This description of Zuzana Stromerova's work was prepared when Zuzana Stromerova was elected to the Ashoka Fellowship in 2001.
Zuzana Stromerova is transforming the birthing process from the expensive hospital model to a more personally tailored residential model that affords choice and greater comfort to mothers and families.
The New Idea
Zuzana is instituting radical changes in the birthing process, affecting the relationship between mothers-to-be and obstetricians and public attitudes about pregnancy in general. As a result of Zuzana's work, pregnant women's perception of childbirth is shifting from one of risk, endangerment, and passivity to one of ownership and empowerment. Zuzana uses a model "birth house" as a means of promoting best practices in obstetrics, focused on full-care and family participation in the pregnancy, birth, and postpartum periods of the mother and child's life cycle.
In the Czech Republic, homebirth and midwifery represent social taboos, despite being common practice in other European countries. There is no model for obstetrics care in the Czech Republic other than hospitalization, where the doctor holds absolute authority and evokes feelings of anonymity and severity, without regard for the patient or family. In most medical facilities, privacy and individualized care are perceived as special needs and are provided only in extreme situations. Healthcare providers are also often nasty and rude to pregnant women, making childbirth an overwhelmingly traumatic and frightening experience. While funds are openly spent on new medical technology or hospital furnishings, there is no acknowledgement of the need to address social problems or move toward systemic changes.
After years of working as a midwife in a medical system where doctors coldly dominate the birthing process and where the focus is on the equipment and mechanics of delivery, Zuzana developed an alternative to the factory-like model of delivering babies. She saw that the lack of democratic process in medical institutions, the social taboos attached to alternative birthing methods, and the disenfranchisement of midwives in the Czech Republic were limiting the variety of birthing options for women. As a response to rigid birthing practices, Zuzana puts women in charge of their own birthing experiences in a home-like setting, encouraging the use of midwives, discouraging frequent interventions by medical staff, and providing concrete information through private consultations.In 1998, Zuzana opened her first Active Birth Center in partnership with the Prague Hospital of Na Bulavce. The care provided there is individualized and consistent and allows clients to take a leading role in the delivery process, including choice of birthing position, medication, family accompaniment, and certain procedures like episiotomies. In 2000, she departed completely from the hospital structure and opened the Stork and Crow home-birth center, the first independently run pregnancy care institution of its kind. The center serves not only as a birthing place, with several rooms dedicated to child delivery and patient care, but also as an educational facility, with a lecture room, study, library, and information center. Stork and Crow also acts as a meeting point for national and international networks of birthing centers and midwifery associations. Using these networks, Zuzana also collaborates with the Ministry of Education to upgrade the quality of midwife education, meeting World Health Organization standards for the first time in decades.
Zuzana has been a practicing midwife for more than twenty years. She worked in a Prague hospital until 1993, when she undertook her first study-stay in Sweden. Although her research focused on the use of epidurals in the birth process, her greatest lessons were in the different methods and approaches to child delivery. After returning to the Czech Republic, she could not return to working in the old way. During the next three years, she served as a prenatal care provider in a hospital and started working with the chief gynecologist/obstetrician at the Prague Hospital of Na Bulavce to develop her Active Birth Center plan, formally launched in 1998. Zuzana opened the Stork and Crow center in 2000 and continues to work in prenatal care and obstetrics, translating books and educational videos into Czech, developing curricula for midwifery courses, and organizing conferences.