NIK Report Exposes Systematic Failures and Illegal Fees in Polish Maternity Wards

A new report from Poland’s Supreme Audit Office reveals widespread irregularities in perinatal care between 2022 and 2025, including illicit patient charges, severe doctor burnout, and chronic lack of access to pain relief.

Systemic irregularities in perinatal care

The latest NIK report highlights numerous irregularities in perinatal care, ranging from excessively long physician shifts and illegal charging practices to an over-reliance on cesarean sections and organizational failures. While the report acknowledges an overall improvement in the quality of care, it notes that unacceptable practices persist in many facilities.

Auditors inspected the Ministry of Health, 14 medical entities operating obstetrics-gynecology and neonatology wards, and nine entities running outpatient clinics. Irregularities were identified in every single facility audited between 2022 and 2025.

Lack of anesthesia and unauthorized costs

Access to anesthesia remains a critical issue. As the Patient Ombudsman noted in 2023, epidural anesthesia is effectively unavailable in some provinces, while in others, it is restricted only to major cities. The NIK report confirms that six of the audited hospitals offered no access to epidural anesthesia, and one facility only introduced it in 2024.

Furthermore, some hospitals illegally charged patients for services covered by the National Health Fund (NFZ), such as prenatal classes. Facilities contracted by the NFZ are required to provide these services free of charge to insured patients. In some instances, private midwifery services included care that should have been provided at no cost as part of standard medical contracts.

Staffing crisis and hospital closures

The audit revealed that in all 14 examined hospitals, doctors working under civil law contracts operated for continuous periods exceeding 24 hours, with some shifts reaching as long as 96 hours. The report warns that the number of births continues to decline, reaching a record low of 272,000 in 2023, while the median age of mothers has risen to 31.

Access to delivery wards has deteriorated significantly. Between 2022 and 2024, 26 obstetrics-gynecology wards were closed, with another 27 liquidated in 2025. As a result, 136 districts will lack such units as of 2026. NIK emphasizes that the safety of mothers and children must be the primary consideration in hospital network reorganizations.