5.  The applicant was born in 1976 and lives in Zagreb. 6.  She gave birth to her first three children in hospital. In 2011 she became pregnant with her fourth child and had a due date in February 2012. 7.  In November 2011 she sent a letter to the Croatian Chamber of Midwives (Hrvatska Komora Primalja), enquiring about the possibility of having professional assistance with a home birth. She explained that her first three hospital deliveries had gone normally, without the need for much medical intervention, but that she had not felt fulfilled afterwards. She therefore wanted to give birth to her fourth child at home. 8.  On 1 December 2011 she received a reply that according to the relevant domestic legislation health professionals, including midwives, were unable to assist with home births. In particular, although the Act on Midwifery allowed the setting up of private practices by midwives, the Healthcare Act, as the general Act in the sector, still did not expressly provide for such a possibility. Therefore, since the matter was not clearly regulated, no midwife had set up a private practice or officially assisted with home births. The letter also cited a statement from the Ministry of Health and Social Welfare (Ministarstvo zdravstva i socijalne skrbi Republike Hrvatske - hereinafter “the Ministry of Health”) issued in August 2011 and published on the Croatian Chamber of Midwives’ website:
“Having regard to the current circumstances, where the requirements for organising a system of professionally conducted home births do not exist (education and training of personnel) and where the other accompanying elements (availability of emergency transport and proper admission [to a medical facility] in the case of complications) which would enable safe delivery at home are lacking, we are of the opinion that in this area of healthcare the lawmaker has ensured, as far as possible, all the conditions for the care of mothers and the right of children to life and health. Considering the above, we are of the opinion that the protection of children, who do not choose the circumstances of their coming into this world, takes precedence over respect for a woman’s right to freely choose to give birth outside a medical facility.”
The Croatian Chamber of Midwives thus declined to assist with the applicant’s planned home birth. It noted that home births nevertheless occurred in Croatia, and for that reason it had urged the Ministry of Health to clearly regulate the matter as soon as possible. 9.  On 15 February 2012 the applicant gave birth to her child at home, assisted by a midwife from abroad. 10.  After the birth a paediatrician and a gynaecologist allegedly declined to examine the applicant and her baby but she eventually managed to find doctors who examined them both. 11.  On 23 February 2012 the applicant registered the birth and obtained a birth certificate. 12.  On 11 May 2011 the Ministry of Health sent a letter in reply to an enquiry from the Ombudswoman for Children (Pravobraniteljica za djecu), which stated that the relevant domestic law provided that babies were to be delivered in medical facilities. The question of home births had not been regulated by law and medical assistance in such procedures was considered as quackery. It further stated that home births were the personal responsibility of the mother and the person assisting with the delivery. In the event of a delivery outside a medical facility and where a woman claiming to be the mother did not have any medical documentation, the doctor carrying out the first examination of the child was obliged to make note of the absence of such documents. The doctor was not allowed to register data which he or she was not able to verify. 13.  On 25 August 2011 the Ministry of Administration (Ministarstvo uprave Republike Hrvatske) sent a letter in reply to an enquiry from the Parents in Action - Roda NGO (Roditelji u Akciji – Roda) stating that the law provided for the possibility to register the civil status of a child born outside a medical facility. It further stated that officials were obliged to verify data reported to them before putting anything down in the State register. Consequently, a person reporting the birth of a child born outside a medical facility was required to submit proof that the woman reported as the child’s mother had indeed given birth to the child. The medical documentation required for proving such circumstances was a matter for the health administration authorities. 14.  On 31 May 2012 the Ministry of Health replied to an enquiry from Parents in Action – Roda NGO by saying that it had never instructed doctors not to examine children born at home. On the contrary, having regard to the increased frequency of situations in which doctors were faced with having to examine children born at home without any medical documentation, it had consistently held that doctors were obliged to examine such children but were not allowed to register any data that they were not able to verify. It added that home birth was still not regulated by law and that therefore there was no mechanism for registering requests for home birth or regulations on the duty to report them. 15.  On 24 January 2012 the Croatian Chamber of Midwives reported on a case in which, according to the media coverage, a woman who had given birth at home had been separated from her child for two days. In particular, the hospital had called the police and social workers in order to establish that she was indeed the child’s mother after she had refused to be examined by a gynaecologist in a hospital. In addition, several midwives suspected of having taken part in the birth had been questioned by the police. 16.  According to information submitted by the Government, no health professional has ever been prosecuted in criminal proceedings or sanctioned for assisting with a home birth. 17.  In the Concluding Observations on the combined fourth and fifth periodic reports on Croatia issued on 24 July 2015, the Committee on the Elimination of Discrimination against Women expressed concern regarding the lack of oversight procedures and mechanisms for ensuring adequate standards of care, the protection of women’s rights and their autonomy during deliveries and the lack of options for giving birth outside hospitals. 18.  A survey on maternity practices in Croatia undertaken by the Parents in Action - Roda NGO in March 2015 noted situations of women’s wishes being disregarded by medical staff during childbirth, of a lack of consent for procedures conducted during labour, and limits on the presence of an accompanying person during childbirth. 19.  The Gender Equality Ombudsperson (Pravobraniteljica za ravnopravnost spolova) issued a research report in 2013 which noted inconsistencies in hospital practices regarding the presence of an accompanying person during childbirth.