Ágnes Geréb

My name is Ágnes Geréb.

My roots and my blossoms: my precious, late mother was a retired paediatrician, my precious father was the late Prof. Dr. György Geréb (https://hu.wikipedia.org/wiki/Ger%C3%A9b_Gy%C3%B6rgy). Both of them were holocaust survivers. I was born on 20 December 1952 in Szeged, Hungary. That was the town where I lived, studied, played in an amateur theatre, worked and had three of my children. My fourth child was born in Budapest. During the two acts of my married life I gave birth four times and I brought up five children. At the moment (2022) three of these fantastic children (this is an unbiased opinion) have 11 equally fantastic children (this is another unbiased opinion). I have a sister. My best friend has been my best friend for 53 years. What else could I wish for?

What I am most proud of in my professional life:

• I am proud of the changes in people’s approach to childbirth; women who have given birth at home are spreading this attitude, and demands towards hospitals have also changed. This has led to a lot of changes in hospitals. Although sometimes these have been only for the sake of appearances, women giving birth in hospitals, and their babies, have benefited from these changes.
• I am proud of our slogans that sound really good in our language:
  The quality of birth means the quality of life.
  Little by little, we will change the world!
  Free choice in birth – free choice in life!
  Dignity in birth – peace in the world!
  To give birth freely, to be born free!
  Feeling safe is the best, no force; 
• I am proud of the first Hungarian Midwife Society – my pupils.
• I am proud that ever since it was founded, our foundation, Alternatal, has introduced a lot of expressions into common usage. Some of those have already existed abroad, like undisturbed birth, doula, independent midwife, independent midwifery, apprentice midwife, midwifery model of care; etc. Some of them were used for a time but then were forgotten, like “várandós” instead of “terhes” (both words mean pregnant but the latter is connected with being burdened whereas the first one simply means expectant). The third phase of birth is called the pushing phase. To push in Hungarian is a transitive verb, it refers to the mother pushing the baby. In olden days they used push in a reflexive way, referring to the baby pushing to get out. It is a nice, old-fashioned word, which we find more appropriate. And there are new words and expressions that did not exist in our language before, created by people working for Alternatal, like birth house, attending birth, and birth assistant.

A few remarks:

Undisturbed birth means that there are no disturbing circumstances either within the mother giving birth or around her. Undisturbed birth is based on the free choice made after getting enough information to choose. Undisturbed birth can happen anywhere, in an institution, in a birth house, in a birth centre or at home.

We think birth attendance and birth management are different methods. A birth attendant is a professional (obstetrician or midwife) who, in accordance with the suggestions of WHO, intervenes as little as possible during the process of labour and birth but constantly monitors the condition of mother and baby, and makes sure that the mother feels safe and keeps her confidence. Labour and birth are not managed by this person, he/she is only present with all his/her expertise. A birth attendant may work in an institution, in a birth house, in a birth centre or at home.

The expression birth house has become so naturalised in our language that when I wanted to get it patented in the early 2000s the office declined my request saying that I could not get the expression food shop patented either. Birth house was created by the Alternatal Foundation in 1993 to differentiate from maternity centres or hospitals. A birth house is a communal place run by independent midwives. It is the place of work of a certain group of midwives, where women can get information, where they can prepare to give birth, where they can meet other families, and where they can give birth. A birth house is something between a home and maternity institute. A birth house is not the woman’s own home, but concerning the birth attendants or the conditions it is like somebody’s home. There is no operating theatre in a birth house. Midwives bring their expertise and their bag to birthing women both in their homes and in birth houses.

Birth houses – at least in Hungarian – are not the same as birth centres. Birth centre is a collective name. There might be some that work under maternity institutions whereas others are independent. Their working methods may also be different.

The word and the idea of homebirth is being introduced and spread throughout Hungary. At the moment homebirth here is only tolerated but not accepted. If it were accepted then the two words home and birth would become one word. It is consequently written in two words, although homebirth is different from birth at home. The fact that both journalists and spelling experts stick to writing it as two separate words is an evidence that, although it has been legal to give birth at home since April 2011, homebirth and its real meaning has not yet become public knowledge.

