As the country went
into an unplanned lockdown towards the end of March, the maternal health
services went from bad to worse. From not getting access to ambulances services
to not being admitted pregnant women suffered with various complications and
some even died. Below are a compilation of 8 maternal deaths from the districts
of Chhindwada, Sheopur, Datia, Rewa, Indore ,Shivpuri in Madhya Pradesh which
were reported in the news and collected from the field in April and May 2020.
Maternal Death during Covid 19 lockdown
1. Chhindwara, Madhya Pradesh - Newspaper PatrikaChhindwara dated 9.4.20
On 30th
March 26 year old Monica came to the District Hospital alongwith her husband as
she had
started having labour pain. She reached at 7 a.m. but was not given any
treatment till 12 noon. Due to repeated seizures and severe labor pain she
became unconscious. The nursing staff took her to the labour room and she
delivered a baby girl in the unconscious state. The doctor sensed the
complication and referred her to Nagpur but the department staff delayed the
formalities and she was discharged only after an hour which further worsened
her condition. The woman died on the third dayof her delivery in Nagpur.
The
doctor and the nurse of the District Hospital are attributing the death to high
blood pressure but the family is of the opinion that the delay in treatment was
the cause. The family has also revealed that the hospital staff behaved rudely
and demanded money post the delivery in the name of gift. The woman’s mother
could not refuse as she wanted her daughter’s treatment to go on smoothly
The
family has put a complaint on the CM helpline. The civil surgeon has assured of
enquiry and strict action.
When whole health system is
fighting to prevent and control the spread of Covid 19 pandemic, maternal
health and reproductive health services somewhere got compromised. But a
country like ours cannot afford even a small negligence as it will take us
many years back. We have come so far in reducing the maternal death rate and
health system needs to come up with a plan ensuring each childbirth to be safe
and healthy.
2. Sheopur,
Madhya Pradesh (MP)
Manav
Foundation is a member of the Maternal Health Rights Campaign (MHRC-MP) and of
NAMHHR. The organisation is working with the Saharia tribal community in the
Sheopur district of Madhya Pradesh since many years. This tribe has been
classified as the Particularly Vulnerable Tribal Group (PVTG) in Madhya
Pradesh. Organisation’s district coordinator who had gone to the District
Panchayat office for some work learnt about a case of maternal death that had
occurred at the district hospital a few days ago. This information had come
through the department’s call centre. He contacted the doctor at the district
hospital followed by the woman’s family to get more information about the case.
23
year old Parvati, resident of Kalarna village was in the 9th month
of her pregnancy. This was her 2nd pregnancy and she had come to her
parents’ house in Ochhapura village a few days prior to the lockdown. Her
pregnancy was registered in the month of November and she received her 1st
TT shot and had her ANC. Her weight at the time of ANC was 48 kg and Hb was
9gm. Parvati did not receive a second ANC nor a TT shot.
On 5th
April late in the night Parvati went into labour and her family members called
for the ambulance. They went straight to the District Hospital (DH) and had to
pay 400rs to the driver. They reached around 1:30 a.m. when the nurse put her
on saline. On 6th April from
morning till night no medical staff came for any checkup or to give medication.
Post-midnight Parvati started feeling breathless and died after some time.
Parvati’s mother ShyamBai said that no one paid any attention to my daughter
and she was not given any treatment.
The
medical staff at the district hospital said that the family was missing from
the ward from 5am to 3pm and therefore they were unable to check on Parvati.
However, ShyamBai said that this was not true as they had only stepped out for
half an hour to have food and no medical staff had come prior to that nor
later.
The organisation will submit a
memorandum to the CMHO and other department authorities highlighting the
negligence of the health officials and demanding a strategy to be made to
ensure safe childbirth in the area.
The negligence on the part of the health department is
condemnable. Is this because Parvati was a tribal woman and her life did not
matter? Or because the health department’s entire focus right now is on the management
of Covid cases? As a country committed
to SDG 5 to reduce the maternal death, can we afford such kind of negligence
which jeopardizes all efforts done so far in this direction?
There is a need to ensure the availability of
maternal health care and services while trying to fight a pandemic since
childbirth is natural and will keep on happening in its own due course. It is
the health department’s responsibility to make special provisions to ensure
safe childbirth even in the time of a pandemic so that no woman
or child has to suffer.
Compiled by: Manav
Foundation (Sheopur, Madhya Pradesh) and SEHER- A unit of CHSJ
3. Indore, Madhya Pradesh -Newspaper
NaiDuniaBundelkhand dated
13.4.20
On 10th
April Dipa reached the M.Y Hospital in Indore with her husband Suraj. Her
husband has reported that the doctor in the hospital did not even come close to
the patient and prescribed a few medicines without any checkup. Suraj took Dipa
to a nearby private hospital where they demanded Rs.25000/- to be deposited.
Suraj requested for sometime to arrange the money but by the time he came back
the private hospital refused to admit Dipa and asked them to go back to M.Y
Hospital. By the time the couple reached the hospital Dipa died. The postmortem
was also delayed by a day.
