FIFTH SECTION

Application no. 28473/12 Alexandra KREJZOVÁ against the Czech Republic lodged on 7 May 2012

STATEMENT OF FACTS

The applicant, Ms Alexandra Krejzová, is a Czech national, who was born in 1980 and lives in Prague . She is rep resented before the Court by Mr R. Hořejší, a lawyer practising in Prague .

A. The circumstances of the case

The facts of the case, as submitted by the applicant, may be summarised as follows.

The applicant is a mother of two children born in 2008 and 2010. She gave birth to both of them at home with the assistance of a midwife. The midwifes assisted at the birth without any authorisation by the State.

Before deciding to give births at home, the applicant had visited several hospitals which all, however, refused her requests to carry out birth without any medical intervention that would not be strictly required by the situation. They also refused to fulfil her wish for an uninterrupted contact with the born child as the regular practice was to take away the child from the mother immediately after the birth for weighing and measuring and for further medical observation lasting two hours.

At the time of lodging the application, the applicant was pregnant again with expected delivery in the middle of May 2012. The pregnancy was without any complications and she wished to give birth again at home with the assistance of a midwife. She was, however, unable to find a midwife, because under the new legislation in force from 1 April 2012 they risk heavy fines for providing medical services without an authorisation. The applicant requested several authorities to help her to solve her situation.

In a letter of 18 November 2011 the Ministry of Health replied that it did not provide medical services to individual patients and that the applicant should inquire with the City of Prague, which registered and issued authorisations to health professionals.

On 29 November 2011 the applicant ’ s health insurance company informed her that the assistance of a health professional at birth at home was not covered by the public insurance.

On 13 December 2011 the City of Prague informed her that no midwife registered in Prague had an authorisation to assist at births at home.

B. Relevant domestic law

1. Act on Medical Services (no. 372/2011)

This act entered into force on 1 April 2012.

Under section 11 a person can provide medical services only with an appropriate authorisation, the conditions for which include having appropriate technical equipments at the place where the services are being provided as specified in a decree issued by the Ministry of Health.

Under section 114 a person providing a medical service without an appropriate authorisation can be fined up to CZK 1,000,000 (approximately EUR 40,000).

2. Decree of the Minister of Health on technical equipments at health care establishments (no. 92/2012)

The decree does not envisage the possibility for health professionals to assist at home births. It envisages a possibility for midwives to conduct births in rooms specially equipped for that purpose. Furthermore, such a place must be maximum 15 minutes from a hospital that could perform a birth by a caesarean section.

3. Criminal Code (no. 40/2009)

Under Article 251 a person who, to a significant extent, provides services or carries on other gainful activity without being authorised thereto shall be sentenced to imprisonment for a period of up to two years or by prohibition of certain activity.

Concluding Observations of the Committee on the Elimination of Discrimination against Women on the Czech Republic , 22 October 2010

“36. While acknowledging the need to ensure maximum safety for mothers and newborns during childbirth, as well as the State party ’ s low perinatal mortality rate, the Committee takes note of reports of interference with women ’ s reproductive health choices in hospitals, including the routine application of medical interventions, reportedly often without the woman ’ s free, prior and informed consent or any medical indication, a rapid increase in the caesarean section rate, separation of newborns from their mothers for up to several hours without health-related reasons, refusal to release the mother and child from hospital before 72 hours after childbirth, and patronizing attitudes of doctors which impede the exercise by mothers of their freedom of choice. It also notes reports about women ’ s limited options for delivering their babies outside hospitals.

37. The Committee recommends that the State party consider accelerating the adoption of a law on patients ’ rights, including women ’ s reproductive rights; adopt a protocol of normal birth care ensuring respect for patients ’ rights and avoiding unnecessary medical interventions; ensure that all interventions are performed only with the woman ’ s free, prior and informed consent; monitor the quality of care in maternity hospitals; provide mandatory training for all health professionals on patients ’ rights and related ethical standards; continue raising patients ’ awareness of their rights, including by disseminating information; and consider taking steps to make midwife-assisted childbirth outside hospitals a safe and affordable option for women.”

COMPLAINT

The applicant complains under Article 8 of the Convention that Czech law does not enable assistance of a health professional at home births in violation of her right to private life.

QUESTION TO THE PARTIES

Has there been a violation of the applicant ’ s right to respect for her private life, contrary to Article 8 of the Convention?