Dear Colleagues,

Obstetrics, more accurately referred to in the 21st century as perinatology (maternal-fetal medicine, MFM), is a field of medicine at the forefront of media and politicians’ interest. Poland, in comparison to other EU states, is a safe country both for the mother and the child, with maternal mortality rate half the average in EU. Nonetheless, press and media releases abound on fatalities among mothers and neonates, delayed C-sections or lack thereof altogether (resulting in the said fatalities), even “murders” committed by Polish obstetricians. The media cast their sentence instantly, someone has to be found guilty, someone loses their job (Opole, Włocławek). The hospital pays out damages just in case, someone suffers a heart attack and passes away (Head of Ward in Włocławek), and in a course of several months or years the majority of those cases are dismissed by the justice system. All this has its consequences. The Ministry of Health creates regulations on providing prenatal care in healthy pregnancy and normal delivery, aimed at delivering a healthy neonate by a healthy mother. This means that even prior to conceiving , and certainly prior to delivery, it has already been established no complications will occur. Further regulations, far more substantive, deal with chosen pregnancy complications. As sensible as they are, they put constraints on medical decisions, forcing given solutions, medications and examinations, thus to some extent tying the attending specialist’s hands. Guidelines, recommendations, algorithms, postulated ways of treatment are indisputably useful and needed, yet they should not become a course of management imposed by some external law/ministry. Perhaps 60-70% of patients fit into some kind of fixed algorithm, yet the remaining ones require an individual, open-minded approach. Colleagues representing other fields of medicine may fail to comprehend my concern, but I beg them to try and imagine a regulation issued by the ministry regulating management of appendicitis, venous thromboembolism, or pneumonia. It is an odd thing how all these regulations are concerned with obstetrics alone, no doubt as a combined result of the notorious media campaigns and a lack of adequate response thereto on the part of Polish Gynaecological Society and the national consultant.