 All right. I would like to introduce Elizabeth Pajasca, who is a barrister in London and founder of Birthright. And Irmin Hayes Cline, who's a US lawyer and director of, I'm going to pronounce this, Bank or Suit, Center for Reproductive Rights in the Hague. So welcome, Elizabeth and Irmin. And I'm handing the mic over to you. Hello, everyone. And thank you very much for coming to me and her new session. I'm Elizabeth. You'll be able to distinguish this by our accents. And that rather unfortunate photo in the top left hand of your screens is me as of this. So we're going to present today on the implications of the European Court of Human Rights decision in the Tinovsky versus Hungary case, which came out of the European Court of Human Rights in December 2010. It was the first case the European Court has ever decided on that it had anything to do with child birthright. So it was pretty exciting for all of us who are interested in child birth and maternity care. But before we talk in depth about the decision, I wanted to give you an overview of what human rights in child birth mean. And this is what they mean to me and her mean. They mean different things to different people. But to Hermine and I, who are lawyers, this is how we understand child birthright. So the first thing to say, and it may seem pretty obvious to everyone in this room, is that pregnant women have the same rights as for other women. And that means the same rights, the same human rights as under international human rights treaties like dignity, autonomy, the right to remain in respect for treatment, privacy, and equality rights. And when we say that they have the same rights as everyone else, we make that point because often you hear that pregnant women have responsibilities to their fetus, and certainly in America, there's American midwives amongst us will know that American midwives are often, pregnant women in America are often subjected to responsibilities around drinking and pregnancy and drug taking and that sort of thing, which might suggest that somehow their rights are less than everyone else. But from our perspective, and certainly under international human rights law and under the European Convention on Human Rights, pregnant women are treated in the same way as other people. But what may happen in pregnancy, and this is definitely something that Hamine and I hear a lot about from women who come to us and request our advice as lawyers, is that women are experiencing real threats to their human rights, sometimes for the first time when they're pregnant and during birth. And those threats might commonly include threats to their decision-making. So they're being told that they can't make the choices that they would like to make around childbirth, and that might be anything from where to give birth, through to all those decisions you make about how to give birth, whether, you know, giving consent to things like diabetes, utomy, or assisted delivery, through to choices about pain relief and choices around having, for example, an elective caesarean. And then of course, there are the threats that women face to their dignity and to respectful treatment. And by that we mean that women can sometimes experience disrespectful care. That could be anything from shouting during labor, through to actual physical abuse, being shouted at through to physical abuse, like being slapped, and you certainly hear from some developing countries that women are physically abused during labor, whether it's a matter of routine, like through to being threatened or coerced with the interference of child protective services or social services, as we call it in the UK. So you're so much wonderful information. We have many different countries participating here and different languages. Can I suggest you maybe just slow down a little and get your mic just a little further away from your mouth? OK. OK, thank you. I don't want to anybody. I always talk to them, sorry. It's a lawyer's problem. I'll slow down a bit. And as you say, Delray, you have a lot of people here from different countries, so I should have said at the outset that Hamine and I are talking about human rights law under the European Convention on Human Rights, which is the Convention on Political to All European States, including some of those who are outside the European Union. But what we have to say is more widely applicable with, and there are some differences in the United States and in other countries around the world, but remember that in general, human rights are international by virtue of things like the international covenants on civil and political rights and social and climate rights and so forth. So although what we're saying is based in European human rights law, we do think that the principles are internationally applicable, and Hamine will say something about that towards the end in the presentation. Do I need to get close to the mic? Someone's saying in the comments box. You're doing great, isn't it? This is something. OK. So what we wanted to do first was give an overview of what human rights have to do with childbirth. And we're doing this in two ways. We want to talk about the consent rights in birth, which all of you midwives will understand, but because you have received education and training on this issue, how to obtain informed consent from a woman. And we want to understand that as a right to non-interference. That means that women have a right to refuse treatment. And that's a right that they have, whether they're pregnant or otherwise. And that's a right that all human beings have. You have that right to decline intervention in your physical intervention in your private life. So any