The Polish Commissioner for Civil Rights Protection, Janusz Kochanowski, is creating a charter of rights of a birthing woman. He wants to put pressure on the Ministry of Health to prepare high-level standards of care to be guaranteed to all women giving birth in Poland.
The document being drawn up at the Commissioner's office is to be submitted to the Minister of Health, Ewa Kopacz, before Christmas. Kochanowski's intention is for the charter to constitute a basis for defining the scope of medical, psychological and other types of care that every pregnant woman should be provided with. "We will demand the Ministry to fully respect the rights of women who are giving birth," claims the Commissioner.
A draft charter is already available at the Commissioner's website. It includes 10 major points related to various stages of pregnancy and childbirth. The Commissioner's demands focus on free-of-charge anesthetization during childbirth, family labor, single labor suites and assistance of a psychologist present in the labor and delivery suite at the hospital.
Right now in Poland there are no binding rules related to standards of medical care to be provided to pregnant women. As a consequence, women often give birth in unacceptable conditions and the infant mortality rate is constantly increasing. "What seems to be a luxury for a Polish woman, in the Western European countries is a standard procedure," says Janusz Kochanowski.
The main postulates in the charter include: free-of-charge anesthetization for every woman giving birth, right to family labor (which is becoming increasingly popular in Poland and is firmly accepted by majority of fathers: they want to provide safety for the partner and set up an early contact with the baby) and single labor suites, providing assistance of a psychologist to the labor and delivery suites at the hospitals, full coverage of birth school participation, and increasing number of beds at the hospitals, so women are not sent from one hospital to another. Many of the above-mentioned proposals have been promoted by various organizations (Foundation Rodzić po ludzku [Giving Birth in a Humane Way]) or in the media (Dziennik newspaper). But the Commissioner's demands go even further. He wants birth school participation and assistance of a psychologist covered by the Polish National Health Fund. Psychologists would be taking care of women who lost their child or suffered from birth trauma. "I would like to create a situation in which giving birth by a woman will no longer be associated with an unnecessary stress," says Kochanowski.
Currently, the Ministry of Health is not making any comments regarding that initiative. They want to wait until a final draft of a charter is submitted to the Ministry. Not long ago, the Minister of Health, Ewa Kopacz herself announced the plans to stop covering anaesthetization during childbirth. Her argument then was that there are not enough anesthesiologists in the Polish hospitals, therefore providing anaesthetization for free was not possible (Poland Says No to Pain-Free Childbirth).
According to the Commissioner, the idea of drafting such a charter came about some time ago. Voices in the media and in various medical conferences underlined cases of negligence in relation to health of mothers and children. And the Ministry of Health has failed to prepare the binding standards on medical care. Such lack of regulation has a negative impact on the health of the whole society. The evidence can be found in the recently published report of the National Institute of Hygiene in Poland. This report explicitly describes dangerous tendencies occurring in the last years. Decline in infant mortality rate has been slowing down recently, despite visible progress in Polish medicine. One of the main causes is the lack of a program specifically designed to provide effective care for pregnant women.
According to Professor Janusz Szymborski, plenipotentiary of the Commissioner for Civil Rights Protection responsible for family issues, it is possible to introduce the standards proposed in the charter. "Money should not be a problem here," he says. "Ensuring these standards would demand only a small part of the budget of the National Health Fund." Poland is obliged to invest into women's health and health of newborn children - the childbirth rate is rapidly decreasing, at the fastest pace in the whole European Union. The Polish population is projected to drop by 8 million by 2050.
All the proposals to be embodied in the charter are equally important. But preventative treatment seems to be the most crucial aspect of medical care. There should be one doctor taking care of a woman throughout her pregnancy state. She has to have a right to free of charge birth school participation, undergo all necessary medical examinations and injections. In the previous years, decrease in infant mortality rate was so high, that focus on preventative care diminished. "And that is why we are experiencing a reverse trend right now," says Szymborski. Infant mortality rate in Poland is, according to the available estimates, by 25% to 50% higher than EU average rate. The negligence in providing adequate preventative care led to worsening chances for Polish women to give birth in a dignified way.
A draft charter is now open for signatures. Anyone is invited to express its own approval of the proposed standards of care. Further steps are likely to be seen in a month or so, after the charter is presented to the Polish Ministry of Health.
