals who assist home births at a disadvantage and have adverse effect on both. As a result, my fears continue to provoke me to fight even harder to achieve genuine free birth rights in our country, and to secure the rights and independence that every authentic midwifery group must have if they are to properly fulfill their professional duties. To achieve these outcomes through future amendments to the home birth regulations I very much look forward to working closely with Hungarian parents, doctors, midwives, and representatives of the legal and political spheres.

As a final idea for this Hague Conference I would ask attendees to seriously consider the need for a definite, long-term and permanent work group to emerge from this wonderful gathering that can eventually benefit many people in many countries. I would propose an international collaboration through the setting up of a Hague Help Group who would initially work over the next 12 months to develop and progress the common themes and difficulties that we are all facing in our respective countries throughout the world. I truly believe this is a great opportunity and challenge for us over the coming days to agree in principle about developing a fixed working structure which will continue long after the conference finishes tomorrow. I thank all of you for your attention and now give the floor over to our expert speaker.