treatment, whether it's connected to pregnancy or otherwise, women have a right to say no to. And that's a sort of negative right. And it's manifested in the requirement to obtain informed consent, which is, of course, what midwives will be doing time and time again whenever they interact with a woman. And we're highlighting there two decisions that came out of the English Court of Appeal in the late 1990s. And some of the British midwives here in the room may be aware of those decisions. They were very important to English law, but they also set out general principles that will be applicable in any country that recognizes informed consent. And that's, as far as I'm aware, every legal system in the world has some version of consent. And so these decisions, the first one, which we've put up on that slide is remb, that was a decision about a woman who had a needle phobia. And so she didn't want to have a caesarean section. And her case went up to the English Court of Appeal. And the Court of Appeal said that women have the capacity to decide for any reason they like, pretty much rational or irrational, whether or not to have a medical intervention, even if that intervention ends in the death or a serious handicap of the child, or even in her own death. And that's a decision that women are entitled to make for themselves. And that then reflected in the following year in another decision. And this was a woman with preeclampsia who was forced, in fact, she did receive a caesarean section before the Court of Appeal was able to hand down its judgment. And she was forced to have a caesarean for preeclampsia. And the Court of Appeal was pretty horrified by that Court of Action. And it explained, repeating what it had said the year before in the UND, that women's rights are not abused or diminished merely because her decision to exercise it may appear morally impugnant. So in this case, the woman said that she absolutely did not want to have caesarean. And that she didn't care whether her baby lived or died. And she didn't care whether she lived or died. But that was her decision to make. So that's a really important way of understanding consent is a right to non-interference. It's a kind of negative right. On the flip side, we have what we call a positive right, which is choice, the right to make choices. And of course, if you are thinking about pregnancy and birth, it will very well could say, oh, I don't want to receive these interventions. But of course, what women really want is support. What they really want is to be able to make choices that they feel they can attain professional support for. And that they're going to be enabled to be autonomous women in their birth. And so that's why we call that a positive right. And those are, of course, in many ways, the most important choices for women, the most important rights for women are those positive ones. And the obvious one, particularly for countries like the UK, where choice of place of birth is such a big choice for women to make, the obvious choice is between home and hospital or home and birth center or hospital birth center. So it's not really a surprise, then, that finally a case got to the European Court of Human Rights about exactly that difference, exactly that choice between hospital and home. And that case, as we said, at the start of the presentation was Chinovsky and Hungary. And the situation in Hungary, and some of you I don't know if we've got any Hungarian midwives in the room at the moment, but the situation in Hungary was that home birth had until the mid-1990s, I think, actually been illegal. But after that point, it was no longer illegal. It was just unregulated. So the only legal, the only regulated, the only recognized place in which to be birthed was hospital. And the only recognized providers of 20 services were hospital providers. It wasn't a crime to give birth outside hospital, but it wasn't regulated. So it was in a kind of limbo in a vacuum. And of course, those health professionals, those midwives who did assist women to give birth outside hospital faced potential disciplinary sanctions. And that would mean either suspension or removal of some kind of condition on their license. So what happened in Hungary was that a committed group of midwives continued to provide home birth services throughout the sedentary era. And afterwards, one of those was Agnes Gereb, the celebrated obstetrician who retrained as a midwife. And she experienced real difficulties being able to attend women at home. She was being threatened with legal proceedings against her. And she is currently facing, as I'm sure all of you know, is currently facing criminal proceedings, not in relation to the out-of-hospital birth. The births she attended were outside hospital, but the criminal proceedings are not that home birth itself was criminal, but that when she had a poor outcome, she had committed clinical negligence on a scale that justified criminal sanctions. Of course, no doctors in Hungary when they had a poor outcome ever faced criminal proceedings. So you can certainly see that as a sort of indirect sanction on out-of-hospital at birth. But anyway, while before Agnes actually got in criminal trouble, one of her, she attended the birth of woman called Anna Kinowski, and Anna went on to get pregnant a second time and wanted Agnes to come in essentially again. But by that point, Agnes was getting in more trouble. And so she, Anna approached some lawyers and decided to challenge the failure of the Hungarian government to regulate home birth. And she challenged that before the European Court of Human Rights. And that led to the decision that we're going to talk about a bit more