A matter of choice

It is the ability to choose which makes us human. These simple words are often attributed to American novelist Madeleine L’Engel, who died in 2007, two months shy of her 90th birthday. She lived through the roaring twenties, the Great Depression of the 1930s, and the Second World War. Her mid-thirties coincided with the golden age of the 1950s when colour TV was invented, Disneyland opened, and a vaccine was discovered for polio. She was around during the Viet Nam war, the decade of hippies, drugs, protests and rock and roll. The far out seventies brought with them Star Trek and the Jonestown massacre, while the eighties welcomed Glasnost, Perestroika and the fall of the Berlin wall. L’Engel would have read about the end of the Cold War and the release of Nelson Mandela in the 1990s and seen news accounts of the Oklahoma bombing and the Columbine massacre. And as she entered the new millennium, she probably had ample time to think about choice… and to come to this conclusion.

Bringing it home

Dr Ágnés Geréb might well have something to say on the subject of choice. Recently arrested and facing charges for reckless endangerment committed during the line of duty, Dr Geréb has spent her career making choices.

An experienced doctor and midwife, she has attended more than 2000 home births (i.e. not in a hospital). As I understand the current situation, Dr Geréb had a patient whom she had advised not to choose home birth as the patient had some sort of blood clotting disorder. During a scheduled prenatal appointment, the patient suddenly went into labour and the baby was delivered – apparently there was no time to get her to the hospital. When born, the baby had breathing difficulties. Ambulance staff called to the scene began resuscitation and took the baby to hospital. Dr Geréb was subsequently questioned, arrested, and taken into custody.

Dr Geréb was elected to the Askhoka Fellowship in 1997 in recognition of the work she is doing in Hungary with her ‘undisturbed’ birth project. She established the first network of midwives, doulas (mothers experienced in childbirth who provide continuous physical, emotional, and informational support to the mother before, during, and just after childbirth), nurses, and doctors who oversee home birth throughout the country. On 6 June 1998, Dr Geréb won an important legal victory in the area of hospital births: mothers giving birth in hospitals could now request that their friends and relatives be allowed into the birthing room. Her foundation ‘Alternatal’ ensures professional help for those who choose to give birth at home.  She is, in other words, offering women a choice, a choice that is apparently denied them by the state. Or is it?

Personalising the experience

Had L’Engel and Geréb had a chance to sit down and talk about choice, about how human it makes us, I wonder what the outcome might have been? I’m not an expert on the merits of home birth, or any sort of birth for that matter. Thankfully, I can’t claim first-hand experience of the Hungarian medical system. What I am concerned about is the basic right to choose. Pregnancy is not an illness. The right for a woman to choose where to have her baby is surely a basic human right, one recognised the world over. Were I a soon-to-be mother, I would want to deliver my child in a familiar environment; with my family present; with the help of a midwife and a doula. The alternative (unless I had the financial wherewithal to pay for a private hospital) is a state-run, sterile, impersonal environment. I don’t doubt for a minute that there are doctors and nurses out there who genuinely care about their patients; whose commitment to their job isn’t measured by their meagre salaries; who see the birthing experience as something more than just another medical procedure. And I’m sure that for every horror story emanating from maternity wards around the country, there is a glowing report of an equally wonderful experience.  This isn’t about competency; it’s about choice.

In many western countries, such as the UK or Germany, home birth is a legal and respected option; an integral part of the healthcare sytem. In Hungary, it is alegal.  Under Hungarian law, a woman has the right to choose where to give birth. So what’s the problem then? Well, the law makes no provisions for anybody assisting the woman with her home birth; doctors and nurses who choose to help run the risk of being prosecuted for misusing their license; independent midwives may be prosecuted for practicing medicine without a license. So the danger of prosecution is really on the helpers, not on the birthing woman herself…as we’ve seen with Dr Geréb. A woman can choose to give birth at home. Those who choose to assist her show their humanity, and for that, they pay a price.

First published in the Budapest Times 25 October 2010

0 replies
  1. Hilary
    Hilary says:

    Nice post, Mary. Choice and autonomy are so important in birth. This is a shocking story and one that’s important to me since I am in the process of applying to go back to uni to become a midwife! Goodbye publishing, hello slippery, wrinkly babies.

    I love this line: “Thankfully, I can’t claim first-hand experience of the Hungarian medical system.” Oh dear…

    • Mary
      Mary says:

      That’s come career change Hilary – mind you, some authors might see the whole process of publishing a book as a gestation period, with their baby arriving nicely bound at the end. Enjoy!


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  2. […] of sorts. Can it really be five years since I first wrote about her? Yes. I checked the dates. My piece published in the Budapest Times on 25 October 2010. And that’s as good as five years […]

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