Giving birth in Serbia: 'You leave your dignity at the door'

Published 31 July 2026 · health

A months-long DW investigation into childbirth in Serbia revealed a striking pattern in women's negative experiences, the widespread use of practices not universally recommended by

A months-long DW investigation into childbirth in Serbia revealed a striking pattern in women's negative experiences, the widespread use of practices not universally recommended by the WHO and a system under pressure. "People say that when you enter Betanija, you leave your dignity at the door. Is that normal?" one woman asked, recalling her experience at the maternity hospital in Novi Sad. "In my village, they take better care of cows than the doctors took care of me," said another. "I've never shown anyone my first photo with my baby because in that picture, I look half dead," said a third. These three women have never met. They gave birth in different Serbian cities, in different years and under the care of different doctors. Yet there is a striking similarity in what they told DW about their experience of giving birth in Serbia. Over the course of several months, DW spoke with over 20 women in Serbia whose testimonies reveal a similar pattern: inhumane treatment and the routine use of outdated procedures that often serve to compensate for the weaknesses of an overstretched healthcare system rather than respond to the needs of the mother and child. Birth on the system's terms In ideal circumstances, childbirth is a physiological process that follows its own rhythm. This is not, however, reflected in practices on many Serbian maternity wards. In ideal circumstances, childbirth follows its own rhythm. But in Serbia, according to Jasmina Mihnjak, 'women in large maternity wards are treated like they're on an assembly line' Image: Yui Mok/PA Wire/empics/picture alliance Upon admission, women are routinely subjected to the same sequence of procedures: shaving, enemas and a first dose of oxytocin, a hormone used to induce or accelerate labor but one that can significantly increase both pain and the frequency of contractions. The World Health Organization (WHO) only recommends these practices when there is a clear medical indication or when the woman herself requests them. "It was so intense and aggressive," recalled Stefani S. from Novi Sad, describing the effects of her first oxytocin stimulation. "I dilated very quickly, but the pushing contractions never started because they forced me open. Then one doctor after another came to examine me, and eventually one of them ruptured my waters.

He didn't say a word. He didn't warn me. He just shoved his hand inside me," she told DW. "They were forcing a labor that simply hadn't started," said Natasha S. from Ruma, who was also given oxytocin. When labor continued to progress slowly, doctors resorted to the Kristeller maneuver — the application of manual fundal pressure to the upper part of the abdomen to physically push the baby out. The method is considered controversial by many professional associations because of the risk of injury to both mother and child. "Afterwards, I had bruises under my breasts. She kept shouting, 'Push!' I was pushing blindly, blood vessels in my eyes burst from pushing the wrong way. Then I heard a doctor say: 'Bring me the vacuum extractor,'" Natasha told DW. For some mothers who spoke to DW, the joy of welcoming a child into the world was tinged with trauma Image: Cavan Images/IMAGO Natasha says that her baby developed a swelling on the head after the vacuum extraction. She says she spent the days that followed afraid that there would be more serious complications, including brain hemorrhage and cerebral palsy. Pressure to speed up labor The pressure in hospitals to speed up labor often results in another intervention that has become almost routine in Serbia: episiotomy, a surgical incision made in the perineum to facilitate the baby's delivery. Although the WHO does not recommend the "routine or liberal use of episiotomy" for women undergoing spontaneous vaginal birth, nearly every second woman in Serbia undergoes the procedure. Data collected by DW from maternity hospitals across the country shows that the episiotomy rate in some institutions exceeds 70%. Episiotomy wounds can make recovery and newborn care more difficult. Many women who spoke to DW said that the procedure was carried out without explanation, without consent and in some cases without anesthesia. For decades, episiotomies were routinely performed, especially on first-time mothers, because doctors believed they accelerated birth and prevented more severe tearing. Current medical guidelines no longer support such routine use, but old habits apparently die hard. 'Outdated medical assumptions' Biljana Stankovic, a psychologist who has spent years researching obstetric practices in Serbia, warns that some of these procedures are rooted not only in outdated medical assumptions but also in gender stereotypes.