Suraj
now wants to file a complaint in the local police station against the negligent
hospital staff but he is being turned away from the police station as well.
It
is hard to understand the reason behind the apathetic behavior by the health
staff at the M.Y hospital. They should have immediately admitted Dipa and
started her treatment. What was the reason for such a discriminatory behavior
against her is beyond understanding. An
innocent life lost due to sheer negligence of the medical personnel presents a
very grim and worrisome picture of the health system.
Compiled by: SEHER- A unit of CHSJ
4. Datia, Madhya
Pradesh (MP) -Newspaper DainikBhaskarDatia dated 14.4.20
SwadeshGramotthanSamiti is a member
of the Maternal Health Rights Campaign (MHRC-MP) and
21 year old Varsha had a normal childbirth on April 12th at
about 4p.m she gave birth to a healthy baby but she died 6 hours later in the
District Hospital itself. Her mother in law who had accompanied her said that
the Nurse had not put stitches post the childbirth due to which there was a lot
of blood loss. When the mother in law asked the nurse to put the stitches she
was told that first the cleaning will happen and then the stitches will be put.
Varsha was not shifted to a bed even. To stop the blood flow the nurse roughly
inserted a thick cotton cloth and some cotton in the vagina which caused severe
pain to Varsha. She kept writhing in pain but the nurses paid no attention to
her. Her mother in law also said that Varsha was also slapped by the nurses
during labour and post-childbirth. When Varsha’s pain increased the mother in
law called the nurse but she was sent out of the room instead. Varsha continued
to bleed and eventually died after 6 hours. After her death the hospital staff
made her husband, Santosh, sign on some papers after which the doctor was
called.
Varsha had received both tetanus shots and as
per her ANC done in February her weight was 40kg and Hb 9.6gm. As per the
family Varsha had no problem in her pregnancy period.
Civil
surgeon’s opinion is that the death happened due to blood clotting and not
bleeding. He says that if it was because of the negligence of the doctor or the
nursing staff then Varsha would have died during or immediately after
childbirth. He thinks that most probably the death has been caused by shock
after 6 hours. Varsha’s mother in law said that none of the nursing staff came
for any checkup post-childbirth inspite of her repeated requests. It was only
after the family protested that the post mortem was postponed till the next
morning and was done in the presence of the police. The reason stated in the
post mortem was pulmonary collapse.
The family has filed a complaint with the
police against the negligence of the doctor and the nursing staff. The Civil
Surgeon has said that the CMHO will appoint a committee for the maternal death
review which will bring more clarity on the cause of death.
The organisation will
extend all possible support to the aggrieved family so that the police
complaint filed by them is appropriately dealt with. In addition, they will
submit a memorandum on behalf of the campaign demanding strict action against
the doctor and nursing staff accused of negligence and to devise strategy to
provide better health services.
It is the health
department’s responsibility to provide quality healthcare services to each
woman who comes for childbirth. The woman needs to be given complete care until
she feels completely fine post-childbirth. One major aspect of quality
healthcare services is the behavior of the health staff and the incident of
slapping Varsha during and post labour is extremely disgraceful and
condemnable.
It is our aim to provide
safe childbirth services to every woman and to make efforts to reduce maternal
mortality which will not be possible if such cases of negligence are not dealt
with.
Compilation:
SwadeshGramotthanSamiti (Datia, Madhya Pradesh) and Seher- a unit of CHSJ
5. Rewa, Madhya
Pradesh (MP)–NewspaperDainikJagranRewa dated
23.4.20
SrijanSevaSamiti
is a member of the Maternal Health Rights Campaign (MHRC-MP) and of
NAMHHR. The
organisation is working with the tribal communities in the Rewa district of
Madhya Pradesh since many years.On reading about the news of maternal death in the local newspaper the district
coordinator tried to contact the family members. However, since the couple was
the only ones who had migrated from another district for work and the husband
had gone back to his hometown there was no one to provide more information. The
ASHA was contacted but she did not have much information.
On the
evening of 23rd April, a pregnant woman was admitted to the Sanjay
Gandhi Medical Hospital as her labour pains had begun. She had a little
discomfort in breathing as well. The doctors started her treatment but her
condition did not improve and in sometime the baby died inside the womb itself.
The woman’s condition started deteriorating and her difficulty in breathing
increased. With suspicion of her suffering from Covid the doctors shifted her
to the isolation ward and sent her sample for testing. However, with no
improvement in her condition the woman died on the morning of 24th
April. She was found to be Covid negative as per her reports which came the
next day.
As per
the head of the pediatrics department the woman was suffering from severe
pneumonia and therefore as per the government guidelines she was shifted to the
isolation ward. Her death happened before the test reports came, but instead of
waiting for the report , department did her cremation considering her a corona
patient, depriving her family to observe her list rites.
This
death clearly shows negligence on part of the healthcare providers. Either it
was the incompetence of the doctors who could not ascertain the cause of the
woman’s deteriorating condition or the ill equipped facility which was not
prepared to handle an emergency situation. The fear of Covid has cost us
another neonatal and maternal life which may have been saved with better
responsiveness from the health department.
