Informed choice leads to healthy mothers and healthy babies

Informed choice leads to healthy mothers and healthy babies

Czech Republic
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$1,000 - $10,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

In long term perspective: women in the Czech Republic should have possibility of informed choice during pregnancy and childbirth. Every woman should have a possibility to give birth at a place, where she feels safe and with a professional she trusts (a doctor or a midwife) and who can provide her with the care appropriate to her health condition and wish.
The midwives should know and be able to work in their full working potential, according to globally recognized standards and support the mothers to choose a healthy, non-aggressive way of care during their pregnancies and birth. Mother-baby bonding should be strongly supported by the healthcare providers as a healthy process.
This will be a major change in a health system, which acts almost contradictory.

About Project

Solution: What is the proposed solution? Please be specific!

The health care system in The Czech Republic counts only on care in pregnancy provided by the doctors and hospital birth. Mothers should be totally subdued to the health care providers. This results in depression for many pregnant or birthing mothers, complications in childbirth resulting from overmedication or too many interventions in childbirth. Some women even say, that they feel like being raped during the birth. Women are taught to be obedient to the doctor, as he is shown as the only expert on childbirth. No female intuition allowed. Midwives are seen mostly as assistants of the doctors. The project is innovative as it focuses on changing the role model. It makes the mother competent and expert in her own birth. It teaches the care providers how to guide the mother through the natural birth, how to assist her. The project also shows a homebirth as a safe option to hospital birth. It views pregnancy and childbirth as healthy, social processes. It does not demand and engage expensive, advanced technology. It calls for changing the attitudes of people. Through education it helps to revive the old midwifery wisdom, which has been almost forgotten with the wave of modern technology, overmedication of childbirth and rush of this era. The project wants to revive and recover the most natural human process.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

The project comprises from following parts: 1. Prenatal classes teaching 2. Publishing a brochure on healthy pregnancy and normal birth – kind of a handbook for parents and midwives 3. Translating the brochure in languages of nations, who are living in Cz as “minorities” 4. Disseminating the information through media 5. Research In prenatal classes the parents learn about natural birth and its benefits. With this knowledge, they may have demands, which break harmful routines practices and step by step will lead the hospitals to become more mother -baby friendly. The brochure is a written information, which can be spread in fact everywhere and given to anyone. Midwives may learn what the mothers wish and thus learn about natural birth. As soon as the brochure is ready I will ave it translated to help also migrant women who come to Czech Republic (or with their husbands or as refugees or any other purpose. The brochure, Czech and also translated, will be given out for free. Some parts of the brochure will be used in magazine articles of various kinds, so that women may become curious. It is important for the Czech and also migrant women, what they may demand and get in Czech healthcare system and what you can get if you remain out of it - like if you opt for a homebirth.
About You
Organization:
Birth House at Stork
About You
First Name

Zuzana

Last Name

Stromerova

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About Your Organization
Organization Name

Birth House at Stork

Organization Phone

00420602958396

Organization Address

Augustinova 2/2070

Organization Country

, PR

Country where this project is creating social impact

, PR

How long has your organization been operating?

More than 5 years

Innovation
What stage is your project in?

Operating for more than 5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

My project focuses on healthy mothers and their families, who wish to have a normal birth in an out-of hospital setting. Apart from teaching and disseminating information, our organization tries to open an independent birth house. This place should serve the mothers as compromise place between the hospital and homebirth and it also should be an example of good practice. The midwives could learn about normal birth here and the women would find a shelter for such an exceptional event in their lives as the birth is.
Our focus group are mostly the women, who view the birth as a healthy live process, but can not find a proper care in regular healthcare system. As a result they often remain alone, unattended by a professional, as currently the midwives, educated in regular educational system, are often afraid to assist at natural birth out of hospital.
At the moment the mothers who wish to have a care during pregnancy and birth provided by midwives out of hospital, have to pay everything cash, instead being refunded by the health insurance office. They also have to pay cash all the tests and examination recommended by midwives. This is a big discrimination. Currently the Czech government is in a process of adopting a new piece of law, according to which the midwife, who would assist at planned homebirth might be punished by 1000 000 Czk (corresponding to approx. 58 825 USD).
Mothers from all social backgrounds would ask for midwifery services in case they feel normal birth is healthy. Often they safe money to be able to pay cash for it, as they feel it to be so important.

