Despite the demands, there is not much progress in improving perinatal care.

And what’s more, there are some worrying signs that the situation is unlikely to improve anytime soon.

It seems that improving the standards of perinatal care in Poland was one of the most socially supported pro-demographic activities, both by society and by all the parties in the ruling coalition. The election programs of all these parties included mentions of this topic, last year at the Left Convention there were postulates, and Donald Tusk also promised something in his speech in September 2023.

The main focus was on improving access to perinatal anesthesia and in this area changes were actually made regarding pricing (you can read about it here https://cowzdrowiu.pl/aktualnosci/post/samorzad-lekarski-o-znieczuleniu-do-porodu-wspolczynniki-moga-pomoc ) The health fund is to spend 25-60 million PLN for this purpose, on a national scale this is a very small amount. We spend 70 billion PLN on 800+, it would seem that even if this amount were increased to 500 million PLN, it would be money well spent.

The medical self-government speaks positively about the changes, but claims that the changes in valuation may not be enough to significantly improve the situation.

Another problem is that maternity wards that do not use anesthesia will be financially punished. It seems good, but these are especially maternity wards in small towns where few children are born and which already have financial problems because they are not profitable. This may end with them being closed – which will mean that women giving birth will have further to go to the nearest maternity ward.

In Poland, perinatal anesthesia in 2022 concerned only 14% of deliveries, and in 2023 17%. It is difficult to say to what extent the change in valuation will improve the situation, but even if it increased by 10 percentage points, it still does not improve the situation significantly – in fact, a woman deciding to give birth to a child still has no guarantee that she will receive anesthesia.

Another problem is that the improvement in access to anesthesia is not defined in any way – the coalition did not promise that 30% of deliveries will be under anesthesia, only that it will happen "improvement". And minimal improvement has occurred even without any action in recent years.

Anesthesia rates in Western Europe are around 50%, in Scandinavia 60%, and in many hospitals in large cities almost all births are under anesthesia.

But problems with access to anesthesia are not the only ones that occur in Polish maternity wards. Births are priced too low to cover all the costs associated with childbirth, which leads to various pathologies. The Rodzić po ludzku foundation is responsible for monitoring these issues. https://rodzicpoludzku.pl/ In Polish hospitals, mothers regularly experience ill-treatment from staff, there is no proper lactation counseling, and episiotomies are performed in situations where it is not medically indicated.

Minister of Health Izabela Leszczyna declared in April that lactation counseling would be included in the basket of guaranteed benefits. However, in July, AOMiT rejected this postulate (https://pulsmedycyny.pl/negatywna-rekomendacja-aotmit-dla-porady-laktacyjnej-pielegniarki-i-polozne-protestuja-1221001)

I’m afraid this will be another issue that will be thrown into the mud on the principle "I want to but I can’t". Only that compared to many other postulates it is not that expensive, and the main reason is that this issue simply concerns a small part of society, because fewer and fewer Poles plan to have children.

If the Good Start loan situation has taught us anything, it is that those in power largely listen to lobbyists, unless there is significant social opposition to something. There is no one to lobby to improve the standards of perinatal care, because there is no one to make money from it.

If you would like someone to "he tightened the screw" If the government has tried to reach out to public opinion on this issue, I recommend donating to the Birthing with Humanity Foundation, because they are doing a great job both by conducting advocacy activities and by carrying out interventions in specific hospitals.