Czech Constitutional Court issues landmark ruling in long-standing battle over home births
The Constitutional Court has issued a landmark ruling allowing midwifes to assist home births. The ruling sets an important precedent in what has been a long-standing battle for home births in the Czech Republic.
Although the Czech Republic is among the top European states in maternity and post-natal care –or possibly because of it –home births have been frowned upon as “a dangerous and irresponsible risk” by medical experts. The legal system reflects the view that a safe birth is a birth in hospital with professionals and medical equipment on standby in the event of an emergency.
Although many maternity hospitals are now increasingly liberal and open to demands by mothers regarding how they want to give birth, the trend of home births in other European countries has led some Czech women to demand their right to give birth at home.
Czech law gives them that right, but paradoxically it prohibits midwifes from delivering babies in a home environment. The authorities and courts in the country have so far largely ruled that midwives' services in the home are limited to preparing women for childbirth and providing care in the six-week period after birth, but they can only assist deliveries in fully equipped medical facilities –effectively ruling out normal households.
Judge Jan Winter, who handed down the verdict, said that with immediate effect, midwives were entitled to assisting home births, but stressed that from the legal point of view it will not be regarded as the provision of health care.
“No court in the land has ever ruled against a home birth. Home births are not banned in this country. So we are only dealing with the issue of a midwife being present at the birth. And in our view it is absurd for a woman to have the right to give birth at home, on condition that she must do so alone, or in the presence of someone other than a trained health care professional. This is something that needs to be addressed. We based our ruling on the fact that we found no legal grounds for sanctioning midwifes for being present at a home birth. However this ruling was made on the premise that the assistance provided will not be regarded as the provision of health care. The responsibility for any resulting complications will not lie with the state, but with those present at the birth. It will not be health care guaranteed by the state. ”
The ruling was welcomed by Human Rights League attorney Zuzana Candigliota who has led many legal battles for the Association of Midwives.
However, Judge Winter stressed that the discrepancy in the legal system regarding a mother’s right to a home birth and midwives' rights and duties, was a problem that needed to be addressed by lawmakers. The present law he said is "complicated, hard to interpret and, especially as regards potential sanctions, highly unpredictable".
He appealed to legislators to clarify the situation by amending the law, because that is not the competence of the Constitutional Court.
The Czech Health Ministry said that it wants to study the ruling in greater detail before stating its position on it.