The difference between pushing as a transitive verb and pushing as a reflexive verb shows the different ways of looking at birth – just like the difference between managing or attending birth. The reflexive push may make you aware that the baby starts pushing his way out after the muscles of the womb have made it possible for him in the course of a natural birth. This happens if we do not urge the baby but wait for the superhuman strength to come and help. If it happens like this, the mother does not have to overexert herself and the obstetrician does not have to heroically push the baby from outside his mother’s belly like in an action film. The routine employing of the so-called Kristeller manoeuvre was banned in 1999 by WHO and it is only permitted in special rare cases as it may cause severe harms to mother and baby alike. In their book, A Midwife’s Story, Penny Armstrong and Sheryl Feldman put it like this: “There is power that comes to women when they give birth. They don’t ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying the child with it.”

What I am proud of and not proud of at the same time:

• I am proud of and I am not proud of that my children have gained and lost with that I am their mother.
• I am proud of and I am not proud that one of my sons prepared his dissertation about me and my life at the art university in 2019 (http://complexblank.org/anyadhogyvan_tarlat). It is only available in Hungarian at this moment and even though the Hungarian text could give more meaning to the content, the visual experience also tells a lot and moves people’s feelings and make them think.

What I am not proud of

• I am not proud of the contents of the Act of April 2011 because it mainly contains regulations to decide who can give birth at home and who cannot. I think the regulation should state who can become an independent midwife, and what expertise is needed for that. And thus the independent midwife must be competent enough to decide whose birth she can attend and whose birth she cannot.
• I am not proud of not having been able to set up an Independent Midwives Professional College. This college should decide the professional rules of midwifery that must be kept both at homebirth and in birth houses. Then, unlike now in controversial cases, independent midwives would not be made responsible for not keeping rules that refer to obstetricians. It is a fact that homebirths (or births in a birth house) are different from births in a hospital, so in certain cases keeping hospital rules at home might be dangerous for mother and baby.

• I am not proud of that the Hungarian law of 2011 legalizing homebirth had not put an end to the criminalization of midwives. There is still no possibility in case of complication around birth to apply to the professional board instead of the case being directly transferred to the police. Still, there are no midwives amongst judicial experts, only OB-GYN experts are accepted in court. The opinion of judicial expert midwives should have at least the same value in court when declaring a sentence than that of experts in forensic medicine. This is one of the projects I am working on.

• Finally, I am not proud of that I have not been able to get it widely accepted that an independent midwife is not subordinate to an obstetrician – they are partners of equal rank; they should hold hands to do as much as they can for the woman in labour and her baby.

Career, Education, Scholarships, Awards

General Practitioner, University of Szeged Faculty of Medicine,

From 1977 to 1994. At the University of Szeged, Faculty of Medicine, (currently Albert Szent-Györgyi Health Centre at the Department of Obstetrics and Gynaecology of the University of Szeged Faculty of Medicine, WHO Research Centre), teaching university students, participation in research work and in the work of the clinic, including oncological surgery and other tasks of the department.

For the first time in 1977, and from then on, the introduction of fathers into the delivery room

1982 Obstetrics Board Exam

1986 Psychology Degree at the Faculty of Education and Psychology of Eötvös Loránd University

In 1984 and 1986 participation in the organisation of the Conferences of the world-famous psychologist, Carl Rogers titled „Cross-Cultural Communication” held at Szeged, where she found her best working method, to accompany the independent development of another person, which method she also applied during birth preparation classes and through accompanying childbirths until her arrest in October 2010.

1986 participation in the First International Conference on Home Birth in London.

From 1989 to 1994 in addition to her work at the Clinic, she was involved in home births throughout Hungary, first all alone and from 1994 with doulas, some of whom later became independent midwives of the first midwife community in Hungary.

