DNA India
22 July 2010
By Jyoti Shelar
Mumbai, India

Anaemia is one of the main reasons for increasing maternal deaths in the city, according to findings of the newly constituted maternal death committee. The committee is investigating the causes of women dying during pregnancy and delivery, which most of the time goes unreported. The initial findings of the six–member committee state that anaemia tops the cause of death. It is followed closely by postpartum and antepartum hemorrhage, and infection, which also result in deaths during pregnancy.

The district level committee headed by Dr Guirish Ambe, executive health officer of the Brihanmumbai Municipal Corporation (BMC), was formed two months ago under the Reproductive and Child Health (RCH) programme which aims to bring down the maternal and neo–natal mortality rates. "Anaemia has topped the cause of deaths. We are training doctors for better investigations and the supply of iron supplements also been strengthened," said Dr Asha Advani, special officer, family welfare unit, BMC, who is also on the committee.

The committee has sent across circulars in order to get all the death reports within 24 hours. "Many private set–ups do not report the deaths as ‘maternal deaths’ to avoid further investigations or any scope of pointing out negligence on their part. Thus, most of these cases get recorded as natural deaths," added Advani.

According to her, the first aim is to improve the reporting of the deaths from private medical set ups.

In 2009, Mumbai reported 149 maternal deaths, out of which about 50 women who died in city hospitals were transferred from rural areas. This year till July 20, the city reported 75 deaths, out of which 31 women were transferred from outside Mumbai. Experts, however, feel that these figures are only the tip of an iceberg.

"There is a possibility that there many more such cases in rural parts and on outskirts of the city," said Dr Rekha Davar, head, obstetrics and gynaecology, JJ Hospital.

According to Davar, who is also a part of the committee, most of these patients are brought to a tertiary care hospital in a serious condition. "The committee will essentially look into all these deaths and find out what went wrong and at which level," added Davar.

Also, in the detailed death audit, committee members will list all loopholes that led to the deaths, and will form guidelines for medical institutions in order to avoid such cases. "It may be that a particular unit did not have a doctor in place, or did not have the required equipments, or medicines, which worsened the condition of the patient. We will record all such details and work towards improvement," said Davar.

Experts have also come across many cases of pregnant women dying of burn injuries or accidents, which are included in the list of maternal deaths. "Such deaths are due to the husband or his relatives assaulting the woman during pregnancy for not doing daily chores, dowry, etc. We are making provisions to ensure that these deaths are not reported as maternal deaths," said Advani.