Labour pains

The pandemic has underlined an old truth about labour room violence. On June 6, Neelam Kumari Gautam died during labour after being turned away from eight hospitals. At the first hospital, the doctor reportedly told her: “I’ll slap you if you take off your mask.”

In Hyderabad, a 22-year-old developed post-partum lung infection and died when no hospital would admit her. And in Uttarakhand, a pregnant woman delivered twins at home after being refused admission by five hospitals. She and her babies died a few days later.

A May 2020 report by Human Rights in Childbirth, finds that pregnant women, especially those from marginalised communities, bear the additional load caused by strains on health systems. The World Health Organization warned recently that women are at “heightened risk” of dying at childbirth.

To meet the Millennium Development Goals on maternal mortality ratios (MMR), government schemes since 2005 have, through cash transfers, pushed for institutional birth, bringing MMR down from 370 per 100,000 births in 2,000 to 145 in 2017. The number remains unacceptably high, but “is a big achievement,” says Aparajita Gogoi, executive director, Centre for Catalysing Change, an NGO that works with women and girls. “Now we need to focus on quality.”

A 2015 study of 275 mothers in three Uttar Pradesh districts found that all had experienced at least one indicator of mistreatment — from being denied a birth companion to being yelled at.

Launched in 2017, the national Laqshya programme’s goal is respectful maternity care. It lists dos and don’ts for care-providers: No verbal or physical abuse, not leaving women unattended, providing privacy and taking consent before examinations and procedures. Reducing MMR is an incomplete goal unless there is an improvement in women’s experience of childbirth; an experience that does not put the priorities of health providers over birthing women, reducing them to passive participants.

If women are to put their faith in health centres, they must be assured of respectful and dignified treatment.

Published in Hindustan Times on June 26, 2020

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