Political Ping-Pong and Women’s Health in Poland

Poland is considered the success story of Eastern Europe. This formidable country led the region adopting democracy, successfully integrated into the EU and has improved its economy and standard of living immensely over the past twenty years. The same could be said in the case of maternity care, which thanks to actors like Childbirth With Dignity has become increasingly evidence-based and has started to put the mother and baby dyad at the center of attention. Childbirth With Dignity even received awards from the WHO and UNFPA precisely for this advocacy work in improving Polish maternity care standards.

These standards are being abolished according to new legislation. Childbirth With Dignity prepared a petition for the Polish government, sending the message that we will not stay silent while the maternity care takes steps backwards. While it was active, the petition got over 70 thousand signatures.

Why Perinatal Standards? Why Now?
This past year has been particularly contentious regarding reproductive rights in Poland, beginning in the summer and culminating in the autumn with Black Monday, an EU-wide protest on the Polish Government’s attempts to even further limit access to termination of pregnancy services. But as we all know termination of pregnancy and rights in maternity care aren’t really on the same radar – or are they? Governments who say that they care about family values and population policies (an important issue on a continent with falling birth rates), which means that they must care about the rights and dignity of pregnant persons in maternity care?

Poland is proof that the rhetoric used by politicians who say they want to limit access to abortion in order to protect families, religious values and fertility rates is too often not reflected in their actions. Limiting one reproductive right does not mean that they are working to protect the rights and dignity of those who decide to become parents.

Being Pregnant in Poland
In 2007, Childbirth With Dignity began a collaborative process with the Polish Ministry of Health and their national professional bodies (midwifery, obstetrics and pediatrics) to form a set of maternity hospital standards known as the Perinatal Standards which had to be respected by every hospital offering maternity services.

These standards set out the minimum that hospitals had to provide women and included standards for obstetric and perinatal care, physiological birth standards, pain management standards, miscarriage standards and others. Poland was the only country in Eastern Europe with such standards, and alongside Britain and the Netherlands was only the third country in Europe to have them.

The standards were not perfectly upheld in every maternity service but improvements in services were evident and palpable, and dignified care that put the mother and baby at the center of attention became all the more present in the healthcare system.

Abandoning Care
All this changed in June 2016 when the Minister of Health acted on pressure from Polish physicians’ groups and signed a decree that would remove the standards as of 2018, destroying a consensus among professional organisations, policymakers and the public for the interest of a single group.

The summer was to be very busy for reproductive rights in Poland. On 1 June legislation annulling all state insurance coverage of medically assisted reproduction services was cut, meaning that couples dealing with infertility were now responsible for paying for all treatments out of pocket. These services had previously been partially covered by state insurance, meaning that infertility treatments, required for 1 in 6 couples in Europe, was now available only to the rich. Quite fitting given that the Polish government has been working on marketing Poland as a health tourism destination offering world-class care, foreigners who can pay for it anyway.

As the Polish government moved to vote on severe abortion restrictions in October under the scrutiny of Europe and the world, behind the scenes the Minister and the government were quietly continuing to hide the fact that they were working not only to restrict the rights and health of women who wanted to terminate pregnancies, but also of women who wanted to become and stay pregnant. This silence was a move of political pragmatism – it is difficult to defend your family and Christian values before your electorate if you have already made moves to restrict medically-assisted fertility and services for pregnant persons and their families. Abortion proves the perfect polarizing façade as the government’s words and actions collide behind the scenes.

What’s Next?
Poland cannot be a microcosm of what is to come in other countries regarding reproductive rights. Women’s bodies must not be used as political pawns to gain face before the electorate only to have governments then work to limit all our choices about our bodies. Women’s lives are more important than short-term political gains. Keep a watchful eye out for what will be going on in your country in the coming months, and keep us posted.