Two-year prison term for home birth advocate Ágnes Geréb

A Hungarian obstetrician and midwife who has campaigned for over two decades for Hungarian women to have the right to give birth outside the official healthcare system was jailed for two years last Thursday
Budapest Municipal Court also banned Ágnes Geréb from practicing for five years.
Her supporters were shocked at the severity of the custodial sentence handed down by judge János Cserni.
The prosecution had called only for a suspended prison term and a ban. Geréb’s lawyer immediately lodged an appeal.
The prosecution’s portfolio case against the four midwives was based on four separate events, of which three involved Geréb.
One case dating from 2003 involved the oxygen deprivation and brain damage suffered by one of twins during a difficult labour. The infant subsequently died.
In another case from 2007, a baby died during childbirth after complications during a difficult labour.
The baby was eventually delivered with surgical intervention at a hospital, but too late to save. The third charge against Geréb related to a woman who suffered heavy bleeding during childbirth. Although the woman was subsequently treated in hospital and recovered, the prosecution alleged that Geréb had not called an ambulance soon enough. A fourth case, in which Geréb was not involved, was of a similar nature to the latter.
In a statement issued after the verdict was delivered, the court recognised that the practise of home birth is not, in itself, a crime. “The lack of regulations governing home birth does not mean that the practice is illegal. Therefore, the court’s verdict did not take a position on the professional debate on home birth taking place in medical circles,” the statement ran. Geréb – a qualified medical doctor, obstetrician and midwife – was found guilty of one count of “causing death” and one of “causing lasting disability” through “professional negligence”. The verdict was a first instance ruling, and was immediately appealed by Geréb’s counsel.
In her closing speech for the defence, lawyer Andrea Pelle spoke of double standards being applied to Geréb. “If a tragedy occurs in a hospital, then not only is the doctor not normally subject to criminal proceedings, he or she is also defended against the complaints of the patient,” said Pelle, who is the head of the legal aid service at the Hungarian Civil Liberties Union, a human rights group.
Geréb and her co-defendants had petitioned President Pál Schmitt for clemency on the last day of the court hearing a week before the verdict was read out. However, no response had been received by the day of the sentencing. The public liaison officer at the Office of the President of the Republic, Norbert Kiss, told the state news agency MTI last Thursday evening that the request for clemency had not yet been presented to Schmitt.
Geréb’s supporters were disappointed and outraged at the verdict. “This sentence is all the more astonishing, given the recent efforts of the Hungarian government to regulate home birth after twenty years of failure,” the organisers of the “Free Ágnes Geréb” campaign said on their website. “The case was based entirely on data provided by the Prosecution, and the opinions of international home birth experts in support of Agnes were not submitted,” the statement ran.
Geréb’s backers called on supporters of natural and home birth to petition Hungarian ambassadors and politicians. “We call on the Hungarian authorities, starting with the President of the Republic, Pal Schmitt, to urgently review this travesty of justice,” they said.
Ágnes Geréb fought for over 20 years for the legalisation of home birth. Earlier this month it appeared that she had won her battle, but it may have been to late to save her from prison.
Geréb earned a medical degree from Szeged University in 1977, with specialisations in obstetrics and psychology. She soon began campaigning to allow fathers to be present during childbirth – commonplace nowadays but forbidden at the time. Later Geréb started advocating the right of women to give birth outside the official hospital system if they so choose. In 1989, Geréb assisted at the first voluntary home birth, and in 1991 she set up civil initiative called the Alternatal Foundation. In 1994 she established Hungary’s first “birthing house”, followed by another in 1997. Since she began, Geréb has assisted in over 3,500 successful home births. In 2007, she was forbidden from practicing for three years after a court case relating to the death of an infant following a complicated labour seven years earlier.
In 2009 the prosecution service launched a case against Geréb relating to another case, in which she was charged with “causing death through negligent malpractice”. In November that year, Pest Central District Court recategorised the case, and ruled that Geréb could be charged with homicide. However, Budapest Municipal Court ruled that the district court had acted unlawfully and the prosecution’s case was back to square one. The present court case began in June last year. Geréb and four co-accused faced charges ranging from malpractice to causing death through negligence relating to four cases dating from 2003, 2006 and 2007. Although women technically have the right to choose where to give birth, there is a legal grey area over the participation of medical staff. Only a handful of midwives and doctors were prepared to join Geréb in risking prosecution and imprisonment.
On 5 October, Geréb was arrested shortly after a women went into labour during an ante-natal class at her Napvilág Birthing Centre in Budapest. The infant had developed breathing difficulties and had to be resuscitated. Her pre-trial detention was extended by two months on 8 December. Meanwhile, demonstrators in Budapest called for Geréb’s release and an international “Free Ágnes Geréb” campaign caught the attention of the international media. The UK’s Royal College of Midwives issued a statement condemning the “disproportionate and inhumane” treatment of the midwife, who was forced to share a cell in a women’s prison and was brought into court handcuffed and shackled.
Things appeared to be moving Geréb’s way in mid December, when the European Court of Human Rights in Strasbourg ruled in a separate case that Hungarian law contravened the European Convention on Human Rights. The case was brought by Anna Ternovszky, a Budapest woman who was prevented from giving birth at home because of legal barriers to the participation of medical personnel. The court found that Hungarian law ran counter to the right to respect of private life enshrined in the European Convention on Human Rights, ruling that this right extended to the right of a mother to choose where and how to give birth.
Geréb was released from prison and placed under house arrest on 22 December, where she remains pending an appeal hearing. On 2 March, the cabinet approved a draft decree that would finally legalise home birth in Hungary. Political moves in this direction in the preceding four years had been stiffly opposed by many in the medical profession. From 1 May, medical personnel will be permitted to take part in out-of-hospital births, albeit under very strict conditions, for example the birth must take place no more than 20 minutes away from an official medical facility.
The Ágnes Geréb case has raised questions not only about the practice of childbirth in Hungary and the right of women to choose. It has also shined a spotlight on the relatively high rate of surgical interventions in hospital births, and the distasteful practice of doctors and midwives – who, it should be noted, are abysmally underpaid – expecting “gratitude money” in return for performing their duties in the state-funded universal health care system.
Geréb was voted in February one of the country’s “ten most influential women” in a poll by the popular women’s magazine Nok Lapja. Because she was under house arrest, Geréb sent her daughter to collect the award on her behalf
Robert Hodgson , Budapest Times, March 29. 2011.

Last Updated on Friday, 30 August 2013 09:11