Monday, February 19, 2007

Fleeing Gypsy Mothers

Here's an interesting story about postpartum women from the Roma community in Eastern Slovakia:

MICHALOVCE, Slovakia (AFP) - A few hours after giving birth, they "escape" from the hospital leaving their babies behind with staff, sometimes attacking the nurses in their desperation to flee.

Too many children, not enough help at home and the disappearance of previously obligatory communist-era, pre-natal healthcare support has given rise to the phenomenon of mothers from the Roma community in Eastern Slovakia temporarily abandoning their infants immediately after birth.

The maternity ward in the 40,000 strong town of Michalovce witnessed an average of a dozen such "escapes" a month last year, with the mothers usually returning a few days later.

Around 1,000 children are born every year at the hospital, around half of them to women from the region's large, often virtually segregated and poverty-stricken Roma community.

"You cannot say that these women are bad mothers, but they have five or six children whom they have to take care of at home," explained the head of the hospital's obstetrics and gynecology service, Jana Fantazirova.

"The hospital is not a prison, we cannot lock someone up," said her colleague at the nearby Trebisov hospital, Jozef Pajtas, who dealt last year with around 30 fleeing mothers, or around one in 10 of the total.

"Some of them are very aggressive, they attack the nurses because they want to get out at all costs," he said.

"The Roma women have to return home as soon as they can after birth because the men do not want to take care of the children: for them it is purely women's work," he added.

The patients have children at home whom they have to take care of, and the men don't want to help out. Even so, I'm not clear on why the women leave immediately postpartum, yet return a few days later.

Beyond the simple health problems posed by a new born baby left without its mother during its first few days, the "escapes" cost hospitals an average 8,100 koruna (240 euros).

Health insurance companies refuse to meet the medical bill when a new mother leaves the hospital less than 48 hours after giving birth. Some companies even demand a minimum four-day hospital stay.

That's just odd. Why would an insurance company *mandate* a four-day day hospital stay after a NSVD?

According to the non-governmental Cultural Association of Slovakian Gypsies the sole effective method of countering the phenomenon is basic school and health education.

"Now, women are no longer obliged to see doctors before they give birth as they had to during the communist era," said the association's director, Helena Jonasova, who is also a Roma.

The association has perfected its own childcare education programme for future mothers in the central Slovak town of Banska Bystrica since 1994 involving around 500 mothers. And it has paid off, with absentee mothers becoming an unknown phenomenon in the town.

Changes in the system for handing out benefits for newly born babies last year have also contributed to curbing the phenomenon in eastern Slovakia.

From now on, mothers who leave hospital without permission will not be able to claim the 4,460 koruna (130 euros) bonus per child and 15,460 koruna (450 euros) for a firstborn.

Without formal educational qualification or work, Slovakia's Roma community often depends on state handouts to survive.

In the east of the country near the frontier with Ukraine, the strongly concentrated community often live in what amount to shanty towns, where the unemployment rate can climb to 100 percent.

In a community where a child is considered as a gift, families of up to 15 children or mothers as young as 13 are not exceptional.

Slovakia's last census in 2001 put the Roma population at 90,000 but the real total is believed to be in the order of 400,000-500,000.

You know, I was going to say something about parental consent laws, but the reality of what these poor 13 yo and grand multips have to go through renders any snark inappropriate.


At 4:45 AM, Anonymous Anonymous said...

We had a patient with 5 kids at home leave about 8 hours postpartum. She was very nice about it, and we discharged her (it wasn't AMA). She returned to the hospital twice a day to see her newborn until he was ready to go.

At 5:20 AM, Blogger ema said...


See, that makes sense to me--the patients stays for observation for a few hrs pp. (Sure, you'd like it to be 24-48 hrs, but 8 hrs is better than nothing.)

What I don't get is why the women in the story leave right away, only to return a few days later. If their hospitals are anything like ours, it still takes them 2-4 hrs to do all the d/c stuff for the baby. It would be better to spend even that limited amount of time pp in the hospital, to insure all's well. I think maybe we're missing part of the story.

At 1:17 AM, Anonymous Anonymous said...

seems to me they leave immediately after birth in order to go home and take care of the children there - baby is left at the hospital for the hospital to take care of while he/she is most vunerable - a few days later when baby is out of immidiate danger mom returns to collect him/her. seems like the hospital is being treated as a babysitter. also, was mentioned that it seemed odd that health insurance mandated a 4 day stay. That's not so odd - Japanese national health insurance mandates a 5-10 day stay after a normal vaginal birth. When health insurance is run by gvpt organizations its more about patient care then money.

At 3:15 PM, Anonymous Anonymous said...

What interests me is that they said MOST of the mothers return. What percentage does not return? And how many new ORPHANS is this creating? That's what we really need to thik about; not about how many return and how odd the situation is. We need to think about who is going to care for the babies when the mother does not return.


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