now. And I think I'll pass over to Hermine at this point because you've probably had enough of my voice. Hermine, do you want to start talking about the decision itself? Thank you for everything you've said so far, has been great. One thing I would add to what you have already, is just before I can go back to your slide about consent and where you focused on some cases out of England. And I'd like to just reiterate the point that the right to receive medical treatment is a pretty fundamental right in just about every constitution as a democracy, including outside of England, including outside of Europe. And when courts, in difference, oh, no, horrible, horrible party, you know, you're not the best. Let me see if I can roll on my mic. Mm-hmm, it's so terrible, horrible. I am using the mic. It's been a while. I'm using the headset. Can you believe it? I can't even hear my own audio. No, you can't hear your own audio. This is the rain. It's probably good enough. We can hear you. This is a lot of background noise. And sometimes that happens. And so that's OK. I'm in a silent room. So the background noise, this must be a low quality microphone. I guess what I would say, and I apologize for the bad sound. But what I say about consent is just that in any legal system that believes that people have rights at all, there's no more fundamental right than the right to make decisions about the body. And so opinions in different jurisdictions that talk about the right to receive treatment, how should in that language? So that they're talking about the fact that liberty rests on a first fundamental right to make decisions about the body. Because if you can't make decisions about the body, what do you really have? So this right to receive medical treatment and to make decisions about health care is extremely fundamental. And the European Court of Human Rights has also addressed it in the context of Jehovah's Witness group's right to receive blood. If I remember that, the rest of the elements are just the right to receive blood. Certainly involved with Jehovah's Witness. And they said, look, when somebody makes a decision up to receive health care, receive medical care, you might not find their decision reasonable. And that's what makes it a human right. Because it doesn't have to be reasonable. It can be personal. And it's the right to make personal decisions about the body. And from that grow a lot of our birthrights. Elizabeth, do you want to add to that point at all? That's one more point. So they're unplugged in? No, that's absolutely right. I just think for some of our American audience, they might wonder about those course-to-day cases that we hear about in the States. I think I was one in Florida a couple of weeks ago. I don't know if you're able to explain how it is that some American states women do seem to be able to be coerced into having that. Well, I think when they see that, that's why we're doing this work. Because Elizabeth started this conversation by describing how we have these rights to make decisions about our body and that pregnant women are people too. And so that if every citizen has the right to make decisions about their body, then pregnant women do too. And so that's our belief about what the law fundamentally is and what the law should be. But that doesn't mean that those rights are being recognized in practice around the world. So we believe that women have these rights and different legal systems have acknowledged these rights to a different extent. But the reason we're doing this work is because we share beliefs that no maternity care system is really adequately respecting these rights in process. And so cases of forced asarians are cases of women having their fundamental rights to make decisions about their body violated in their jurisdiction. And so we believe that more legal work needs to be done in those jurisdictions to get those rights practically recognized and protected by law. So to the extent, so when women are forced into asarians in the state of Florida, what we have there is a judge saying, well, the doctor says you need a caesarean and you're not allowed to engage your babies. So we're going to force you to have a caesarean and Elizabeth and I would agree with that law. And there are basically different ways that jurisdictions can address these opposing problems. But I think we'll get into that as we go on a little more. So we talk about turnout papers this time, because as Elizabeth said, it's the first time we've seen the European Court of Human Rights address childbirth. And because the way that it does so is so interesting and creates a good way to talk about problems in birth care. So this slide here, throughout turnout, we got this action to say, hey, don't I have the right to choose where I give birth and to whom I give birth and the court agreed. And it wrote all this language saying that Europeans have the right to private rights, the right to privacy, protected under Article VIII. And that includes the decision to make. The logic was actually really interesting, because they said just as a woman has the right to decide whether to become a parent, go also to she have the right to choose how she becomes a parent or the circumstances in which she brings that baby forth. And they held that that included the right to give birth with a midwife and the right to give birth at home instead of in the hospital. So the court has satisfied the circumstances of giving birth in contested weeks long, part of one's private life. That's a pretty exciting sentence. For those of us who believe that this is true, that women everywhere have a human right to choose the circumstances in which they give