Maternal Health in Hungary – Increased Medicalization Of Birth As Well As Higher Risk At Home Birth Have Contributed To The Rise Of Maternal Mortality
In recent years, maternal health outcomes have come under some contentious debate in Hungary, where rising rates in recent years are blamed on two distinct narratives.
In 1990 the maternal mortality rate stood at 23 deaths per 100,000 births. As the Hungarian government began to increase public access to health care services and provide numerous perks, such as better maternity leave laws, the rate dropped to ten deaths per 100,000 births by 2000. Several years reported less than five maternal deaths. Significant progress was made during this period.Then rates began to rise again. By 2010, the rate stood at 21 deaths per 100,000 births (WHO).
One narrative used to explain this increase is that an increase in home births has led to the rising maternal mortality rate. Several high profile cases have given some weight to this perspective. In 2010, two mothers died due to errors committed by the midwife. Two of the midwives received house arrest prison sentences and are banned from practicing for up to ten years (The Agnes Gereb story). Midwifery is allowed in Hungary, but specific rules must be followed, and while the mothers did choose to give birth at home, their circumstances warranted transfer to a hospital.
However, even accounting for these deaths under the care of a midwife, the overall maternal mortality rate is still increasing. Beginning in 2000, the government shifted from direct interventions in lowering the maternal mortality rate toward a policy of prevention of risk factors prior to birth (CEDAW 2000 ). This shift in resources and focus has contributed in part to an increased use of C-section deliveries by doctors who must increase access to services under largely fixed prices. To ensure safer births, extra gratuities have become common to ensure proper care for those who can afford it. These practices in the hospitals have contributed to the increase in the number of women who desire to give birth on their own terms, despite the potential increased risk for some outside a hospital setting.