Is childbirth in Slovakia only for the brave?

Simona Petrík is an MP and Vice-Chair of Progressive Slovakia party.

Compassionate and respectful care during and after childbirth is still far from standard in Slovakia. Many women leave Slovak maternity wards with traumas that make them either hesitant to have more children or seek childbirth services abroad.

"They told me—actually, not directly to me but among themselves—'fetus mortus,' a dead fetus. Without any emotion, as if informing me the baby had merely changed position."

This also happened to a woman in Slovakia, likely due to neglected care in the final weeks of pregnancy. I had the opportunity to read this and 732 other stories in a questionnaire completed by women from across Slovakia.

I asked about experiences with healthcare during the last month of pregnancy. The results are disheartening, some even horrifying. Four cases, including the story I already mentioned, ended in the death of a newborn.

Lightning-fast check-ups

More than half of the women reported that their antenatal check-ups during the last four weeks of pregnancy lasted less than 15 minutes. Nearly 13 percent underwent check-ups that lasted only five minutes, consisting solely of: blood pressure, urine test, and the question, "Do you feel movement?" Nothing more. When it comes to the health of both mother and child, this pace amounts to gambling with their lives.

The data also confirmed that almost every maternity hospital mentioned provides women with different levels of antenatal care. Frequently, in the final stages of pregnancy, they were missing essential examinations, such as cardiotocography (to monitor the baby’s heartbeat and uterine contractions) or ultrasound scans (to check, for instance, blood flow or the baby’s size).

They spoke of a conveyor-belt system where there was no time for their individual needs. In Slovak maternity hospitals, there is no uniform standard for providing antenatal, birthing, and postnatal care that aligns with the internationally recognised standards of the International Federation of Gynecology and Obstetrics or the World Health Organisation.

When it came to the birth itself, women often experienced mockery, insults, cynicism, and a lack of respectful care. Such experiences are far from uncommon in Slovak maternity hospitals. Women repeatedly reported being treated without dignity, empathy, or understanding.

Postnatal care? One respondent described it as "a complete nightmare for a first-time mother; a weaker person wouldn’t cope." In another instance, a doctor told a woman struggling with breastfeeding, "Even a cow can feed her calf."

The most frequent criticism was inadequate communication from medical staff. Unless the women themselves asked questions, they were not provided with the necessary information—and often not even then.

Inappropriate attitudes from healthcare workers, complications, and a lack of support not only cause long-term trauma but can also impede the natural progression of labour and contraction activity. Women were left feeling stressed when they needed to be relaxed and focused on themselves and their babies.

Thirteen percent of the women in my survey reported experiencing anxiety or a profound sense of helplessness, feeling they had no control over their births.

Positive change is possible

Changes are also happening here in Slovakia. We cannot lump all maternity hospitals together. For instance, regional hospitals such as those in Levice, Zvolen, and Krompachy are described by women as facilities that offer respectful care with an emphasis on individual needs. Examples of good practice exist, but they have yet to become the standard.

Slovakia even has its first Centre for Midwifery Care, located in Trenčín. It was established thanks to the efforts and perseverance of three midwives and the support of their head doctor.

In Stará Ľubovňa, women receive high-quality antenatal preparation, lactation counselling, and aromatherapy. They also have access to a birthing couch, one of the few places in the country offering this option. The maternity unit in Ružinov, Bratislava, is also gradually improving, having undergone renovations and receiving increasingly positive feedback.

In Liptovský Mikuláš, they have a modern room for natural childbirth equipped with a birthing steamer, a mat, a birthing stool, a sling, a telemetric cardiotocograph for monitoring the baby’s functions, and even round-the-clock refreshments.

However, the portable cardiotocograph in Liptovský Mikuláš and the birthing couch in Trenčín were funded solely through public fundraising. Where is the state in all this? Where is the Health Ministry's interest in this matter? Where is the adequate financial support for the field of maternity care?

Approximately 50,000 women give birth in Slovakia each year. That is not a small number. We cannot afford to be indifferent to the way these children are born and the condition in which we leave their mothers during and after childbirth.

Although maternity care in Slovakia is gradually improving, thanks to the dedication and commitment of some doctors and midwives, we are still far from ensuring that every woman receives respectful care during childbirth without any infringement of her or her child’s rights.

Because it is no longer sufficient to simply say, "At least she went home with a healthy baby." Of course, the life and health of the mother and her baby must remain the top priority for every doctor, midwife, and healthcare worker. However, it must also be a priority to ensure that the mother goes home without trauma or psychological burden, that her physical and mental well-being is looked after, and that she feels supported and at ease.

It's time to change this

How? A good birth begins with adequate preparation. This can be influenced by quality prenatal care and proper management of the birth. Postnatal care and support for breastfeeding have a significant impact on the lifelong health of the child, the quality of life for the mother, and her decision about future pregnancies.

The state must care about this.

I am convinced that women deserve healthcare that will respect them—not ignore them.

Measures that will lead us to provide quality and respectful obstetric care include the development and support of regional perinatal centres, the rigorous application of internationally recognised obstetric standards in hospitals, and mandatory disclosure of obstetric care quality indicators.

We must tie financial inputs from insurers to the quality of the work done by maternity wards. Midwives must be available at births, and centres for midwifery care must be created, while home visits from midwives and community care for new mothers with children in marginalised communities should be covered by public insurance.

The National Breastfeeding Support Program must function with appropriate financial investments, breast milk banks must be reinstated in hospitals, and last but not least, in vitro fertilisation must be made accessible to all women, at affordable prices, with no age or relationship status restrictions.

We have a long journey ahead, but if at the end of it Slovak women are giving birth in dignified conditions, it will be worth starting the journey as soon as possible.

© Sme