birth and that their right to make decisions about giving birth are part of their private life. Elizabeth, do you have anything to add to that? So I'll proceed. I'll proceed. No, I don't have anything to add. I mean, I share her music excitement about the recognition of that fundamental right about the way in which one gives birth. I mean, it seems pretty obvious to me that a human right choice, that that was the case, but it was great to see a court acknowledge that. And that's as far as I know, there hasn't been a court elsewhere in the world that's done that yet. So I was pretty pleased that it would be a king court human right. Right. And so they said, OK, women have these rights. And then they went on to address how the state can violate these rights and whether Hungary was in fact doing so. And they made two basic points about how the state can violate this human right in the context of this Hungary problem. And they said, one way that the state can violate this right is by treating home birth, it is by failing to regulate home birth and make clear that it's illegal. So if women are trying to choose home birth in a country or in a jurisdiction where they're not sure whether that's allowed, that that is undermined as a legitimate choice. And so the state should regulate home birth and treat it in a straightforward way as it treats hospital birth. And so that's the woman's ability to ask that home birth and whether it's legal. And so then they address the role of the midwife in this. Because Ann, if you're not to be the saying to the court, I want to be birthed with my beloved midwife, Agnes, who attended my first home birth. But the situation here is so sketchy and where all of us mothers are so concerned with legal vulnerability that Agnes is in or choosing to show up for us and attend us in our birth that I can't, my ability to exercise my choice is limited. And so the court says here, another way that the state can violate this human right is by having, is this the health professional, can't, doesn't, isn't sure whether she can attend a woman at home without fear of sanction. So legislation which arguably dissuades such professionals, that is, those professionals who are inclined to attend women at home, who might otherwise be willing from providing the replicate assistance, constitutes an experience with the exercise of that right and present the perspective model. And so then, and then the court is talking about this in the context of regulatory sanction because in the case of Hungary, they're observing that Agnes, that in Hungary, arguably, any health professional assisting a home birth runs the risk of conviction for a regulatory effect. And at least one such prosecution of a regulatory offense has taken place in recent years. So they said that the state should provide adequate legal protection to the right in the regulatory scheme. And this sentence is very interesting. And you could say that this sentence is the heart of this opinion or at least one of its important organs in the context of home birth, regardless of the matter of personal choice of the mother that implies that the mother is entitled to a legal and institutional environment that enables her choice. And in case you get too excited, except where other rights render necessary the restriction thereof. And so therefore the practical meaning of this decision in Europe and implemented in European countries is gonna turn on the balancing that that sentence requires. So let's talk more about that. So do women, therefore, have a right to give birth at home? That's the synopsis created in Europe, a right to give birth at home. When we think about, is there a right to home birth? It's important to start with the question, well, is there a legal obligation to give birth in the hospital? Because the right to home birth, yeah, it turns on that. So question one, do women have a legal obligation to go into the hospital and push their baby out or have their baby removed in the hospital? And the answer is or should be no, because everybody, including pregnant women, have the right to receive care. You know, when we see those for caesarian cases or when we see cases around the world in which women's right to make these decisions is being violated, because pregnant women and birthing women are in those cases being treated as different from everybody else. Because everybody else, not pregnant, has the right to make decisions about their body, including the right to not save another human being. I mean, if you want to, it's problematic, of course, extremely problematic, to a birth that a mother who receives a hospital treatment is endangering her baby. That is just not true, and it's not the reality of women making decisions in birth. But even if you were to go into that argument when somebody says, well, other people have the right to make decisions about their body, but not if you have another human being inside your body, because what about that person and their interests? And the fact is, when people have a right, when citizens have a right to receive treatment, that includes the fact that they cannot be forced to save the life of another human being. Even a human being that's outside their body and walking around, so that you can't be forced to give bone marrow to save your cousin, even if we know that if you do that, you'll save your cousin. That's still your choice. So, if there's a right to receive treatment and there should be, then you don't have an obligation to go into the hospital. And then the question is, can I ask you to create a positive rate to give birth at home in some sense? And Oliver, will you comment upon that in the context of positive