Share the story of the founder and what inspired the founder to start this project

Share the story of the founder and what inspired the founder to start this project:
I had finished my midwifery studies in 1981. Till 1996 I had been working in a big Prague hospital – a perinatal center. In 1993, together with my colleague , I went to Sweden to study the epidural analgesia. More than by epidural, I got touched by the approach of Swedish midwives to their clients. Arriving back home, me and my colleague, we thought that it would be easy to bring ideas of individual care and gentle behavior to our working place, if we explain the benefits of it. Instead we were fired from the delivery suite.
I started to do prenatal classes in the same hospital and got a tremendous chance to listen to people – the expecting parents. Their wishes and ideas brought me to the idea to start an Active Birth Centre, where natural birth would be promoted. With 4 colleagues we have succeed to do that in 1998. The centre was working for almost 3 years. Then we have decided to leave the hospital because of working and financial conditions it offered.
Since 2000 I have been working as an independent homebirth midwife. I have started non-profit organization Birth House at Stork.

Social Impact
Please describe how your project has been successful and how that success is measured

Considering the project, there had been some very successful interim goals reached. The first one was opening the Active Birth Centre (ABC) – the first place, after tens of years of “darkness”, where the mothers could have experienced normal birth without interventions, have not been separated from their babies, have been provided with supportive midwifery care, could have made an informed choice, as the regular delivery suite was just behind the door. This ABC had been a wonderful occasion for midwives to learn about natural birth and practice it in practice.
After 2000, when the “founder” midwives have left the ABC and started their homebirth career, the mothers got a chance (first time since World War II), to give birth at home accompanied by a professional.
4 meetings of parents who gave birth at home and friends of natural birth have been organized by our organization since 2003.
Enlightening brochures (about 5 titles)to support mothers informed choice and to educate the midwives have been published. These brochures are handed out for free.

How many people have been impacted by your project?

More than 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

I will:
1. Finish new enlightment brochure for pregnant women
2. Our organization will continue addressing the hospitals to encourage a new Active birth centre
3. We will start our PR activities

Task 1

Finish the text of public enlightment brochure - information about normal birth and their rights within the regular health care system will give mothers strenght in their minds and hands

Task 2

Our organization has already send letters to Prague hospitals offering our help with building special midwifery wards in obstetric clinics to enable the mthers to make informed coice in the hospitals.

Task 3

As the information needs diseminating we will start our cooperation with media - we will address magazines for women, try to get invitation to some TV program for women etc.

Identify your 12-month impact milestone

We will try to establish and deepen a good cooperation with the hospitals, will address the members of parliament who may influence adoption of new regulations regarding midwifery care.

Task 1

Start negotiations in hospitals, present a midwifery ward project to them.

Task 2

Search for contacts in parliament, arrange meetings with chosen members of perliament

Task 3

Focus on public - organize another meeting of parents who gave birth at home and the friends of natural birth, encourage a self support group among these parents,inform the public about the situation.

How will your project evolve over the next three years?

The direction of the project would much depend on development of the political situation in the Czech Republic. More effort would be put in supporting establishing self support groups among the parents, and making these groups stronger.
We will deepen the cooperation with the organization The League for Human Rights (they are lawyers).
We will also focus on midwifery education, as without properly educated midwives the mothers could hardly demand he care provided by independent midwives out of hospital.
We also will focus on education of public, as properly informed mothers may present demands in hospitals, which would lead to improvement of the type of care provided.
We will organize an international conference on normal birth bringing together proffesionals and consumers.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