Compilation:
SrijanSevaSamiti (Rewa, Madhya Pradesh) and Seher- a unit of CHSJ
6. Shivpuri,
Madhya Pradesh (MP)- Newspaper
NaiDuniaShivpuri dated 4.5.20
20 year old Sonam’s husband is stuck in Delhi due to the
lockdown and therefore she decided to go to
The partner organisation of Maternal Health Rights Campaign
(MHRC) in Shivpuri district is trying to get in touch with Sonam’s family to
get more information about her death.
This case clearly shows that there is a need to constantly
keep in touch with the pregnant women especially those identified as high risk
and are in their third trimester. Here role of front line worker and family is
very important to understand as both of them are missing in this case. Also, one needs to educate the care givers of
the woman about the possible risks and how they need to be alert about the
woman’s health and to be better prepared. In case the women is alone then we
need to identify local support for her from the community so that she can be
taken to the hospital and can get medical assistance on time as required.
Compilation:
Maternal Health Rights Network (MHRC- Madhya Pradesh) and Seher- a unit of CHSJ
7. Morena, Madhya Pradesh (MP)- Newspaper DainikBhaskarMorena and Patrika dated 5.5.20
23 year old Mamta who was seven months pregnant was referred
from Ambah CHC toMorena DH as her condition was not good and she was bleeding.
She was admitted around 9 p.m. on 3rd May 2020 and the nursing staff
had put her on saline. The doctor on duty was not present in the hospital and
the nursing staff did not pay any attention to Mamta’s condition. She kept
suffering the entire night with continuous bleeding and died at 7a.m. in the
morning. The family members have alleged that Mamta was probably dead but still
the nursing staff hurriedly came and put her on saline and also gave an
injection. They were also making arrangements to refer her to Gwalior to avoid
but the ambulance driver refused and then a senior nurse came and informed the
family of Mamta’s death. Instead of sending the body for post mortem they again
took her to the ward. The family members and others from the community came and
protested outside the collector’s house demanding action. The local police
intervened and assured the family of appropriate action but to first let the
post- mortem to happen. This pacified the family a little bit and they returned
to the hospital.
A committee has been set up by the
Civil Surgeon to look into the matter and the report is expected to be produced
within a week.
Maternal Health Rights Campaign
(MHRC-MP) is actively working in this district and the partners went and met
the CMHO on 5th May 2020 to discuss the case. The CMHO said that
when Mamta arrived at the DH the doctoron duty immediately examined her. It was
found out that Mamta had not received any ANC, her Hb level was low and she
started having seizures due to high BP. It was a case of eclampsia and they
were unable to save her. The CMHO said that the committee will submit a report
based on the Post mortem report.
The MHRC group is trying to get in
touch with the family for further details and will follow up the case with the
CMHO once the enquiry report is out. The group is also advocating for
initiation of VHND services in their area in the lockdown period as the ante
natal checkups should not be delayed to avoid such adverse circumstances. The
group also routinely monitors the VHND to keep a check on the quality of care being
provided to the women and children.
Compilation:
Maternal Health Rights Network- Morena Unit (MHRC- Madhya Pradesh) and Seher- a
unit of CHSJ
8. Sheopur, Madhya
Pradesh (MP) - Newspaper
NaiduniaSheopur dated 14.4.20
and Patrika 15.4.20
Manav
Foundation is a member of the Maternal Health Rights Campaign (MHRC-MP) and of
NAMHHR. The organisation is working with the Saharia tribal community in the
Sheopur district of Madhya Pradesh since many years. This tribe has been
classified as the Particularly Vulnerable Tribal Group (PVTG) in Madhya
Pradesh.
On reading
about the news of maternal death in the local newspaper the district
coordinator tried to contact the family members. The woman’s husband could be
contacted but he could not share much information as he was not aware about the
status of the ANC checkups that his wife had received. Since they used to live
in Jaipur even the family members were unable to share details of her health
during pregnancy.
25 year old Sima
and her husband VimleshMeena used to work in Jaipur as daily wage labourers.
Since Sima’s 9th month had started and she was experiencing some
discomfort they had come to Sheopur for the childbirth. On 13th
April, Sima went to the district hospital with the ASHA and had a normal
childbirth. The ASHA left the hospital after the childbirth as things were
normal. However, 5 hours after the childbirth Sima died owing to complications.
The husband is unaware of what went inside the labour ward as he was not allowed
to enter. As per the doctors present Sima’s condition was not good and they
were making arrangements to refer her to Jaipur but she died till the
formalities could be completed. The neonate has been admitted in the NICU as
she weighs only 2.5kg.
A case has
been registered in the local police station and investigation is ongoing. The
partner organisation is keeping a close watch on cases of violation at the
health centres especially those of maternal deaths. Advocacy is being planned
around these cases to demand accountability from the health system for the
negligence of their staff which has led to this maternal death and others.
Apart from this the partner organisation is also closely monitoring the VHND
services which have recently begun in the district to ensure proper ANC
checkups and counseling are carried out.
Compiled by: Manav Foundation (Sheopur, Madhya
Pradesh) and SEHER- A unit of CHSJ
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