choices under the European Convention and so on? Yeah, so the European Convention, traditionally, when it deals with questions about healthcare, says that women don't have positive rights to particular treatments, or people in general don't have positive rights. So, for example, in the UK, women have tried to force the UK government to provide a set in a breast cancer drug to treat their breast cancer, which is going to be the most efficient and effective drug for their particular symptoms. And the courts have looked at those cases on a number of occasions and said that you don't have a positive right to those particular forms of treatment. And so that's always been the assumption that in context of healthcare, it's very difficult to say that a person has an entitlement to a type of healthcare service. But what's different about home birth is, of course, that that is the expression of a fundamental asset of your autonomy as a woman, as a pregnant woman. And so you're not asking for a particular drug, and you're not, importantly, asking for a massive outlay of state resources because as we are all aware, home birth is actually the cheaper option. So what you're asking for is for someone to support you in the exercise of your autonomy. And I think that is the reason why, although it's not made explicit, but I think that's the reason why the European Court accepted that decisions around childbirth are different decisions from those around traditional forms of healthcare for particular conditions like cancer and so forth. So that's why there is a positive right to give birth at home and to receive the support of the midwife in doing so. The question is, the kind of million dollar question is, what are the limits? What are the limits on that, on that positive choice? Because as we will go on to show in the next slide, if I go forward, there are, of course, boundaries to that positive right. I mean, do you want to talk about this or do you want me to do it? Either or both. But I would like to add to what, before we move on from this right to home birth slide, I think that, I'm wondering that's an option practically speaking down for, is the right to access physiological childbirth. Especially in sort of healthcare systems where the medical birth that's being served at the local hospital, one thing that, if you study birth care, that of course you know, as everybody's listening, how it regards is that there's great variability in the protocols and the services that burden women are sort of put through in different hospital settings. And in some hospital settings, it's more possible to give birth without pharmaceuticals and without other kinds of interference with the physiological process than it is in others. In many places, and this is a violation of the right to informed consent, women are hooked up to an ID line and then chemicals are pumped down that ID line before the women are really told what's going on. So the right to give birth at home is really the right to access a birth care setting in which physiological birth is most likely to be possible. So I think it's worth bearing that in mind that what we're talking about it to you here is, okay, I'm in a healthcare system that supports my ability to give birth, to have a medical childbirth. And I can access that, but I also am interested in the right to access physiological childbirth with healthcare support. And what does that mean to access physiological childbirth with healthcare support, right? So you're not just asking to be left alone, although that is in fact part of what women are asking. They're asking to be able to give birth without being told that they have to do anything, to participate in coming to the hospital, getting a wheelchair, lie down for the ESM, et cetera. And yet, it also includes the right, as discussed in this case, to have a midwife with you if you want one and if she wants to attend you. Because we're not talking about midwives being forced to attend women, we're talking about the midwives who want to attend women, being able to do so without fear of sanction. And then we're also talking about backup, backup from the medical system. So in order for home birth to be a legitimate choice and a safe choice and a choice that's supported by the healthcare system, you have to be able to transfer to the hospital. Your midwife has to be able to communicate with the medical staff. And so again, that goes back to this interesting sentence, legal and institutional environment that enabled her choice. What would that look like? But again, it's not just the right to give birth with your dog and your stuff and all that stuff when we're talking about the right to home birth. But we're also really talking about will your healthcare system support and protect the access to physiological childbirth for those citizens that want to use it? And so then are there boundaries to the right to birth at home? Well, human rights of the citizens are obligatory on the state. The state has to recognize and protect them. And yet the state, of course, tribunals, human rights tribunals recognize that the state has other concerns other than in addition to protecting the human rights of the citizens and that the state has, and it gives states leeway to use their own balance in some extent, balancing their concerns against the human right. And so in the case of the European Court of Human Rights, they're saying to all these different kinds of European nations that they have to respect this right. And yet they give each of those European nations some latitude to do balancing acts about what are that nations legitimate aims for protecting the health and the world and rights and