As pregnancy and birth are viewed as medical events rather than social processes in the Czech Republic, the governement and specially the Ministry of Health are trying to forbid midwives to be regular care providers for healthy pregnant and birthing women. They try to adopt such legislation, which would make it impossible.
Another barrier seems to be lack of money for engaging and paying the lawyer, who would set up deep analyses of pieces of legislation influencing current situation in midwifery, .
As not being a part of regular healthcare system, midwives work is not covered by the health insurance. Mothers have to pay cash, so many would hesitate , whether to use midwifery service or not, specially when their partners are unemployed.In the same time these mothers save money of this system, as they do not demand any remedies or use of advanced and expensive technology. This is discriminatin both - the mothers and also the midwives.
Myths about risk of normal birth are spead through the whole society in spite of large research studies, which show the safety of midwifery care provided out-of-hospital under certain criteria.
How to overcome these barriers? Inform, inform, inform. We plan to disseminate proper and useful information as wide as possible among public and also professionals.

Tell us about your partnerships

Since the the beginningof the project our organization cooperates with the Czech Confederation of Midwives. This is also because I am a vice-president of this organisation responsible for international relationship. In 2008, together with this organisation plus the Active Maternity Movement we have organized an international midwifery conference. The theme of the conference was: The midvives reach out to women, where ever they decide to give birth. We have ivited speakers from several European countries to show the audience, that midwifery care is just normal in other health care systems.
To strenghten partnership with women, we have also encouraged the 4. meeting of "homebirth parents" and friends of natural birth, and encouraged them to start an initiative to support informed choice for women.

Explain your selections

Since the very beginning I got a tremendous support from the family. This support included help with organization of various activities (courses for midwives, courses for mothers-to-be, conferences) their patience with my not beeing at home very often, with my devoting time to projects and not to them.
From time to time a new person (individual) entred the project and brought a new idea. Sometimes these people became kind of project advisors in other fields than midwifery.
Fonds and foundations - there have been few which have provided us with finantial support, mostly used for education of midwives in the field of normalbirth.
Bussienss - a bussinessman had devoted more than 50 000 USD to start a Birth House at Stork, as a place for practical training for midwives and an out-of-hospital place for birth. Without his support we would have no place to implement the project.
Without customers, without women demanding and wishing other than hospial services in pregnancy and childbirth, there would be no necessity to implement such a project.The women support the project with their pure existence.They come to meetings contribute to discussions, offer the opinions...
Other - Social European Fund - we have obtained 2 grants for 2 of our subprojects. One focused on education of midwives, the other one on setting up the standards for out-of - hospital midwifery care. These standards have not existed before.Together with my coleagues we have written a textbook for midwives, dealing with out-of-hospital midwifery care.

How do you plan to strengthen your project in the next three years?

In next three yers we hope to be able to distribute the enlightenment brochures in public. Our negotiations with hospitals will deepen. We will focus on midwifery wards being opened in hospitals. This would demand quite a lot of work and time. These wards can represent a compromise between home and hospital births.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

Restrictive cultural norms

SECONDARY

Lack of insurance/financing options for healthcare

TERTIARY

Lack of access to targeted health information and education

Please describe how your innovation specifically tackles the barriers listed above.

In general people think, that an out-of hospital birth is a high risk process, in spite of the fact, that large researche works show, that for healthy woman, accompanied by a professional care provider, a homebirth is the same safe as hospital birth. For multiparas it may be even safer.
We encourage the professional association of midwives to lead the negotiation with the health insurance offices.
Throu our publications we want to educate the public, politicians, the same as the midwives.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

Influenced other organizations and institutions through the spread of best practices

SECONDARY

Enhanced existing impact through addition of complementary services

TERTIARY

Repurposed your model for other sectors/development needs

Please describe which of your growth activities are current or planned for the immediate future.

Finnishing and translating the enlightment brochure on different aspects of normal birth.Then we will distribute the brochure all around the Czech Republic + the translated versions to migrant women. We plan to organize a conference on normal birth and plan to invite also participants from East European countries, where the sitation for midwives and birthing mothers is very similar to the one in the Czech republic.

Do you collaborate with any of the following: (Check all that apply)

NGOs/Nonprofits.

If yes, how have these collaborations helped your innovation to succeed?

We cooperate with the Active Motherhood Movement, with both midwifery associations that operate in the Czech Republic, civic association Rozalio (dealing with vaccination), the League ofr Human Rights (lawaers).