Home labor is not “medieval,” but the 21st century’s right of choice!

  • 2013-02-20
  • By Linas Jegelevicius

STRUGGLING ON: Women are still fighting for the right to decide where they can give birth.

KLAIPEDA - An increasing number of Lithuanian women due to give birth would love to hear their baby’s first cry in this world in a home setting. This isn’t yet possible.
Medieval… or modern?
That would be a return to the medieval ages when women in childbirth had only one option - to give birth at home,” pouts the new Social Democrat Health Minister Vytenis Andriukaitis.

“Not giving the right for would-be mothers to decide on their own in what they want does make Lithuania a medieval country,” scoff women who have stood up for this right, and are ready to give a fight.

They’re taking the fight as far as Strasbourg, where the European Court of Human Rights has started reviewing a group of Lithuanian women and their appeal to lift the ban. What comes as a natural thing in the United States, Australia and a majority of European countries, even Latvia and, don’t forget the Baltic trailblazer, Estonia, is still outlawed in Lithuania.
While in many EU countries only a mere 2-4 percent of women in childbirth opt for home birth, the number reaches a whopping 30 percent in the Netherlands.
Who or what is to blame?
When it comes to a slew of social and ethical issues, Lithuania, often called the land of Saint Mary because of its population’s supposed piety, is still reluctant to proceed with any change.

“We just have to accept the things the way they are. I mean, Lithuania is really a conservative country where the Church still plays a big role in social life and politics,” says Jonas Pikciunas, a member of the Lithuanian Family Union.
But some put this claim in doubt, arguing that the faith factor has waned significantly over recent years. “I really doubt whether the religious sentiment is so strong in the population. The prohibition has more to do with the outdated mentality of 75 percent of governmental officials who tend to stoke [sentiment]. It still works, out of tradition, not religiosity,” Dana Kasetaite, a mother of two, said to The Baltic Times.

But four Lithuanian women, avid supporters of the idea of home birth, instead of grumbling about the out-of-touch state policies and the conservative-minded policy makers, have geared up for a serious fight for the right to give birth where they choose.
The women have handed the European Court of Human Rights (ECHR) in Strasbourg a complaint over the absence of their right.
Home labor illegal in Lithuania

“In Lithuania, every woman who decides to give birth at home does so after long deliberations and a conscious decision, but at the end she is left to the sheer twist of fate. It means that, in Lithuania, doctors are not allowed to help those women who favor home labor. In fact, those doctors face the possibility of judicial responsibility,” said Elena Kosaite-Cypiene, one of the four women who appealed to the Strasbourg Court.

Lithuania is obliged, within a few months, to prepare answers to the questions on the matter.
“When we have the answers, then the ECHR will see what to do next - dismiss the complaint or proceed with its deliberations and a possible ruling in the case,” said Elvyra Baltutyte, the Lithuanian representative at the Court. She added: “The institution, in fact, does not always ask to be given explanations. Sometimes upon reception of a complaint, it just tosses it away if it deems it ‘unacceptable,’ for a number of reasons. If it cannot rule clearly on it, then the procedure of inquiring for more information follows. That is what happened with the complaint on the home-birth issue in Lithuania,” Baltutyte stressed.

Gripping home birth stories
Encouraged, the four women have launched a strong support campaign for the cause back in Lithuania. The Web site aiming to give information about home birth had always seen large traffic since its launch, but the browsing activity has soared rampantly after the four’s Strasbourg appeal received extensive coverage in the national media.
And some of the stories, also posted on the four women group-led Web site, www.gimimas.lt, are heartening and… heart-gripping.

“It is such a usual thing in Holland! And yet still a big fuss in Lithuania!” wonders the notable Lithuanian ballet dancer Ruta Jezerskyte-Banfi, who, with her husband Massimo, raises two children, two-year old Aras Leonardo Gabianno and six-month tot Chiaras Milda. Both of whom were born at home.

“Sure, home labor is an increased responsibility, but we’ve embraced it as the entire Dutch system encourages the woman to decide on her own when it comes to picking up the place where to deliver. Before the childbirth, I had enrolled and completed a pregnancy course. Its message was clear: where to deliver is up to us, the would-be mothers,” Ruta Jezerskyte-Banfi said, sharing her Dutch labor experience.
More hospital equipment does not mean a safer childbirth
Germany and Iceland are among the other European countries praised by Lithuanian child birth givers. Rasa Ragauskaite-Driukiene, a preschool Valdorf education consultant and mother of three, has delivered her third child in a natural birth center in Germany, where she had come for completion of her studies.