freedoms of others in that jurisdiction. Elizabeth, I'm going to pass the microphone about the silence, and that's in VHR's prudence in this case in particular. Yes, so we said earlier that we can obviously write the right to choose a certain census in which you become a parent. So you'll write to choose how to give birth. And that right falls under Article 8 of the European Convention. And that is a qualified right. That means it's a right which has a limit. And it can be limited by reference to legitimate aims, and that means that those chosen by the state, so the state determines what is or is not a legitimate aim subject to the court's scrutiny. And those include the protection and the rights and freedoms of others, and indeed the protection of health. So if, for example, you had a situation where a woman, the situation we talked about earlier, say for example, the woman with queer cancer who is told that she and her baby may die if she does not have one, that's the very end. How would Article 8 work in those circumstances? Well, it wouldn't give you the straightforward answer that the right to choose treatment would. So you would balance up your rights. If a woman with queer cancer said, do I want to birth at home? And her doctor said, I'm sorry, but we're not going to let you birth at home. We want you to come into the hospital. I don't think we should guarantee that the European Court on human rights would say at that point that that was a decision that would be protected under Article 8. Of course, she has the right to decline the treatment, the right to use the cesarean, but could she insist with a midwifery centre at home? That's a different question, and I think that would be harder to say. So that's a kind of technical legal answer, but it is important that we all understand that the right to home birth is not an absolute right. And I think that's important partly because when we're advocating the right to give birth at home, we explain that it is about that there are reasonable limits on that right, and we're not suggesting that the state provides home births, provides for home births in absolutely all circumstances. So that's about getting your understanding of how the law works and getting the rhetoric right. But at the moment, we don't know where those boundaries are. Of course, there have been many other cases since the Q&A, which was just in the 40th or 15th century. So at the moment, it's not clear where those boundaries lie. Moving on then to the million dollar question, which is the fetal rights issue. So when we say that the right to home birth is limited, the first question that people will ask is, well, does the fetus itself have rights that can be used against the mother? And this is a question that can be answered really only in each jurisdiction. So Ireland is obviously different from the UK, it's different from the United States, with different states within the United States and so forth. But in the UK, as the UK mitweist here we know, there isn't a separate legal right for the fetus. So its rights, its interests cannot be used to override women's decisions about whether or not to accept care and services. But as we know from what's happening in the United States and in Ireland, and that terrible abortion case in Ireland recently, quite a woman died of disabilities to the same abortion. We know that fetal rights are increasingly on the agenda. And I mean, I don't know if you want to say something about what's happening in the States and what's happening with that particular age-old obstacle that we quote on this slide there. The essential question regarding whether women have the right to choose the different senses in what they could do is, who's the person with the law is more interested in in the body of the pregnant woman? Is it the woman or is it the fetus? And those two drunk will be used that women have a right to choose for home birth. For example, are they going to look at this sentence to some, except for other rights when they're necessary to put them there of? And they already do, in fact, in online commentaries, and they say, oh, look at that clause. That means that there is no right to choose a certain sense in what she did first. And they will almost do that clause to nullify the entire traumatism attitude, because it's obvious that the other right, that the most significant other right is the right of the fetus. So when states that want to resist supporting the right to home birth and midwifery do so, they do so by saying that the woman does not have the right to put her baby at risk, and they argue with study like the law study at all that home birth puts the baby at risk, and that midwifes put the baby at risk sometimes it's argued. And so, so indeed, what we think is that the more a person, a jurisdiction, a legal system or a judge treats the fetus as separate from the woman, the less likely the woman's agency is to be defective in decision making around childbirth. And so in the United States, we have, you know, abortion has sort of a political significance and power here that it doesn't have in mainland Europe, although Ireland is not to be a significant exception for the European rule. But we have this whole personhood movement going on here in states that are passing or something to pass laws that will recognize fetuses as people with full rights. And once you do that, as the national advocates for pregnant women are up when it comes to now, you'll essentially turn the woman into a container. And because what's happening in these separations of mother and baby arguments is that the mother and baby are separated. We have a fetus with rights and a mother who may or may