Karnataka, the South Indian state with the highest maternal mortality rate, could have averted 74 per cent of all deaths with timely referrals and interventions.
This disparity in the referral system and lack of staff at the taluk, district and primary health care centres has aggravated the problem.
Late referrals are not only causing maternal deaths, but have also increased the number of mothers and infants being put under intensive care. This increases the overall cost of the birthing process.
“Late referrals are putting pressure on tertiary care hospitals and causing maternal deaths that could have been averted,” said Dr Suresh S Kanakannavar, assistant professor, Department of Obstetrics and Gynaecology, Vanivilas Hospital.
Last November, the state-run maternal care unit at Vanivilas witnessed eight deaths in 10 days.
An external committee has been set up to investigate this. A nurse attached to the unit said most patients were admitted in a critical condition.
The tertiary care centre witnesses 40 to 50 deliveries a day, around 18 of which are caesarians (C-Section). Nearly 50 to 60 per cent of these are referred, 40 per cent of which are late referrals of patients suffering complications. Tertiary care maternal centres in the city receive patients from a radius of 250 km.
According to a study by St John’s Institute of Medical Research, published on October 6, 2015, there is a shortage of emergency neo-natal care centres (EmNC) in the state. The study was conducted in eight districts and 42 sub-districts (taluks).
“There is an average of 3.6 EmNC facilities available per 500,000 population for the entire region. Only three out of eight districts and 10 of 42 sub-districts in the region had recommended — greater than, or equal to five — EmNC facilities per 500,000,” the study says.
The situation is similar across the state, and poor mothers are at the receiving end, despite intervention by state and central governments to bring down maternal mortality and meet the millennium development goals.
Sharadamma, accompanying her pregnant daughter in-law from Hassan Medical College to Vanivilas, said, “Doctors attended to her after six hours of admission. She was screaming in pain, due to which the nurses kept abusing us.”
Her daughter-in-law is out of danger, but as the C-section was delayed and the umbilical cord was choking the baby, it is paralysed in one limb.
Dr Kanakannavar said, “On an average, we witness six to eight deaths a month in the age group of 21 to 26. All these are preventable but for the lack of primary healthcare. We also don’t have enough 108 ambulances with ventilators. And the poor can’t afford private healthcare .”
The St John’s study states that around 95 per cent of critical emergency neo-natal care facilities and 88 per cent of basic neo-natal care facilities are in the private sector.
“It is a shame that mothers are dying in our state in the 21st century. There is a need to improve emergency newborn care that is accessible to everyone,” Dr Kanakannavar said.