Are home births being
targeted?
Written Question of N. Chrysogelos concerning the rights of a new mother
to handle her own placenta
Nikos Chrysogelos,
Member of the European Parliament of the Greens/European Free Alliance,
brings forth to the European Commission in a written question the issue of the
management of the placenta by home births, which recently prompted an unprecedented
profiling of persons and health care professionals in Thessaloniki that are
associated to home births.
The region of Central Macedonia adopted a Directive
on home births, where the placenta is characterised as a Hazardous Medical
Waste and therefore the placenta should be handled by entities that have an
approved license. It is noted that women who choose to give birth at home
usually want to handle their own placenta, respecting the fact that it symbolizes
the connection of the mother with the infant. Also, the incineration of the
placenta from a private company costs 100-150 Euros, putting extra strain on
the overall cost of birth at home, while control of what happens after delivery
towards incineration is inadequate, a fact that raises issues of bioethics.
In connection with this Directive, in December 2012
a midwife who undertook births at home was sentenced in Thessaloniki with the
basic charge of contaminating the environment with «hazardous medical waste»
(meaning the placenta from the new mother) that is produced at home births,
resulting in the removal of her license for one year. The conviction of the
midwife followed in February 2012 by the Court of Justice in Thessaloniki on
the basis of a perineal rupture at a home birth (to the point that women are typically,
as a precaution, subject to a perineotomy when they are in a maternity ward).
Extensive research was preceded by public
institutions, through the processing of birth certificates that clearly state
(even though not specifically required by law) whether the birth was carried
out at home or in a maternity ward, so as to identify by name all health care
professionals and parents who attended home birth and to examine these
individuals by the judicial authorities on suspicion of committing offenses.
Prosecutions of 79 individuals (5 doctors, 1 midwife and 73 parents) then
followed with the charge of, amongst others, repeated environmental pollution
by not “delivering” the placenta to the authorised management companies. None
of the citizens who were finally prosecuted had been informed concerning the
research that was conducted.
It
is noted that in countries, such as Germany , Britain , the Netherlands , Spain , Romania and Canada Netherlands
Nikos
Chrysogelos stated:
"Giving birth at home is a natural and
perfectly legitimate process that millions of women opt for around the world.
Women have every right to manage their own placenta in other European states,
always respecting the rules of ethics and practice, from which there is no risk
to the environment and public health. The management of the placenta exclusively
as a hazardous medical waste is incomprehensible, as it also leads to
additional significant financial burden at a time of economic crisis. If the
state is genuinely interested in environmental pollution and is not targeting
home births in general, it does not need to re-invent the wheel. It can follow
proven examples of other European countries."
(The entire content of the written question follows.
Note that this is NOT the official translation by the Commission)
Subject: «Management of the placenta by home births»
The
Region of Central Macedonia adopted a Directive on home births, where the
placenta is characterised a Hazardous Medical Waste of Infectious Character
(HMW-IC). According to the JMD (Joint Ministerial
Decision) 37591/2031/03 ΚΥΑ (FEK 1419/Β - Hellenic Government Gazette) the "management of HMW-IC
must be carried away by institutions which hold an authorized permission."
It
is noted that women choosing to give birth at home usually wish to manage their
placenta by themselves, with respect to the fact that it entails a mother-baby
connection. Furthermore, the placenta's incineration by a private company costs
around 100-150 Euros further burdening the giving birth at home, while there is
no control as to what happens following the placenta's delivery for
incineration, a fact that brings up bioethics issues. As a result of this
Directive, in December 2012 in Thessaloniki
The
Disciplinary Board accepted as the main disciplinary offense that the midwife
had not managed the placenta as a hazardous infectious medical waste giving it
for incineration to a health unit.
A
public research preceded the conviction in order for all health care
professionals and parents who attended births at home to be identified and
examined by the judicial authorities on suspicion of committing offenses. A
prosecution of 79 individuals (5 doctors, 1 midwife and 73 parents) followed
with the primary offense of environmental pollution by not "delivering"
the placenta to the authorised management companies [1].
The
Commission is being asked:
1.
Does it consider that new mothers should be given the
option to manage the placenta by themselves, instead of the imposed specific
way?
2.
Does it consider the Directive issued by the Region of
Central Macedonia on home births, as well as on the creation of a file of
persons involved in home birth, compatible with EU legislation?
3.
Does it have any information on relevant
legislation in other Member States?
4. Does
it have at its disposal any statistics for the
percentage of women who give
birth at home in other
Member States?