not have rights. But then the assumption was that the mother is not an adequate protector of those rights. And in fact, it's the professional who is just situated to protect those rights. And so there was this article late last year in the American Journal of Obstetrics and Gynecology in their ethical, in their ethics. It was their ethical statement and it was on home birth and they said, well, there's this thing, home birth happening, and what should we do about it? And they said that the rights of the woman should be balanced against the beneficence obligations of the professional and the doctor, and that the doctor has rights that flow directly towards the fetus and that when women try, for example, to give birth at home, that the doctor should strong arm them into giving birth at the hospital in the name of the baby, in the name of their responsibility to protect fetal and neonatal patients. And other editorials like this one cited in the Lancet have said the same thing. Women might have the right to choose to make choices about birth, but they do not have the right to put their baby at risk. And so then the question always becomes, well, who decides if the woman is putting her baby at risk and it's this decision that she's making? Who gets to make the decision about whether this is a risky choice that she's interested in making? Oh, look at this, what do you think? Okay, question. Well, should we move forward then? We're talking about whether women have a right to homeless and here there's another question of do homeless midwives have a right to process? And if so, how do we talk about that right? Are there any comments on this under EU law? Okay, do you hear this? Well, what can not be said is that homeless midwives, if homeless midwives are unregulated or if they're, if not sure for them whether they can process a discussion that the right of the burdened women is actually being violated. So it's important to be clear that cannot be about the right of the burdened women. It's not explicitly about professional rights of midwives. It's about the rights of women to be attended by whom they want and that that right is being violated when midwives cannot process without fear of tension. Yeah, now let's see. Yeah, I can see people want to ask questions and we've only got a few minutes left. So just skipping through these slides. There are some cases coming up in the European Court of Human Rights from these other countries. We hope that they're gonna define the right more clearly and we're confident that they're not gonna limit the decision into most of these. I think we're gonna say something about the value of commercial Europe, but I wonder whether perhaps we should, we should hear from people before we do that. What way is that? Is that the best way forward? That sounds good to me. Yeah. Do we take questions? There's one from Ruth. Ruth. So that's what I believe is something that we're gonna talk about in the UK and the UK lawyer. Does this, will this really need to change it and will it need to be incorporated into the UK law? Well, it is incorporated into the UK law because the human rights that means that all decisions of the European Court of Human Rights must be respected by UK public authorities and that includes hospitals and care providers. So it is part of a UK law and part of what birthrights my organisation is doing is lobbying to make sure that people understand that and understand what the implications of this must be judging the new. Well, there are other questions earlier on on that list that we should respond to. There were some questions there around risk and the fact that hospital births as the birthplace study showed are actually more risky for mother and baby, particularly for multi-parasites women. And I think that that raises a really interesting question about who is the arbiter of risk. And ultimately, only the woman can be the decider about what risk she's willing to bear for her and her baby because as soon as we put that risk analysis into the hands of the health professionals or into the hands of the judges or social services or chopchetta services or whatever, then we basically decimate the woman's decision making capacity. So discussion around risk always has to focus on what risks the woman is given or the information is able to make that decision and see what the women are not given information about risk that's genuine and honest information. So our information about hospital births being risky, I don't know any multi-parasites women in the UK who are being told they're really much riskier for the baby to be born and have children at home. And really they ought to be being told that. But to me, I'm not going to tell any superiors and midwives that they're between appointments that women should be told when they're multi-parasites or birth at home, I can't imagine. I can't imagine. So there are a couple of questions. If I can add to that point, when we think about, the turnoff school is just great opinion to talk in a really smart way about birth care and it raises the question, what would maternity care look like in any country? The women in that country, if they're right to choose the person's sense in which they're birthed was actually respected. And that prism for looking at maternity care can be really valuable. And then when we come up, but what's going to happen? Basically, turnoff school needs to be converted into a reality in any country in Europe. It's an opinion of the court, and some European nations are more closely in the court that's upholding the turnoff school than others. But in all cases, what would have to happen for women to have that right respected is for them