Human Rights in Childbirth
May 31 – June 1, 2012
The Hague University of Applied Sciences,
The Hague, The Netherlands
http://www.humanrightsinchildbirth.com
Overview | Programme | Panelists | Registration
PROGRAMME
Day 1: Human Rights in Childbirth: International and European Perspectives
8:30 – 9:00 Registration
9:00 – 9:30 Welcome and Day 1 Keynote Speech
9:30 – 11:00 Panel 1: Ternovszky v. Hungary: Context and Consequences of the ECHR Decision
11:00 – 11:30 Coffee Break
11:30 – 1:00 Panel 2: Safety, Risk, Costs & Benefits: Weighing Choices in Childbirth
1:00 – 2:00 Lunch break
2:00 – 3:30 Panel 3: The Rights of the Baby: The interests of the unborn child and the power to speak for those interests.
3:30 – 4:00 Coffee Break
4:00 – 5:30 Panel 4: Collaboration, Competition, Money and Monopoly: The legal status of doctors, midwives, and hospitals in pregnancy and obstetric care
5:30 Reception
Day 2: Legal Issues in the Choice Between Home and Hospital Birth in the Netherlands
8:30 – 9:00 Welcome
9:00 – 9:30 Day 2 Keynote Speech
9:30 – 11:00 Panel 5: Perinatal Mortality in the Netherlands: Facts, Myths, and Policy
11:00 – 11:30 Coffee Break
11:30 – 1:00 Panel 6: Cases on the Edge: Contraversial Birth Choices in the Netherlands
1:00 – 2:00 Lunch Break
2:00 – 3:00 Panel 7: Financial Pressures in the Dutch Obstetric System
3:00 – 3:30 Coffee Break
3:30 – 5:30 Panel 8: Ternovszky in Holland: The Future of Choice in the Dutch Obstetric System
5:30 Reception
Overview of Panel Topics
Note: For more information on each panelist, please see the panelist page.
PANEL 1: Ternovszky v. Hungary: Context and Consequences of the ECHR Decision
This panel will lay the groundwork for the conference through an overview of the Ternovszky v. Hungary case, the European Court of Human Right’s (ECHR’S) holding, and its legal significance. This will include a discussion of the Hungarian birth system for a contextual analysis of how choice in childbirth can be supported or undermined. The panel will consider the legal proceedings against Hungarian obstetrician-midwife Agnes Gereb, and how they gave rise to Ternovszky. It will also explain the role of the ECHR in articulating and applying human rights, and describe the human rights articulated by the Court in the Ternovszky case. What does it mean to say that a woman has a human right to choose the circumstances in which she gives birth? What are the implications of this case for all European nations? Panelists will describe the Hungarian government’s reaction and response to the holding, in both its legislature and its judiciary. Has Hungary complied with the ECHR’s orders?
Panelists on Panel 1:
Karen Guilliland, midwife, New Zealand
Marton Istvan, obstetrician-gynecologist and professor, Hungary
Stefania Kapronczay, human rights attorney, Hungary
Elizabeth Prochaska, human rights attorney, UK
Barbara Katz Rothman, sociologist, USA
Imre Szebik, doctor and bioethicist, Hungary
Anna Ternovszky, mother, Hungary
PANEL 2: Safety, Risk, Costs & Benefits: Weighing Choices in Childbirth
This panel will explore the ways in which perspective informs an assessment of the best course of action in childbirth. Why might the people involved with a birth have different opinions about how that birth should be handled? Mothers, doctors and midwives each perform their own cost-benefit or risk-utility analyses on the basis of the variables that matter to them, either consciously or unconsciously. What are the factors that weigh in the balance when doctors recommend a particular choice or intervention? What are the factors that birthing women weigh in the balance, and how might they differ? The panel will consider the role of variables including fear of litigation for healthcare workers and past sexual trauma for birthing women, among others.
Panel 2 will also discuss the relationship between statistical and individualized assessments of safety and risk. Is a 1% risk in a particular population a 1% risk for any given individual in that population? Panelists will assess recent scientific data on the relative “safety” and significance of home and hospital birth, and discuss the relevance of this data for choice in childbirth.
Panelists on Panel 2
Peter Brocklehurst, doctor, Director of National Perinatal Epidemiology Unit, UK
Robbie Davis-Floyd, medical anthropologist, USA
Soo Downe, professor of midwifery sciences, UK
Elitsa Golab, civil rights lawyer, USA
Jennie Joseph, midwife, USA
Jo Murphy-Lawless, sociologist and historian, Ireland
Helene Vadeboncoeur, public health researcher, Canada
PANEL 3: The Rights of the Baby
This panel will explore the most common objection that people make when a woman chooses for home birth or goes against an obstetrician’s advice: “But what about the rights of the baby?” Panelists will discuss the legal issues at play in any discussion on the "rights" of an unborn child and the legal status of the being-born under the ECHR and other international regimes. The panel will also address the underlying suggestion that mother and unborn child are in conflict if the mother goes against medical advice or gives birth outside the hospital, and that authority figures other than the mother are more reliably invested in the survival and health of the baby than its parents. It will also discuss the possibility that an unborn baby has rights or interests that go beyond the right to survival, and include the circumstances in which it is born.
