The Case of Dr. Ágnes Geréb

Donal Kerry – International Spokesperson of the Movement for Justice for Dr. Geréb, Hungary

Dr. Ágnes Geréb has been under house arrest since December 21st, 2010. Before this she was imprisoned from October 5th, 2010 until December 21st, 2010 and was then transferred to ongoing and indefinite house arrest. All of this started on the evening of October 5th, 2010 when she came to the aid of a mother experiencing a precipitous birth. This and other birth incidents have since been combined and Dr. Geréb was charged with professional negligence in these matters. These cases come before the courts starting December, 6th 2012.

Additionally, on 10 February, 2012, Dr Geréb was sentenced to 2 years imprisonment/10 year work suspension for professional negligence related to two home birth fatalities from 2006 and 2007. Dr. Geréb avoided immediate imprisonment as she sought clemency from the Hungarian President. President Áder made a statement in the matter on 8th October and declared his intention to await the finish of the trial starting December, 6th before making his final decision on the 2 year prison clemency request.

How can this criminalisation apply to Dr. Geréb who has recorded over 3,500 healthy home births with only 3 fatalities in 17 years, when hospital doctors avoid criminalisation even though they have been involved in the deaths of thousands of babies and hundreds of mothers in the same time frame. A double standard applies whereby midwifery led adverse birth incidents automatically become the subject of criminal investigation whereas doctor led hospital adverse incidents are first investigated by their professional peers and rarely if ever get referred to the police for further criminal investigation.

This unjust and unequal situation has its roots in the fact that successive Hungarian governments failed to legislate to give full and proper effect to a Hungarian woman’s constitutional right to give birth at home (as per the Civil Rights Ombudsman Peter Polts’s ruling of January, 1998). From then until May, 2011 the absence of legislation meant it was illegal for all licensed medical professionals to provide services into the home. Parents wishing to birth at home would have been left with the unenviable choices of doing so alone or going to the hospital, had Dr. Geréb and her unlicensed independent midwives not continued to support them and attend their home births.

Very quickly the medical establishment resented this move as they saw it as a threat to their power, prestige and income-flow from the lucrative maternity industry. Gradually, they influenced the political powers to their way of thinking and then the law enforcement agencies escalated scrutiny on parents, independent midwives and Dr. Geréb in particular. In 2006/2007 this led to Dr. Geréb facing criminal charges of professional negligence relating to an adverse birth outcome in 2000 and she was suspended from working as a doctor for three years. Then in October, 2010 she was imprisoned before being transferred to house arrest.

It was through Anna Ternovszky, a young mother who had already had an assisted home birth with Dr. Geréb, that Hungarian home birth parents made their move to assert their constitutional rights. Anna, already pregnant with her 2nd child, asserted her claim through the ECHR that her human rights were being denied by not being able to receive medical services in the privacy of her own home when birthing. The ECHR upheld her challenge in their Ternovszky verse Hungary ruling of December, 2010. The current Hungarian Government were now obliged to act and in May 2011 they introduced first-time home birth legislation. Independent midwives or doctors wishing to lead home birth deliveries are now able to apply for licences as “service providers”. Unfortunately, the home birth legislation is so restrictively drafted that to-date, only 3 midwives have received this licence and many expectant mothers are deemed ineligible to give birth at home. It’s clear that these regulations will need to be modified through negotiation or by further legal challenges.

The new legislation made no attempt to address, let alone remove, the discriminatory and criminalising procedures which independent midwives have always faced in dealing with the investigation of adverse birth incidents. It remains a telling fact that all present and future licensed midwives, who lead in an adverse birth incident, will automatically become the subject of criminal investigation and will most likely find themselves facing serious criminal charges in court. Additionally, they will face a criminal court whose current procedures are incapable of providing them with a fair trial. One has only to look at the obstacles and challenges that Dr. Geréb has had to face to see how impossible it remains for a midwife to get a fair trial:

  • Midwives are not registered on the courts current expert list and cannot therefore be called as expert witnesses.
  • Courts have only used experts who are maternity hospital doctors with no direct experience of home birth.
  • International home birth experts have been disallowed from providing expert opinion before the courts.
  • Hospital based experts have been allowed to claim that home birth is dangerous.
  • Hospital doctors without appropriate obstetrics/gynaecological qualifications allowed status of experts.
  • Courts refer only to hospital protocols in evaluating Dr. Geréb’s birth actions when in fact home birth protocols should have pre-eminence in these cases.