to claim their rights under turnoff school. Because in Hungary, and that's happening in various ways in different nations, as Elizabeth just mentioned. But when this challenge occurs when women try to have this right implemented and there's resistance to that challenge, they're going to be called, well, you're not allowed to put the baby at risk and other things. And so then, I think what people are making arguments about the right to privacy and the right to the burden is to deal with some challenge obstetric, this claim of obstetric, that obstetricians are the best protectors of facing the mother and baby at this point, and that only they can be trusted to really make these decisions. And so thinking about America and how it would turn out to be right to be implemented in America. In 1976, the State of California had a case in which unlicensed middle-aged were being prosecuted, and the defense argued in that case that women have the right, under the right to privacy, which also exists in the United States, to choose the person's chances in which they give birth. That was 1976. And they argued under Roe versus Wade, again, as with Chernobyl, just as you have the right to choose whether to have a baby with the right to choose how. And in that case, in 1976, the court said that women, the California Supreme Court said that women do not have the right to choose the person's chances in which they give birth under the right to privacy. And they said, well, look, under Roe versus Wade, it has this sort of trimester distinction, and therefore they said, actually, the way we do Roe versus Wade is that at the point of fetal viability, the state's interest in the fetus supersedes the mother's right to privacy. Therefore, she does not have the right to choose the person's chances of birth. And I think that decision was limited, because a lot has happened since 1975. In 1975, the caverian rate was about 5%, and now it's 35%. So if there was a holding on that right to choose the person's chances of birth that essentially assumes that a woman leaving obstetric care and giving birth at home with a midwife was risking her baby and that the safe thing for her to do was to be in the hospital with doctors, I believe that that holding and that assumption could be revisited in light of changed person's chances. And that the caverian rate alone in just about every place is grounds for pulling the rug out from under the medical claim that only doctors can be trusted to have that final authority. And in fact, in any jurisdiction with a caverian rate over, shall we say, 15%, the old World Health Organization member out, could be argued that it's essential that the state recognizes that the woman has the right to make the decisions about, for example, whether she's going to have a caverian section, because what are we dealing with if we're in a place where doctors with 30, 40, 50% caverian rate have the authority to say whether a woman is going to have a caverian section, and the woman does not hold the authority to assume that. And that's extremely concerning. And that's an argument to be made in a lot of different places. Other than this, I want to talk about the dignity. Yeah, so I think there haven't been too many other questions. Do you guys, whether we have contact with obstetricians in the UK, that's certainly something that birth rights is doing with people of obstetricians? Actually, in the UK, at least, the resistance, you don't encounter the resistance that women in the United States are some of the issues. I just wanted to mention one conference that birth rights is putting on on October 16th. In London, at the Royal College of Physicians, they're going to have speakers from a very wide variety of backgrounds and experiences, including with life, but also academics and ways of talking about what dignity is in the right to mean and childbirth. And do you want to mention your conference in Belgium? I'll just flip to the other side. Here we go. Honey? I think we might. Sorry. I had to unhook my mic. So I'm involved with a organization called Human Rights and Childbirth, and we held a conference in The Hague in 2012 on the subject, and then another one in 2015, actually, last month, in which we looked at the clause of Trunovsky versus Hungary that says that the woman's right is violated if midwives can't report her without fear of sanction and what does that look like in the USA, for example. And so we're going to have another one-day conference. That was a joint conference with Midwifery today, this April in Eugene, Oregon, where they have their annual conference. And they're going to have their European conference in early November in Belgium. And so we are together going to have a one-day event on November 4, in which we look at cases in Europe that are implicating Trunovsky versus Hungary. Both the cases that Elizabeth mentioned earlier that are coming out of different countries, and we're going to try to gather these places. And the lawyers behind those cases and some cases of midwives across Europe that are facing sanctions in different ways for supporting that impossible birth. And Elizabeth and I should both be there. And we've been asked whether we're going to lie to three new conferences. And that supporting our intention is just very expensive. So if we can raise the funds to do that, then I hope that we will. But please do think about coming along. And the tickets will be back, I think. They will be back in a few weeks. And we'll be back in a few weeks. We'll be back in a few weeks. There we go. Great. So thanks, everyone, for listening. Thank you, Elizabeth, and Ray. Thank you for showing the advice for this opportunity.