A few months in America – together with her family including her three children – a study visit to a midwife group accompany home births.

After returning, continuous submissions of applications, formal steps to make home birth accepted, regulated and legalised – unsuccessfully.

1992 an International Conference on Childbirth and Birth – for the first time in the Hungarian Obstetrics she brought the best professionals in the world to Hungary from her own resources and with her friends and family she organised a highly successful 300-membered conference with hundreds of Hungarian participants in Szeged which revolutionised the obstetrical approach. The world’s most renowned professionals of Midwifery were also represented (chief patron Dr Michel Odent M.D. obstetrician and gynaecologist, founder and director of the Primal Health Research Centre in London, patron Sheila Kitzinger social anthropologist, Beverly Chalmers former consultant of WHO, speakers among others were Wendy Savage Obstetrics and Gynaecology consultant of the Royal London Hospital, Dr Marsden Wagner M.D., head of Department of WHO), and several leading Hungarian specialists among them Dr Sándor Bálint M.D. who starting from here later got to the “Home birth in the Hospital” movement.

In 1993 the Alternatal Foundation was established, and she was a member of the Board of Trustees at that time and also an active co-worker, today she is a professional consultant. The Honorary Chairman of the Alternatal Foundation is Dr Michel Odent, who became from a world-famous surgeon professor to an obstetrician accompanying home births. The introduction of waterbirth also linked to his name.

Since 1993 lobbying in the framework of Alternatal Foundation – The Hungarian Parliament, voted by 256 to 4 the amount of HUF 32.6 million in favour of the setup of the first birth house which was also announced in the Hungarian Official Gazette. Subsequently – presumably due to the effect of the counteractive lobby of obstetricians – in that same year the whole amount was taken back by a supplementary budget. Meanwhile, the Soros Foundation granted a loan on the sum announced by the Hungarian Official Gazette. From this amount, half of a house was bought, and the first birth house was founded and operated (the house had to be sold later, because of the withdrawal of the money and the whole project had to be started all over again). This was also the time when doula care was introduced to Hungary – Alternatal Foundation invited Dr Marshall Klaus internationally known neonatologist who gave presentations on the significance of doula care at the Semmelweis University of Budapest. He proved its significance with experimental situations. From then on, beside accompanying homebirth the work of the Foundation also covers regular birth preparation classes, doula trainings (the founding members of MODULE – the Hungarian Doula Association, which is the training centre of doulas working in hospitals – were also trained here), the education of midwives, running the birth house, organising and participating in conferences, film production, book publishing and building international relations. Meanwhile, there were further steps made for the acceptance and the legalisation of home birth, and for the establishment of a decree protecting the independent midwives, and for the introduction of the so-called „primary care”, which is the midwifery model of care (in which the midwives can accompany the pregnant women independently, so to speak, they could provide maternity care independently – as from June 2014, it has come into force as a principled option).

In 1993 Alternatal Foundation was a founding member of the European Network of Childbirth Associations (ENCA), which is still working actively for the interest of birth to this day and of which Hungary is still an active member through the Alternatal Foundation. In the course of its work, Alternatal Foundation opened the eyes of such professionals who then created a new profession in Hungary: the “perinatal consultants”, to which the Eötvös Loránd University now offers a degree by a postgraduate education. Alternatal Foundation established the Birth House Association, from which today’s EMMA Association has evolved. It has also founded the Association of Independent Midwives.

1993: In the Eötvös Secondary Grammar School, Midwives and Parents – presentation for 300 people.

1994: Presentations in Dunaújváros, Veszprém, Szeged and Budapest

1994: Press conference at the Ministry of Welfare about the objectives of the Alternatal Foundation on October 12,

1994: “Conference on the Newborn or the latest Research Results on the Effects of Interventions during Childbirth on the New-born Infant” – Dr Marshall Klaus, co-speaker: Phyllis Klaus, American Psychoanalyst.

