Magyar 
English
IF HISTORY were a guide, obstetrics in Hungary should be wonderful. In
1847 Ignac Semmelweis pioneered mother-friendly childbirth, insisting
that doctors should wash their hands between autopsy and delivery rooms
(they objected to this slur on gentlemanly cleanliness).
Obstetric care in Hungary is indeed excellent today. It is tightly run
by skilled doctors, with low mortality rates. But those who challenge
the medical profession still face problems. Agnes Gereb, a pioneer of
home births, is facing up to eight years in jail. Prosecutors are going
after her over one fatality in childbirth, one case in which a baby
died some months after birth and two births that ended up as emergency
hospital admissions. In the eyes of many Hungarians, such incidents
show that home births are insanely risky and that those who promote
them are little more than irresponsible cranks.
That view may seem outdated in the West, but not in the ex-communist
East, where birth is a medical problem not a natural process, and where
abortion has long been commonplace. Such procedures as episiotomy
(cutting the vulva) are standard, whereas Ms Gereb says she has
performed it in just ten out of 3,000 home births. She criticises
hospitals for their frequent use of drugs to induce labour, which suits
doctors' timetables rather than nature's. Women in Hungary also expect
to pay, formally or informally, to be looked after in hospital, and
especially for pain relief.
Outsiders who unsettle the obstetric cartel meet clannish (and even
self-interested) opposition. Ms Gereb's supporters are inviting
international experts to testify that home births can be quite safe and
that her record is commendable. But the court may choose to take expert
opinion only from the obstetricians' trade body, which dislikes home
births--and also Ms Gereb. An obstetrician herself, she has often
clashed with her colleagues. In 1997 she was suspended for the
outrageous act of allowing a father into the birthing room. Things have
changed, but in Hungary only one birth in a hundred happens without
some form of medical intervention. Ms Gereb thinks that many more could
be natural, given a bigger role for midwives and a smaller one for
bossy doctors.
Semmelweis went mad and died (of an infection) after being beaten up by
warders in an asylum. Ms Gereb does not face that fate--and she
flinches modestly at any comparison to the great man. But, she notes,
he might have sympathised with her over one big problem: the surprising
difficulty of changing medical routine.
Mar 11th 2010