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Chandigarh records highest number of maternal deaths in last 10 years

Death of a mother: 21 young mothers died during childbirth in Chandigarh in the last one year, which is the highest in a decade.

punjab Updated: May 24, 2018 11:21 IST
Tanbir Dhaliwal
Tanbir Dhaliwal
Hindustan Times, Chandigarh
Maternal mortality,Chandigarh maternal mortality,Maternal deaths
Pregnant women often have to share their bed with two others while waiting for delivery at government hospitals. (Hindustan Times)

On August 14, last year, a 28-year-old pregnant woman in one of villages of Chandigarh felt a shooting pain in her abdomen. Scared of being hospitalised, she kept it a secret for two days. Six days later, she died while delivering a baby boy named Vansh.

Ruchi Thakur is one of the 21 mothers who died in Chandigarh in 2017. Every year, 14 to 15 mothers in the age group of 20 to 30 succumb to delivery-related complications. Last year, this number shot up to 21, the highest ever maternal deaths recorded in the last ten years. All these mothers had something in common- they were young, poor, residents of peripheral areas of Chandigarh and most died in hospitals.

The spike in maternal deaths in a city like Chandigarh has put a question mark on the various mother-care schemes being run by the UT health department.

Married at 22 into a lower middle class family in Khuda Ali Sher, Ruchi delivered a baby girl after a year. Her daughter Kashvi was 5 when this postgraduate conceived again, but she could not survive the complications during her delivery. Nine months after her death, her two children are looked after by their step-mother Babita.

Her mother-in-law recounts how they rushed her to civil hospital, Sector 22, from where she was referred to GMSH-16, where she delivered a baby boy. “She was in acute pain for five days, but the doctors didn’t bother. Finally, they referred her to PGI where she died soon after reaching.”

In another case, a pregnant mother of three was made to shuttle from the Civil Hospital in Sector 45 to Government Multi Specialty Hospital (GMSH) in Sector 16 and then to the Postgraduate Institute of Medical Education and Research (PGIMER) before she returned home to deliver a stillborn. She died on the way to hospital after excessive bleeding.

When a team from the UT health department visited the family to inquire into the death, they learnt she had hidden the fact that this was her fourth pregnancy.

“She might have done so because usually hospital staff are rude to pregnant mothers who are undergoing a third or fourth delivery,” says Dr Manmeet Kaur, a professor from the School of Public Health.

A study by PGIMER has found that at 26%, post partum hemorrhage (heavy blood loss within the first 24 hours following childbirth) is the most common cause of death among mothers in Chandigarh.

Dr Manju Behl, programme officer, Reproductive Child Health, UT, says, “Out of 21, 12 were direct maternal deaths, and nine were indirect maternal deaths.” Indirect maternal deaths result from a previously existing disease or disease that developed during pregnancy, and which was not due to direct obstetric causes.

PGIMER’S REPORT ON MATERNAL DEATHS:

A PGIMER project on ‘Improving Monitorable Reproductive and Child Health Indicators in Chandigarh,’ which collected data from 2008 to 2015 from medical institutes, including PGIMER, Government Medical College and Hospital, Sector 32, GMSH, Community Health Centre, Sector 22 and cremation grounds, uncovered the following findings:

* Pregnant women in slums are more vulnerable. A total of 47% pregnant women who had died during these seven years were from slums, followed by rural and urban areas. Dr Behl attributed it to reluctance among families to get these women admitted to hospitals. “Once I got to know about a case, where the HB (haemoglobin) of a seven-month pregnant mother was only four (instead of a normal 10 or 12) and the family was not ready to send her to hospital. I had to take her (to hospital) in my own car against the wishes of her in-laws and on the way informed her parents,” she added.

*68% pregnant mothers who died were aged less than 30. Only one was more than 40 years old. * Then maximum deaths (47%) were reported at PGIMER, followed by home (15%). The trend of maternal deaths at home has declined, with none reported in the recent past, says Dr Behl.

*The maximum number of deaths was due to post partum hemorrhage (26%), complication during delivery (19%), eclampsia or convulsions following high blood pressure (6%), sepsis (12%), obstetric embolism or severe reaction to amniotic fluid entering the mother’s bloodstream often resulting in heart or lung collapse (12%), maternal distress during labour /obstructed labour (6%).

*The UT health department also points to hemorrhage, sepsis, and hypertensive disorders in pregnancy as the most common cause (28.57%) of maternal deaths in 2016-17.

*The delay: Of the twenty-one deaths in three years (2012-13 to 2014-15), 18 resulted from delay in providing medical care and 14 due to delay in decision making by the family.

First Published: May 24, 2018 11:19 IST