Our organisation has been working in this field for several years. As our knowledge of the situation and problems has increased, so has our understanding for women who are not satisfied with the services offered in Slovak maternity wards.
Where should I go to give birth?
A week does not pass without a Slovak woman asking us where to go to give birth. These women want to be partners of the healthcare providers in the decision-making process regarding the childbirth procedures. They ask for a Slovak hospital where their individual preferences would be respected and where they would not be separated from their children. Regretfully, we do not have an answer for them. Many of them then leave the country to give birth. They leave in hope that during their births, their human rights will be respected and only evidence based medicine will be used.
They prefer to give birth in settings where administration of drugs is not routine during physiological birth. They prefer hospitals where they can choose the position, in which they birth their children. They look for places where they will be cared for together with the newborns in uninterrupted skin-to-skin contact immediately after delivery and from then on as one unit. Some of them travel even from the eastern part of Slovakia to southern Moravia to make sure that they can be together with their newborn child and partner even in case of caesarean section. And surprisingly, it is possible. Even during the surgery, the baby is skin-to-skin with the mother and they remain together also afterwards. In the news, these women are called birth tourists and often also by other shaming names.
Is it tourism?
Have you ever been on vacation? What have you done there? Let me guess. You swam in the lake or in the sea. You sailed on a boat. You rafted down a white-water river. You skied or snowboarded down a mountain covered in fresh powder. Together with your loved ones you hiked a mountain. Tired, but happy that you made it, you were enjoying the breath-taking views. Or maybe you were sightseeing ancient cultural monuments of some city. Or climbed a castle ruin and ate a snack there. You slept in a tent or under the open sky and in the morning you watched deer get their breakfast, fog roll in the meadow and millions of water droplets sparkle on the tips of the grass blades in all directions. Maybe you were just laying on a blanket by a lake and reading a book. There are many possibilities.
Wikipedia says that tourism is a hobby, travel for pleasure, getting to know new countries, monuments, customs and people mostly with recreational intentions. Or active travel, exercise and stay in nature, such as alpinism, cycling, hiking, climbing, rafting and other outdoor activities.
To which category would we assign the women who undertake the birth tourism? Are they going to discover new countries or actively travel? Camp in the hospital to get some leisure time? Ski down the slopes above the clinic directly into the delivery room? Swim in the birthing tub? Or are they going to learn about the culture, artefacts or customs of the healthcare provides of the foreign maternity ward and enjoy the views from the windows? No, they are not going to do anything we could call hobby or vacation. They are not tourists.
These women sacrifice their time, significant amounts of money and lengthy bureaucracy. They often travel in labour, in contractions. They do this to get respectful evidence based care during their births. They travel to get common courtesy. They travel to hospitals where they will not be separated from their children.
A refugee is a person who involuntarily leaves his or her home country because he or she is persecuted or there is a bad political situation or war in the country.
At the first glance, to call women, who leave the country to give birth abroad, refugees seems too strong. I am wondering how would we call a woman fleeing her country because somebody wants to perform a routine genital mutilation on her. Somebody else is making decisions about her body and about a painful procedure that will have life-long impact on her health. I think we agree that she would be a refugee.
Slovak hospitals publicly proclaim that harmful and routine practices such as not giving the option to choose a position for delivery or separation of mothers and babies are a norm in them. They say in advance: „Here, we will not meet your needs and uphold your rights.“ In this situation, it is correct to say that also a woman leaving her country in desperation is a refugee. If she gave birth there she would get a routine episiotomy, often against her will, which would be sutured without adequate anaesthesia. She would be physically or psychologically forced to give birth in a position she does not want and have her child taken to another room.
Unfortunately, for some women, even the journey abroad does not save them from having their rights violated or their wishes disrespected.
The birth escapes are a serious reflection of the current situation and should be a call to action and system change. So that no woman has to travel abroad to be respected at birth.
Zo slovenského originálu preložila Iveta Jančigová.