Giving birth in Croatia
Last weekend I was in Croatia as the guest of RODA - Roditelji u akciji (“Parents in Action”).
On the Friday night I addressed a public meeting that was well attended by pregnant couples, and on the weekend I facilitated a workshop for 40 women, including a number of midwives, some pregnant women and a number of members of RODA. Everyone was keen to learn what they could do to improve the birth experiences of women in Croatia and to formulate some plans for achieving change.
I began the workshop by asking everyone to introduce themselves and tell a little of their history and involvement in the birth scene. It took 1 ˝ hours and became a kind of group therapy. Story after story tumbled out about their births, most of which were horrendous and traumatic. By the end we were all exhausted with emotion and overwhelmed by the sheer magnitude of the suffering of Croatian women during birth. It was sad, and the pain was obvious, but the passion for doing something about it was palpable and impressive.
In summing up the birth scene in Croatia, I would have to say that it sounds like torture for the women. Pregnancy care is also characterised by demeaning and humiliating experiences. Many of the aspects of maternity “care” being inflicted are outdated, without scientific foundation and could, in some cases, be considered physically, emotionally or psychologically dangerous.
Here are some of the facts I gathered from these women, many of who had given birth once but were reluctant to go through the process again (unless they could travel to another country).
During pregnancy, women attend the hospital clinics for check-ups. They are weighed, have their urine tested and then receive a vaginal examination from a doctor (who they will probably not have seen before). There appears to be no palpation to feel the baby’s size or position and no measuring of the height of the fundus to check for appropriate growth.
I asked about all the VEs - what was the purpose of this invasive (and often painful) procedure? I was told that the doctors state it is check the health of the baby and the condition of the pregnancy. On many occasions it is discovered that the woman’s cervix is partly “open” and she is then ordered home on complete bedrest. This is a common diagnosis in the second trimester and many women spend months languishing in bed as a result.
When a woman thinks she is in labour she immediately goes to the hospital. She is not told to phone first and speak to a midwife. On admission, all her possessions, including all her clothes, are taken away and given to her husband to take home again. She labours in a hospital gown, with nothing of her own for comfort. Bringing anything into the hospital is outlawed because it may upset the sterility of the hospital. It was suggested that a safety pin was a useful thing to take to hospital, so the gown could be pinned closed.
If the woman is lucky, she will be allowed to have her husband with her (never more than one person, and it can only be the husband - no other woman, such as her mother, sister or friend, is allowed to be present in his place). In many hospitals, the first stage room contains many beds in a row, with no curtains or screens, and in this case, her husband is not permitted to be with her. Many women therefore labour alone.
All women will receive an enema (of the old fashioned “high, hot and helluva lot” soap and water variety) and are shaved. The membranes are then ruptured routinely, and in almost all cases, a drip is started.
Very little information is offered and there is no concept or hope of being able to make any decisions herself. If the woman asks a questions or challenges the routines in the slightest way, she will be roundly rebuked, with threats made and punishments sometimes meted out. One women in the group mentioned that she challenged the necessity for a routine procedure and was then rudely told that if she didn’t want to co-operate then she would have to “do it by herself” and was abandoned with no checks at all for hours. Eventually she had a normal straightforward birth because no-one came near her until the baby was about to be born!
As the labour progresses, routine vaginal exams will be undertaken at frequent intervals, usually by a different person each time. They are always performed by a doctor - midwives are not trained in the art of internal examinations.
Women are confined to bed and not allowed to move about. If she needs to go to the toilet this may also be denied and a catheter inserted instead.
Drugs may be given for pain, and more women are choosing an epidural (one way of blocking out the pain of labouring like this).
Second stage means moving her to another room and the usual “push! push!” routine. Fundal pressure is often used as well. Episiotomy is mandatory and the third stage is managed aggressively. The baby is removed immediately after birth and will be kept from the mother for some hours, even days if there is any indication of a problem with the baby, no matter how minor.
Breastfeeding may then begin, but little help is available to assist is a problem arises. After a number of days, the mother and baby are discharged - the father arrives to collect his family (and bring her some personal items and clothes) and he meets his child, perhaps for the first time.
Throughout all of this ordeal, the mother is often treated rudely and controlled through both bare threats to her baby and innuendo. There are few avenues for women to find out any information and choice is non-existent for most.
Listening to story after story revealed the depth of some women’s pain and suffering and was a humbling experience. The birth rate is falling in Croatia and it is clear that many women never want to repeat the experience and risk suffering further emotional and physical trauma.
There were women who had heard of the prospects in Croatian hospitals and had decided to go elsewhere. A number of women in this group had gone to Austria, Germany or the Netherlands to get a better chance of a normal birth, and many had succeeded. One women had decided to birth her second baby alone at home after a successful first birth in The Netherlands, because she didn’t want to risk herself or her baby in the local hospital in Zagreb.
It is a pretty bleak picture, but one I gather is common throughout many eastern European countries.
Posted by andrea at March 01, 2007 09:39 PM
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