January 17, 2018
Dear President Janos Áder:
We, the board of Human Rights in Childbirth, write to show our concern that the important issues raised around the case of the obstetrician and midwife Agnes Geréb be addressed and resolved in her favor and to the benefit of future maternity services in Hungary.
Our organization was founded in The Hague in 2012 as a result of the Ternovszky v. Hungary decision in the European Court of Human Rights. Anna Ternovszky, a client of Geréb’s, sued Hungary for the right to give birth at home; the court found in her favor, and Hungary implemented a legal, safe home birth system.
The Ternovszky decision, which held that parents have the right to determine the circumstances of their own births, influenced a global discussion around the respectful
treatment of pregnant women, their families, and newborns. Respectful treatment is now the standard of care of the World Health Organization.
Sadly, respectful treatment within birth facilities is not the norm in many countries. According to a recent nationally representative survey, some 50% of Hungarian women report being disrespected in their childbirths. This same study also demonstrated that illegal payments (hálapénz) were very common in Hungarian maternity care and that these payments did not improve the quality of maternity care. Despite this, illegal cash payments have not become a public priority in Hungary. Finally, in part due to the ethical questions raised by these payments, young Hungarian physicians are emigrating to work in health systems characterized by fairness and transparency.
The criminalization of midwives and other reproductive health care providers only serves to lower the quality of care within a country. Criminal action against providers who are simply doing their job sets a dangerous precedent, potentially deterring other providers from reporting and learning from complications. When services are not legal and accessible with quality providers, pregnant women will seek options for care outside the formal health system.
So that we may improve the quality of maternity care, our organization has recently advocated against the criminalization of midwives in countries as diverse as Australia, Argentina, India, Lithuania, and the United States. As an alternative, we support fair and independent review of birth complications for midwives and obstetricians without criminal action.
In our review of the situation of Agnes Geréb we believe a real opportunity exists to re- introduce her and her many skills into Hungary's continuing efforts to improve the quality of its maternity care towards becoming a future regional leader in this important activity.
The Board of Human Rights in Childbirth