Rasa says she has gone a long way in making up her mind where to have the baby. “Seventeen years ago, when I was given the news of my first baby in my womb, I started thinking that I’d give birth where there’s a more sophisticated facility with more equipment. But with the belly swelling, I caught myself thinking: ‘Gee, what difference does the amount of equipments make? None! I started realizing that I’d been overwhelmed with another wish: to have the baby where it is safe! I just saw doing it at home, which was my safest place,” remembered Rasa.
Flat birth table does not work wonders!
Among the reasons she snubbed delivery in Lithuania was the existing tradition of giving birth on a flat birthing table.
“It gives only one option, that suits 98 percent the hospital, but is unacceptable for 99 percent of women. The  labor process requires pushing, but how can a woman do that when she lies on the table? When I chose the Stuttgart Natural Labor Center, I was told this: choose a pose that suits you best, except the traditional laying on your back, which is the least favorable pose during delivery,” remembered Ragauskaite-Driukiene.

She still believes that home labor might be safer to an extent, but she says she has been awed at how the German obstetricians, are very polite, caring and don’t have any adverse attitude.
“They believe that each woman is entitled to the right to make a decision, one that she considers to be the best for her and the newborn’s interest,” she marveled.
Latvia has out-stripped Lithuania

Latvia is perhaps the only rival that Lithuania can size up against in the region, with Estonia being a half-century ahead of both, but, in home childbirth, Latvia goes a stride ahead of Lithuania and is in-step with Estonia.
Having scrutinized the German home birth model, Latvia in 2006 passed necessary legislature opening the gates for home birth. “It has created a lot of furor in the country as is still reminiscent of its Soviet history. But for a breakthrough that the very sensitive field as childbirth is, Latvians have to credit their modern prime minister, Einars Repse. It was he who set up a working group of 12 doctors and a single obstetrician in it, me. We had had a lot of heated discussions before legitimizing home labor. But only if the dwelling is not further than a 30-minute drive from the nearest in-hospital gynecology ward,” said Rudite Bruvere, an obstetrician of Latvian descent, who before returning back to the homeland had completed obstetrics studies in Germany.

“Besides the EU regulations entitling women the right of choice, have played a significant role. Every year, I help approximately 40-50 women in birth who opt for home delivery. And the numbers have been going up,” she added.
The Latvian statistics show that, in 2006, 51 babies were born at home, and in 2012 nearly a four-fold increase, to 189.
Lithuanian Health Ministry frowns at neighbor’s example
But things are not as bright as the obstetrician wishes them to be. “So far, the issue of medical insurance for women has not been solved. Besides, the state doesn’t yet finance the medical services for home births, which, therefore, are exclusively left for private medicine,” she noted.

Yet the closest neighbor’s example has not yet bent the thinking of the old-fashioned officials in the Lithuanian Health Ministry.
Fearing complications through home labor, which the former Vice-minister Nora Ribokiene said “often are inevitable,” the Social Democrat-led ministry, with the vice-minister becoming the new minister’s advisor, is still frowning at the idea of giving a green light for homebirth any time soon.

“Foreseeing a delivery complication-free is impossible as the woman and her newborn may need urgent assistance at any time. There is quite a few scientific research comparing home birth and in-hospital birth. The results show that the birth-related probability of death is two to three times higher when delivering at home,” the former vice-minister stressed.
Knocking on the door will help
But that proves nothing to the increasing flock of Lithuanian women who want to be given the right to choose where to deliver their baby. “To claim that home birth is unsafe, I believe it is really wrong. In fact, a hospital is a very unsafe place for giving birth because of all those infections, doctor blunders, neglect and malpractice,” counter-argues Ruta Aldonyte, a bio-medicine scientist who has given birth at a natural birth center in the U.S.

The spearheads of the movement for home birth, joined in the organization known as Gimimas LT, to boost their positions both on the European and domestic fronts, have appealed to the Ministry of Health, asking it to set up a working group tasked with preparation of homebirth guidelines and, subsequently, a full-fledged legislature.
But with an array of quite opposite conclusions from a number of experts and ministry officials, it seems the issue is doomed to stall. However, the increasingly louder voices both in Lithuania, Brussels and, now in Strasbourg, for a woman’s right to choose where to hear her newborn’s first wailing may bring the day of the first-ever legal Lithuanian homebirth closer.