1994: Dr Michel Odent, a renowned specialist and researcher in the field of obstetrics and gynaecology who was one of the first experts to apply natural birth, came to Hungary for professional consultancy. Meeting with the leading physicians of birth clinics and providing professional research results he gave background to Alternatal Foundation with its work regarding the initiative of natural birth.

From the beginning of September 1995, she participated in the preparatory work of the 3-year school of the Magyar Hagyományörző Műhely (Hungarian Tradition keeper Workshop). The objective is to explore the possibilities of recreating traditional midwifery and to participate in the education.

1995: Health Sciences College, Budapest: presentation on undisturbed, natural birth

1995: Further training for midwives, with world-famous guest speakers: Barbara Harper, Beverly Beech, Phyllis Klaus, Dr Michel Odent.

1996-2000: regular open days in the Birth House and clubs

1996: Budapest: SEAL Conference and Exhibition, speaker

1996: World Day of Breastfeeding, Health Visitor Training College, Kaposvár, speaker 

1996: Within the programmes of Days of the Érd the presentation titled “a Human being is born”, Érd, Citizens’ House

1996: Naturopath Conference, Budapest, Petőfi Hall, speaker

1996: Third Symposium of the Association of Obstetrics, Perinatology and Anaesthesiology, Budapest, speaker.

Since 1996 continuous cooperation with the Hungarian representatives of the La Leche League and with the Hungarian Association for Breastfeeding.

1997: Ashoka scholarship, since then lifetime membership – a three-year scholarship at the world organisation of Innovators for the Society. The Ashoka world organisation, founded in 1980, supports social entrepreneurs with financial and other professional services building on the risk investment model. The activities of Ashoka members have a significant impact on the value and norm system of the society, covering education, environmental protection, healthcare, human rights, activation of the community, and the field of economic development.

2001: The launch of the „Giving birth and being born freely” campaign and petition to provide the legal and professional framework for homebirth.

2001: She made two presentations at the Third World Conference of Homebirth (Past attends at birth and Birth is not gentle)

2001: Polish Midwives Conference, Warsaw, speaker

2002: Warsaw ENCA (European Network of Childbirth Association) meeting, speaker

2002: Prize „Pro Naturopathy”

From 2002 training groups for processing feelings about caesarean section, giving birth and loss and training for grandmother groups, and for so-called „Rebirthing” groups are held by her.

From 2002 onwards until October 5, 2010 (until the day of her arrest): she participated in the process of establishing a home birth regulation (which since the beginning of October 2010 underwent through many changes and came out in April 2011)

2002: Birth Tunnel – She is one of the editors of the video and audio materials of the exhibition titled “Insights into the intimate events around birth, with sound and pictures”. Venue: Millenáris Park Hall „B”

2003: With her colleagues, she organised the first “Week of Birth” event which is taking place every year since then.

2003: Organiser of an unusual International Midwife Conference, Budapest

2004: Speaker at ENCA meeting, Athens

2004: ENCA’s 11th Anniversary, Annual International Meeting at Budapest

2004: Conference of Alternatal Foundation with world-renowned speakers (e.g. Ina May Gaskin, Dr Michel Odent, Elisabeth Geisel)

2005: Speaker at the Conference titled “Past, Present and Future in Obstetrics”, Balatonalmádi. The topic of her presentation is: „Statistical summary of home births accompanied by professional help in Hungary „.

2005: Diploma of Midwifery, University of Debrecen, Faculty of Health

Since 2006 she has held multi-day training for maternity care professionals in Tirgu Mures (Marosvásárhely) and Cluj-Napoca (Kolozsvár) for several times.

2006: Promenade Prize – The prize was founded by a female civil initiative for the recognition of women with remarkable personality performing outstanding civil society activities. Its objective is to acknowledge worthwhile women who are performing public activities and to draw the attention to women, women’s roles and the indispensable work performed by women during the practical operation of the society. Its intention furthermore, to highlight real female role models that are to be followed.

