Reproductive rights are human rights, but for many Roma women throughout the EU, they are non-existent, explains Erika Schmidt.
Erika Schmidt is an EMMA Hub programme manager and Safe Motherhood Week ambassador.
These reproductive rights include a woman exercising control over her own body. This means making her own informed decisions on where and how she gives birth and what treatment she receives. Equally, all treatment must be underpinned by dignity and respect.
Whilst many mothers face significant barriers to quality maternal healthcare, the problems encountered by Roma women and other disadvantaged groups are even more serious.
Many healthcare providers and local authorities fail to reach out to Roma women to educate them about childbirth issues in a comprehensive, culturally and linguistically appropriate way. This leaves Roma women in the dark about family planning, pregnancy and birth care, caring for new-borns, and whom they can turn to for advice.
Yet we also underestimate basic practicalities; many Roma women may not be registered or possess health insurance at all, making them reluctant to seek help when they need it. Some individuals cannot even afford the bus fare to reach a maternity clinic or hospital in the first place.
To make matters worse, Roma women often experience a three-fold discrimination, based on their gender, ethnicity and economic status.
According to a Fundamental Rights Agency survey, 17% of Roma experienced discrimination in healthcare within a 12 month period.
From being kept in the dark about their condition, to being pressured into Caesarean operations without being explained the reasons or alternatives, to even being kept in separate wards, Roma women often experience degrading treatment. Spurious judgments and even racial profiling about their unhealthy “lifestyle choices” often discourage Roma women from seeking professional help during pregnancy.
The consequences of this are very real; whilst the infant mortality rate throughout the EU is 4.3 per thousand live births, the rate among Roma communities is estimated to be much higher, with much research showing much higher rates of premature and underweight births among Roma women.
These estimations remain vague though, since little effort is made to record and share such statistics, not only among top-level health professionals, but also with Romani (and other) women themselves, who are not encouraged to share their experiences with healthcare professionals or authorities.
This means both that they and other vulnerable groups are neglected and that authorities miss the chance to utilise this data to improve maternity care and help women make informed choices about childbirth and their expectations when they seek care. The resulting uncertainty and isolation can cause long-term physical and psychological harm.
The EU’s Framework for National Roma Integration Strategies 2020 includes healthcare as a crucial pillar of continent-wide and individual member state efforts to tackle discrimination against Roma, with the specific aim to “reduce the gap in health status between the Roma and the rest of the population”.
Yet in this year’s communication from the Commission on effective Roma integration measures, it is clear that this gap still exists. The executive calls specifically for better pre- and post-natal care, improved access to family planning, and crucially stresses that “qualified Roma should be involved in healthcare programmes targeting their communities”.
We are therefore calling on member states to convert this participation into reality, with regular oversight and support from the European Commission.
It is precisely by empowering Roma women to understand healthcare processes – and to actually have a say in these – that we can make sure they receive the best care possible.
This means raising awareness among these communities and encouraging mothers to discuss issues they may face. It also means educating mothers to navigate bewildering medical jargon and healthcare processes so they can explain to their communities how systems work, accompanying them to the hospital and helping build a safe environment of open discussion and support.
Through practical initiatives like these, we hope that a collective effort can be made to ensure that every mother receives quality maternal care, because if motherhood means nurturing the next generation, we are all responsible for making it safe.
It is my firm belief that this kind of participation and empowerment of mothers must grow, not just for Roma but also for all marginalised and vulnerable groups at risk of missing out on the care they deserve. It is only through working together with these individuals that we can take real action to fill maternal healthcare gaps and minimise unnecessary risks.
We have all the tools necessary to make every woman feel safe during pregnancy and childbirth – now we need to ensure that all women benefit from these, so that no community is left behind.