Women entitled to have costs for homebirths covered by health insurance

Prague, Jan 26 (CTK) - A Czech hospital must secure a midwife for a woman who decided to give birth at home, according to a breakthrough verdict by the Prague Municipal Court, referring to the European Court of Human Rights, a lawyer has told CTK.

Under the European court's decision, women have the right to choose the place of their child delivery and the state is obliged to secure conditions for it.

Neither the Czech Health Ministry nor the Gynecological Society recommends home births. They did not change their stance after the verdict. They argue with safety of the mother and her newborn baby.

"The court's verdict will not change our negative stance on home births as a matter of principle," Vladimir Dvorak, president of the Czech Gynecological and Obstetrical Society, said.

Zuzana Candigliota, lawyer of the Human Rights League, who passed on the court verdict to CTK, said a woman who wanted to give birth to her third child at home turned to the court.

She was healthy and had results of all medical check-ups normal, but she could nor find a midwife. This is why she asked the Prague-Motol Teaching Hospital for its midwife to assist in the home birth, Candigliota said.

The hospital rejected it saying it provides care only for hospitalised patients in compliance with the valid standards.

Hospital spokeswoman Pavlina Dankova told CTK that four nurse-midwives are on duty to assist in 12 to 16 child deliveries a day, and this is why the hospital cannot release any of them without threatening its own patients.

It is not clear either who would be legally responsible for a possible harm to the baby or mother during a home delivery, she added.

Most midwives are employed by maternity hospitals in the Czech Republic. Their professional organisation does not support home childbirths.

A group of midwives is fighting for the legalisation of homebirth care and its coverage by health insurance. At present mothers must pay for a midwife assisting in home birth from their own pockets.

Health Ministry spokesman Vlastimil Srsen told CTK that the ministry is not considering a legislative change in this respect. "It is primary to provide safety for the mother and the newborn baby," he said.

Deputy health minister Martin Plisek explained that under law, a patient gives consent to provided health services but, on the other hand, the ministry must insist on the observance of health care standards, technical and professional.

The hospital cannot execute the court's decision as its employees have a work contract for providing care in hospital, Dankova said, adding that the hospital lawyers would deal with he case.

Plisek stressed that the ministry would still prefer child deliveries in hospital owing to high risks of home births.

Candigliota praised the court decision saying it secured the right to homebirth care if women apply for it in time.

"On the other hand, it is absurd that hospital midwives will have to provide homebirth care though they have no experience with it and do not want to do it, while independent midwives who want to provide the care must not do it," she said.

Last year, a Czech court for the first time punished a midwife assisting in a child birth for her mistake. Midwife Ivana Koenigsmarkova was given a suspended sentence for having caused a fatal bodily harm to a newborn baby, she had to cover the health insurer's costs and was banned from working as a midwife for five years.

($1=19.597 crowns)