Home Birth in Hungary – results of the first research effort concerning home birth in Hungary

Author: Varró, Gabriella

It is the highly educated women from the capital and the agglomeration, who primarily choose home birth due to negative previous experiences in hospital. They tend to have significantly more children than the national average: a third of home-birth families are raising three or more children. Some of their doctors, once they became aware of their choice of home birth, refused to continue prenatal care. One in six paediatricians refused to examine babies born at home.

Although the right to choose the venue and method of birth is guaranteed to women in the Hungarian Constitution, those opting for home birth are often subject of harassment by the authorities and the vocal disapproval of healthcare employees. During a long unregulated period, home birth was a theme that families were being secretive about while the various institutions and authorities rejected it.

Those are some of the results of the first comprehensive research on home birth in Hungary. Our sample of 1095 births covered the great majority of all planned home births in Hungary – the questions we asked were aimed to establish who is choosing this form of birth, and why. What are their experiences with the healthcare system and the various authorities? The survey was conducted in October 2010.

As regards to the social composition of the families opting for home birth we found that in the most common scenario, both parents have higher educational (college of higher education or university) qualifications, or at least completed their secondary school education. While in general, the number of births in Hungary has been dropping continuously for some time, these families tend to have significantly more children than the Hungarian average: a third of them have three or more.

This group of expectant women feel that hospitals are unable to provide the tranquil and undisturbed birth they wish to have. It says a great deal about the Hungarian healthcare system that half the women who completed our survey had had negative experiences with hospitals, which had a strong influence on their decision, and they also feel some aversion towards the hospital way of conducting birth. 90% of the women mentioned the desire to avoid unnecessary medical intervention as a reason for their decision to give birth at home. The defenceless position that women occupy during hospital birth is attested by the fact that 60 of the women who ended up in hospital while in labour did not know what would happen to them there and were given no information whatsoever about the interventions that the attending doctors were conducting.

The women are highly distrustful of the healthcare system and its representatives, including the ob-gyn providing care during the pregnancy as well as the health visitor. This is expressed, for instance, by the fact that one in twenty of our subjects did not attend regular pregnancy care sessions, while half of those who did attend regularly did not tell their doctors that they intended to give birth at home. A large proportion of healthcare staff were hostile towards those who did make it known that they would give birth at home, sometimes getting to the point of doctors refusing to provide prenatal care (one in eight expectant women), while paediatricians refused to examine newborns (one in six doctors).

The air of secrecy around home birth was not limited to prenatal care, it was also present when women who had planned to give birth at home were hospitalised for any reason. The negative experiences associated with the healthcare system and the unresolved legal situation imply that it was probably no accident that a third of women going into hospital attempted to hide it from the hospital staff that they had attempted to give birth at home.

Cooperation between home birth attendants and hospital obstetric staff is far from great: in a quarter of the relevant cases they were not even allowed to accompany the women in labour. The extent to which the lack of cooperation – the failure to pass on information about the progress of labour thus far – delayed the provision of appropriate care to the birthing women is an open question.

The research indicates that in Hungary, home birth has been severely criminalised. The undisturbed character of home birth is jeopardised by the constant rejection and harassment that women face should they opt for it. The stakeholders of the healthcare system and the authorities often treat home birth as a criminal activity. This is borne out by the fact that in eight cases, the ambulance crews called to home births immediately informed the police, while in another two cases, the hospitals reported the mothers to the police for leaving the hospital with the newborn at their own risk. The latter also indicates that ambulant hospital birth is not accepted in practice in Hungary, although it is not expressly prohibited by the applicable legislation.

Some parents had official inquiries launched against them on suspicion of endangering their children, while the National Public Health and Medical Officer Service called them in repeatedly to ask questions about the conditions of their home births. And even if they did not encounter any of these difficulties during and around birth, over a quarter of their families did encounter obstacles when it came to obtaining a birth certificate for their children.