2007: ENCA meeting, in Bosnia and Herzegovina, speaker

2007: Presentation titled: „Current practice of Homebirth”, Budapest, Hotel Danubius

2007: preparing a standpoint within the Preparatory Commission for the regulation of the out-of-institute birth. The members of the Commission and the representatives of various professions within the scope of pregnancy, childbirth and birth, discussed and accepted every paragraph of the draft plan called the “Protocols and Guidelines for Planned, Out-of-Institution Births” and declared it relevant for legislation. This document was submitted to the Ministry of Health.

2008: International Midwife Conference in Prague, speaker

2008: She invited the world-famous Sheila Kitzinger to Budapest, who made a presentation titled „The Situation of Childbirth in Different Cultures”.

2010: Graduate Diploma of Midwifery, Semmelweis University, Faculty of Health Sciences

5 October 2010: Day of her arrest

In 2011, after her arrest and apparently without her, the first home birth regulation came into force in Hungary.

In 2011 she was elected as the favourite public figure of the decade in public opinion in Hungary.

In 2011, The „Freedom for Birth” film went around the world.

2012: She was invited to the „Human Rights in Childbirth” Hague Conference, but due to the house arrest she could not make her presentation.

From 2013, graduation in 2018: study at The Centre for Homeopathic Education in Budapest.

In March 2013, the Danish foundation called „The good start of life” („En god start i livet”) gave her a prestigious professional award. She was the only foreigner, as only Danish citizens receive this award, but they made an exception for her.

In 2014, apparently without her, as one of the steps of catching up with the EU directive, it was declared that midwives could carry out maternity care independently in Hungary.

Europe Summit 2016, Strasbourg: „Human Rights in Childbirth” and Midwifery Today Conference, speaker on both events.

2016: Became the member of the Global Midwifery Council, an internationally integrated science organisation.

2019: Agnes Gereb Champion Award – ‘The Agnes Gereb Champion Award is a special award that celebrates individuals who have furthered the cause of human rights in childbirth in extremely adverse conditions, and who may have faced bullying, mobbing, professional sanctions, legal persecution, criminalization and even acts of direct physical violence. This year, we are honoured to be able to give the award to the person it is named for – midwife and obstetrician Agnes Gereb from Hungary.’ HRiC (Human Rights in Childbirth, http://humanrightsinchildbirth.org/index.php/2019/03/08/announcing-the-2019-hric-champions-award-winners/).

2022. David Chamberlain Award (Prenatal Sciences Global Congress: Prenatal Sciences, Human-Earth Connection and Life Sustainability)

On 10 February 2021 the ban on my activity as an obstetrician-gynecologist and independent midwife was lifted. I fulfilled all the conditions to get my license back but constantly facing obstacles of various nature, I failed. 

Biographical data:

Personal details:

Name: Ágnes Geréb, M.D.

Place and Date of Birth: Szeged, Hungary. 20th December 1952

Children: 4 + 1 stepson, 8 grandchildren + 3 stepgrandchildren

Education:

2018:  degree at the Centre for Homeopathic Education in Budapest

2010: BSc in Midwifery, Semmelweis University, Faculty of Health Sciences, Budapest

2005: certified midwife, University of Debrecen, Faculty of Health

1990: Research on professional practice of home births in a birth centre at Livermoore, California, 6 months traineeship

1986: MA in Psychology, Eötvös Loránd University, Budapest

1982: Obstetrician and Gynaecologist specialist

1977: Doctor of Medicine, University of Szeged, Faculty of Medicine

Employment:

From 1994: Staff member of Napvilág Születésház® (Daylight Birth Centre)

1994: Foundation of the first Hungarian Birth Centre (Napvilág Születésház®) which functioned as the basis for home births.

From 1989: Started independent midwifery practice. Assisted home births for the first time in Hungary. Since then has attended 3500 home births.

1977-1994: Albert Szent-Györgyi Clinical Centre, University of Szeged, Obstetrics and Gynaecology Department, obstetrician and gynaecologist