The evidence throughout Dr. Geréb’s trial and from everything else before and after it suggests that court changes of the type needed to get rid of the impediments to a fair trial will, at the very best, be very slow in coming. Therefore, the most effective way of avoiding an unfair trial is to ensure that independent midwives no longer have to be processed automatically through the criminal code system. In future they must be treated similarly to hospital doctors with respect to the investigation of adverse birth incidents and have their birth actions assessed by a permanent medical committee of their peers. How long it will take the Hungarian Government to legislate in this direction is difficult to say but it surely is less a question of if than when. The trend in nearly all western countries is in this direction and as a member of the E.U., Hungary has its obligation to support the best modern practices which apply in this area.

For Dr. Geréb these changes cannot come in time to undo the grave injustices she already has had to suffer: the professional suspensions, imprisonment, continued severe house arrest, previous unfair trials, pending trial of 6th December with unfair structures and procedures still in place, and still having to cope with the threat of the delayed February, 2012 two year prison sentence being finally implemented.

The Movement for Justice for Dr. Geréb and certain other Hungarian midwives will continue its campaign to seek justice for Ágnes and to help her promote the rights of birthing mothers.

MORE INFORMATION:

Birth House Association, Hungary

Birth House is the website of Ágnes’s support group, with up-to-date information on her case in English

BBC News : Midwife under house arrest for home births in Hungary

Nick Thorpe, BBC Budapest Correspondent, June 2012

Birthrights – Hard labour in Hungary

Film examining the growing criminalisation of homebirth midwives and underlying issues in Hungary, March 2011

A 21th Century Midwife – Interview film (video at http://vimeo.com/37878482 no longer available) with Ágnes Geréb by Cultural Creatives, English, March 2012

Original language: (video at http://vimeo.com/37040564 no longer available). Szabadon szülni, szabadnak születni

Short excerpt from the speech of Dr. Geréb at the trial of 6th December 2012

English summary of the video, no literal translation:

“I was banned from practising as ob-gyn, but I was not banned from practising as a psychologist or a midwife. Whatever I did belonged to midwifery competence. Independent midwifery was unregulated, but not illegal. Women need midwives to have a healthy pregnancy and birth, they also need that ob-gyns and midwives work together in respect for each other. Ob-gyns are trained to resolve problems when something goes wrong during childbirth. It’s the task of the midwife to see the barriers of the healthy pregnancy and birth. I would ask a question to myself: Who could possibly seriously think that it’s not the mother who wants the best for her child with the most possible responsibility and caution?”

Joint statement released from ICM and FIGO (International Confederation of Midwives & International Federation of Gynecology and Obstetrics) against criminalization of midwifery in the European Union, March 2012

ONE OF THE CASES OF CRIMINAL PROSECUTION AGAINST DR. GERÉB: Birth stories of Eliza’s parents

First person birth story of the mother (Joli Száz) and the father (Thierry Fouilleul), video of Eliza, the 2 year-old girl who is supposed to have permanent brain damage due to a streptococcus infection at the birth in May 2010 with Ágnes Geréb. According to the mother she is perfectly healthy, and actually alive thanks to Dr. Geréb’s procedures after the birth.

Click here for a YouTube video of Eliza. Her diagnosis of permanent brain demage was stated by the medical expert without ever examinining or actually seeing the girl. Criminal charges against Dr. Geréb were based on this medical diagnosis.

Click here for Eliza’s birth story, as told by the mother (Nightmare) and the father (Arrested).

There are further cases against Ágnes Geréb before the court. All the parents are grateful to her and fully supporting, but they are not being listened to. The three mothers involved in the cases were asking in vain for the possibility to share their actual birth stories with the Minister President of Hungary. Their request received no answer whatsoever.

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