Introduction and Background
Women traditionally served as healers and midwives; in early modern Europe, birth was believed to be a woman's "problem" and was thus attended to by female midwives. As birth was not male-centric, and men were not present at births, the event itself was a mystery. Obstetrics, as a field and profession, has historically been dominated by men. Women healers were suppressed by the Church out of an issue with the use of plant medicine during birth. Midwives lost their status as male midwives and surgeons rose in power due to the increased use of surgical instruments during labor which aided in the successful delivery of babies, and which women were legally prohibited from using. Men were able to dominate the medical field as they were able to receive formal education and training.
Obstetricians have claimed the environments of home births are unsafe compared to hospitals, that more mothers and infants die in the home setting, and the midwives who attend home births are unskilled. Thus, if medical attention or intervention becomes necessary during birth, it would be most beneficial for the person giving birth to do so in a hospital.
Obstetrics, a field dominated by males, looks to control the birth process within hospitals due to fear and jealously over the nature of women's natural gift to give birth. (It is important to note obstetrics is male-dominated in Hungary, and no women have served on the Hungarian Board and Obstetricians and Gynecologists).2 The practices used in obstetrics – such as the practice of the pregnant person laying on their back for labor, the use of drugs to induce or speed up the birthing process, and episiotomies – are for the benefit of the doctor, rather than for the person giving birth. The World Health Organization, in 1985, reviewed birth technologies and released a list of recommendations of "appropriate technology for birth" and denounced many such practices that are in place without consideration of the birthing experience of the individual giving birth:
There is no indication for shaving pubic hair nor for an enema before delivery.
"It is not recommended that the pregnant woman be placed in a dorsal lithotomy position during labour and delivery. Walking should be encouraged during labour and each woman must freely decide which position to adopt during delivery
The perineum should be protected whenever possible. Systematic use of episiotomy is not justified
…
Artificial early rupture of membranes, as a routine process, is not justifiable.3
Such practices that are performed in hospitals, it seems, are dehumanizing to the individual giving birth and they are not afforded the right to have full control over their birthing experience.
The Board of Hungarian Obstetricians and Gynecologists, in two statements on home birth in 2002, declared "Pregnancy is a biological process that has several special patho-phsyiological features even in 'normal' cases. Pregnant women must not endanger the health or life of their fetuses/new-born babies by rejecting birth in a clinic/hospital," and "The restoration of home births would, even after significant investments, endanger the safety of child-births, and put the health and lives of mothers and new-born babies at risk."4 Additionally, they touted the medicalization of birth that started with the use of forceps in the 17th century; Canadian midwife Betty-Anne Daviss, a colleague of Geréb, thus writes in regard to the medicalization of birth "It is also the reason why the women of Hungary have coined a creative description of what they want to provide for their country: 'undisturbed birth.'" The author similarly notes the Board of Hungarian Obstetricians and Gynecologists's tactical decision to highlight statistics on babies delivered in hospitals, stating that high numbers of babies are born in hospitals in the developed world, and the author presents the idea that inclusion of such information exploits Eastern Europeans to support hospital births given a concern about their image on the international stage.5
Prior to 2010, Hungarian law limited the birth experiences of pregnant people. Pregnant people were not able to give birth in their homes and have their birth attended to by a trained midwife throughout this period in Hungary, due to a refusal to issue licenses to independent midwives. In hospitals, the birthing experience was not empowering for many due to such practices mentioned above, which additionally endangered the person giving birth and their baby.6 Childbirth was under bureaucratic control which prevented a pregnant person their full autonomy when giving birth, and midwives such as Agnes Geréb were assisting home births illegally.
The tradition of home birth was viewed as being out of date. The communist system in Eastern Europe forbid reproduction outside of the control of the state in an effort to increase the birth rate.7
Despite these limitations, celebrated midwife Agnes Geréb defied Hungarian law and attended to around 3,500 home births from 1990 to 2010. During this time, a pro-home birth movement emerged in Hungary in reaction to the medicalized nature of birth. Geréb was arrested in 2010 and is currently unable to practice midwifery, despite a change in birth regulations.8
In embracing modernity and science under the communist system, the medicalization of birth and the monopolization of obstetrics through restrictive birthing practices put in place by Hungary stripped women’s right to bodily autonomy. Despite the legalization of home births in Hungary, restrictions prevent the widespread practice of home births and work to subjugate women.
2 Katalin Fábián, “Overcoming Disempowerment: The Home-Birth Movement in Hungary,” in Beyond NGO-ization:The Development of Social Movements in Central and Eastern Europe (Abingdon: Taylor & Francis Group, 2013), 79. ProQuest Ebook Central.
3 "Appropriate Technology for Birth," The Lancet 326, no. 8452 (1985): 437, accessed November 27, 2020. doi:10.1016/S0140-6736(85)92750-3.
4 "Statement of the Board of Hungarian Obstetricians and Gynecologists on Home Birth," (2002), quoted in Sheila Kitzinger, “Sheila Kitzingerʼs Letter from Europe: Whatʼs Happening to Midwives in Europe?” Birth 31, no. 1 (March 1, 2004): 68–70.
5 Betty-Anne Daviss, “Hungarian Woman Unveil an Ironic Curtain,” Midwifery Today with International Midwife, December 22, 2003, 48-49.
6 Nick Thorpe, “Kafka in the Circus District: A Short History of Homebirth in Hungary,” Hungarian Review II, no. 01 (January 1, 2011): 50–56.
7 Katalin Fábián, “Overcoming Disempowerment: The Home-Birth Movement in Hungary,” in Beyond NGO-ization:The Development of Social Movements in Central and Eastern Europe (Abingdon: Taylor & Francis Group, 2013), 71-72. ProQuest Ebook Central.
8 Amdrew Symon, “Clemency for Hungarian Homebirth Midwife Ágnes Geréb,” British Journal of Midwifery 26, no. 9 (September 2018): 618–19. doi:10.12968/bjom.2018.26.9.618.