Serbia's Maternity Crisis: Investigation Reveals Widespread Mistreatment During Childbirth

A woman in Novi Sad once said something that stuck: when you walk into Betanija maternity hospital, you leave your dignity at the door. Another, from a village, remarked that the cows back home received better care than she did from doctors. A third could never bring herself to show anyone her first photograph with her newborn because in it, she looked half dead.

These three women never met. They gave birth in different cities, at different times, under different doctors. Yet when Deutsche Welle spent months investigating childbirth in Serbia, speaking with more than twenty women, a pattern emerged so consistent it could not be dismissed as coincidence: a system delivering not care but something closer to an ordeal, one built on procedures that contradict what modern medicine recommends and what mothers actually need.

When a woman arrives at a Serbian maternity ward, she enters a sequence that feels less like medicine and more like protocol. Shaving. Enemas. Oxytocin—a hormone that accelerates labor but also intensifies pain and contractions—administered routinely, without clear medical reason and often without asking. The World Health Organization recommends these interventions only when medically necessary or when the woman requests them. In Serbia, they are standard. Stefani S. from Novi Sad described her first dose of oxytocin as so intense and aggressive that her body dilated rapidly but her labor never truly began. Doctors came one after another to examine her. One ruptured her amniotic sac without warning, without a word, his hand forced inside her. "They were forcing a labor that simply hadn't started," said Natasha S. from Ruma, who experienced the same.

When labor stalled, doctors turned to the Kristeller maneuver—applying manual pressure to the upper abdomen to physically push the baby out. Professional associations worldwide consider it controversial because of injury risk to both mother and child. Natasha described a doctor shouting at her to push while blood vessels burst in her eyes from the force. A vacuum extractor was brought in. Her baby developed a swelling on its head. She spent days terrified of brain hemorrhage, of cerebral palsy, of complications that might never come but might.

The pressure to accelerate birth has made episiotomy—a surgical cut to the perineum—nearly routine. Nearly half of all Serbian women undergo the procedure. In some hospitals, the rate exceeds seventy percent. The World Health Organization does not recommend routine episiotomy for spontaneous vaginal birth. Current medical guidelines have moved away from it for decades. Yet in Serbia, the old practice persists. Women reported the incision was made without explanation, without consent, sometimes without anesthesia. Biljana Stankovic, a psychologist who has researched obstetric practices here, found something darker still: documentation of the so-called "husband stitch," an extra suture allegedly meant to restore the vagina to its "former size." One woman in Belgrade reported her doctor commenting, "Here's a little bow for the husband."

Beyond the physical interventions lay something equally damaging: the words. Women were called spoiled, weak, rude, disobedient, selfish. When Stefani asked a doctor to explain what was happening, thinking it might help her cope, they laughed at her. The man who delivered her baby barely spoke to her at all—he was annoyed at being woken for a night shift. A 2022 report on treatment in Serbian gynecological and obstetric institutions identified verbal abuse as one of the most common forms of mistreatment. Midwives threatened to slap women awake if they fainted. Humiliating and sexualized remarks were routine.

Why does a healthcare system do this? One answer lies in sheer volume and collapse. One third of all Serbian births happen in just four major hospitals in Belgrade and Novi Sad. Smaller facilities close. Women in large wards are processed like items on a line—everything must finish within twenty-four to forty-eight hours so the bed empties for the next patient. But not everyone accepts this explanation. Data shows two-thirds of Serbian maternity wards handle no more than three births per day. Under such circumstances, women could be given time for labor to unfold naturally. Instead, one anonymous gynecologist said, "habit" and "routine" prevail. "That's just how it's done."

The Serbian Health Ministry has produced new national guidelines acknowledging these problems and recommending different approaches. Dr. Olivera Kontic, one of the authors, said the testimonies were shocking but also catalyzing. Yet Serbia already has numerous guidelines and strategic documents that remain poorly implemented. There is no mechanism to monitor whether recommendations are actually being followed. Women are turning to legal action. Sanja Radivojevic of the Belgrade Centre for Human Rights describes these cases as clear violations of patient rights, abuse, infringements of constitutional protections. She recounts a case where a woman explicitly refused vacuum extraction, understood the risks, and was held down by four or five men while it was performed anyway. Not a single case of obstetric violence has reached final judgment in Serbia. Radivojevic fears that if one does, prosecutors will side with the system and let cases expire under statutes of limitation. Meanwhile, women leave maternity wards carrying more than a baby. For many, the fear and trauma outlast the birth itself.