Panelists on Panel 3
Susan Bewley, obstetrician-gynecologist, UK
Farah Diaz-Tello, civil/ human rights lawyer, USA
Barbara Harper, nurse and birth activist, USA
Michel Odent, obstetrician, France
Roanna Rosewood, mother, USA
Noam Zohar, professor of philosophy and ethics, Israel
Moderator: Ina May Gaskin, Midwife, USA
PANEL 4: Collaboration, Competition, Money & Monopoly: The Legal Status of Doctors, Midwives and Hospitals in Pregnancy and Obstetric Care
This panel will discuss the professions involved in birth care, and how the relationships between these professions form the frame in which “choice” in childbirth is meaningful or not. How do obstetrics and midwifery conceive of authority in childbirth? What kind of collaboration between these professions would be necessary to support the choices described in Ternovszky? How have the historical relationships between medicine and midwifery shaped the reality of women’s choices in childbirth, and continue to do so? What role does the state play in shaping or reinforcing power dynamics in obstetric care?
Panelists for Panel 4
Barbara Hewson, human rights lawyer, UK
Amali Lokugamage, obstetrician-gynecologist, UK
Debra Pascali-Bonero, doula and filmmaker, USA
Becky Reed, midwife, UK
Moderator: Anna Verwaal, nurse and doula, Netherlands and USA
PANEL 5: Perinatal Mortality in the Netherlands: Facts, Myths and Policy
Public discourse on the Dutch birth system has been powerfully shaped in recent years by concerns about Dutch perinatal mortality rates relative to other European nations. This panel will clarify and discuss the scientific research on perinatal mortality and other safety/ outcome studies in the Netherlands. It will also assess the ways in which Dutch media has reported on these issues, both accurately and inaccurately, and how these reports, in turn, affect public perception and choice in the Netherlands. Finally, the panel will consider the connection between the science, the media, public opinion, and the direction of healthcare policy in the Dutch birth system.
Panelists for Panel 4
Marial Croon, journalist, Netherlands
Ank de Jonge, midwife and researcher, Netherlands
Elselijn Kingma, professor of philosophy and medical ethics, UK and Netherlands
Moderator: Hein Bruinse, obstetrician-gynecologist, Netherlands
PANEL 6: Cases on the Edge: Contraversial Birth Choices in the Netherlands
This panel will discuss controversies concerning the boundaries of “choice” in the Dutch birth system. In particular, the panel will look at the choice for home birth in cases of breech babies or twins, and the choice for caesarean section without a medical need. The panel will discuss particular cases in which mothers and midwives have faced negative legal consequences for choosing home birth, and discuss the legal status of the Verloskundige Indicatie List, which defines when pregnant women are transferred from midwifery to medical care in the Netherlands. It will also unpack the legal and ethical rights and responsibilities of healthcare professionals with regard to refusing to support certain choices or deliver certain kinds of care.
Panelists for Panel 6
Wilma Duijst, forensic doctor and criminal law researcher, Netherlands
Arie Franx, obstetrician-gynecologist, Netherlands
Robert Kottenhagen, professor of law and ethics, Netherlands
Rebekka Visser, midwife, Netherlands
PANEL 7: Financial Pressures on the Dutch Obstetric System
Panel 7 will discuss the role of finances, and especially health insurance policies, in shaping trends in Dutch obstetric practice. Many professionals in the obstetric system remark that financial pressures will put an end to the “traditions” of Dutch midwifery in a matter of years. This panel could explain ways in which financial practices have already affected significant changes in the Dutch system. Similarly, this panel could investigate the extent to which the financial models underlying Dutch childbirth effectuate a spirit of competition or collaboration between doctors and midwives.
Panelists for Panel 7
Jos Becker Hoff, CEO, Koninklijke Nederlandse Organisatie van Verloskundigen (KNOV)
Marian van Huis, treasurer, International Confederation of Midwives
Marlies Rijnders, midwife and researcher, Netherlands
Rachel Verweij, mother, Netherlands
PANEL 8: Ternovzsky in Holland: The Future of Choice in the Dutch Obstetric System
This concluding panel of the two-day conference will discuss the future of the Dutch obstetric system. This panel will be 30 minutes longer than most conference panels, and that time will be used for audience participation and general discussion. Is the robust choice that Ternovszky described as the human right of all birthing women a reality in the Netherlands? What are the possible directions that the Dutch system might move in? What decision-making processes will shape that outcome? How could these processes be optimized to ensure that the resulting system will best serve women and babies? This panel brings the conference full circle, from a consideration of the circumstances of the Ternovszky case and the abstract meaning of the human rights it articulates, to a concrete application of this holding in Dutch law and obstetric practice.
Panelists on Panel 8
Marjolein Faber, student of midwifery and medicine, Netherlands
Fleur van Leeuwen, human rights attorney, Netherlands and Turkey
Angela Verbeeten, Chairperson, KNOV
Jennifer Walker, doula, Netherlands
Barbara Wijsen, secretary general, Commission for Perinatal Health, Netherlands