Poland Says No to Pain-Free Childbirth

Anna Wilkowska-Landowska

Poland is struggling with record low numbers of women having children. So why would the Minister of Health suggest that the national health care plan no longer fund anesthetization during delivery?

Here is another curious proposal from the Polish Ministry of Health Director Ewa Kopacz. Not long ago, Kopacz made public her plan to require pregnant Polish women to register their pregnancies (Pregnant
in Poland? Government Considers Tracking You for Illegal Abortion
).
A week ago the Polish
newspaper "Dziennik"

wrote that the Ministry of Health was not planning to refund anesthetization
during childbirth.  Kopacz, in response to the letter of
the Polish Gynecological Society, which on behalf of women appealed
to the Ministry to refund anesthetization, said that the state budget
cannot afford to ensure free anesthetization during childbirth to all
Polish women. "Childbirth is a pure physiological process and we, women,
were created by nature in such a way as to run certain things in their
natural way, therefore to have childbirth run in its natural way with
no medicine and anesthetization," said the Minister. According to
Kopacz, if anesthetization were provided for free, then hospitals would
have to ensure that the services of anesthesiologists are guaranteed for female
patients to a much broader extent than it is currently. And there are
not enough anesthesiologists in Poland.

"We appeal to the Ministry
of Health not to pull back Polish medicine to the nineteenth century and to
take into account that anesthetization during childbirth has been recognized
as a standard procedure for many years now in the whole Europe," said
Joanna Kluzik-Rostkowska, former Ministry of Labor and Social Policy.

She underlined her disappointment in Kopacz’s words, because these
"difficult words addressed to women" have been expressed by "a
minister, a woman, and a doctor."

"There have been many declarations
stating that we have to do much more in order to make Poles decide more
easily to have children, to encourage Polish women to have more children
and now, what we are hearing is that they have to rely on the forces
of nature," Kluzik-Rostkowska claimed. According to her, Kopacz’s
statement about lack of funds for anesthetization, as well as lack
of anesthesiologists during childbirth, constitute "a sufficient argument
for women to make it more difficult for them to decide about having
a child."

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During
a discussion following the Ministry’s declaration, advocates suggested that the Minister
should be doing everything possible to ensure an adequate level of medical care,
in order to guarantee that childbirth with anesthetization and with
assistance of anesthesiologists, according to the standards of the twenty-first century, may take place at the hospital. The Minister seems to be forgetting
the European standards she so often refers to when discussing
other aspects of healthcare. In Western European countries, as well
as in Poland’s neighboring countries, childbirth anesthetization
is considered a standard service provided to women. The question becomes, then, why do Polish women have to pay for it? This situation divides the
Polish women into two groups: those who can afford to pay for anesthetization
and those who cannot afford to pay for something to which they are entitled.

Resistance to pain depends inherently on personal features, and
there are women who simply cannot imagine themselves experiencing childbirth in a natural way. That fear can cause negative consequences
to the woman’s physical health and therefore may endanger the security
of a child, say experts of the Polish Gynecological Society. According
to female MPs, the Minister should take all the necessary efforts to make
such a process a safe and non-threatening experience for women and ensure access to anesthetization is refunded from the National Health
Fund for all women in need.

The Ministry of Health prepared
an official response to the article published in "Dziennik." Her response
states that anaesthetization when instructed by a doctor is and will
be financed from public funds. It is for a doctor to decide on the mode
of delivery and potential use of anesthetization. The scope of services,
including procedures used (anesthetization, cesarean section), depend
on the health status of the patient, and the process of her pregnancy
and delivery.

The Ministry also mentions a committee that will prepare health standards on childbirth and related issues. The committee’s purpose
is to draft a legal act describing standards of medical procedures during
pregnancy and delivery. Services resulting from the standards prepared
will be financed from public funds. Completion of the committee’s work is closely
connected with the works of the Polish Gynecological Society experts’
team, acting independently and preparing recommendations related to
medical procedures during childbirth.

The declarations of the Ministry
of Health offer some hope that Poland may develop more
precise and clear standards related to pregnancy and childbirth in particular. Information that Polish women have been given in the last few
weeks have resulted in a state of uncertainty and fear, and those feelings are
least welcome when planning a family or when already pregnant.
It appears that the Polish Ministry of Health easily makes statements
or disseminates information, but unfortunately does not take into consideration
the consequences of these statements or information on the general public,
and women especially. I do hope we will not have a chance to experience
any more "interesting" solutions and the three times rule will not
be applied here.

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