Amid the ongoing lockdown in Inda, non-institutional deliveries have been frequently reported. Dr. Ahmed sheds light on the need to prevent these by strengthening institutional measures and ensuring accessibility.
By Dr. Ahmed Raza
With the imposition of nationwide lockdown in India, there have been a number of incidences of hardships associated with the individual life and their survival, particularly for migrant workers, daily wagers and poor. Though, incidences of such hardship continually hit the national media with breaking headlines which stir the governments for introspection, improvement and quick actions.
Meanwhile, the agony of pregnant women and childbirth have been another hardship of nationwide lockdown which have been overlooked even after passing of more than one month as a number of incidences of delivering babies on road-side, outside the hospital or en-route are still continuing to rise.
Though, police and other emergencies care remain intact extending their full support by providing vehicles and ambulances to the pregnant women during their labour pain. But, no appropriate measure could be explored from such type of incidences except finding a space in news coverage.
Hence, more than one month of nationwide lockdown has been an eyewitness of such incidences where women have delivered babies at the roadside, police vehicles or en-route to hospitals. The incidences of giving births outside hospitals kept on rising as 24-hour emergency phone helpline for medical emergencies, provided by the government, has seen a massive spike in the number of daily calls ever since the lockdown began on 24 March. Unfortunately, institutional measures for preventing such incidents or sufferings of pregnant women during the ongoing lockdown could not be prioritized by any government.
Therefore, this article focuses on major risks on non-institutional deliveries during the ongoing lockdown and how individuals, police and NGO’s interventions evolved as a lending a hand to the pregnant women during their emergencies hours?
Non-institutional deliveries during lockdown and major risks
Hypothermia, hypoglycemia and infections etc would be the major risks for the newly born babies if delivering babies without health care facilities continue to rise due to lockdown, barricades, non-availabilities of public transport etc. The expected mothers always need immediate accessibility to the hospital during labour pain which must be on top priority for the government during this ongoing lockdown.
A number of incidences of delay in accessing hospitals, leading to delivering babies at the street, home or en-route are occurring throughout India. As per media reports published in several parts of India since the beginning of nationwide lockdown, 25-30 women all over India have delivered their babies at street or en-route to the hospital including in Delhi.
Frequent occurrences of such kind of sufferings of pregnant women put the entire society disappointed and disheartened. Therefore, ensuring institutional deliveries must be a prior responsibility of every government amid lockdown as there are already huge anxieties among the expected mothers due to the spread of COVID-19.
The expecting mothers and their family members are already going through unprecedented trauma on account of the spread of COVID-19, and delay inaccessibility to health care facilities during childbirth may jeopardize other psychological traumas and anxieties of labour pain.
The childbirths in an unhygienic environment would be more vulnerable with three health concerns; infections, lack of aseptic precautions while cutting umbilical cord and interventions cannot be taken if the baby does not cry at birth. On the one hand, the imposition of nationwide lockdown happened to be a matter of compulsion for the government to fight against COVID-19, on the other hand, safe and institutional deliveries have been marred by the travel restrictions resulting in the numbers of unfortunate incidences where pregnant mothers are compelled to walk, reached the hospital by motorcycle, delivered babies at street or police vehicles due to delay in ambulance facilities, non-availability of specializing in health care etc.
At the same time, the police and other health staffs deserve to be applauded as they always acted as an angel for pregnant mothers by taking them to hospitals immediately so as to ensure childbirth safe and secured.
Individual intervention did not turn up any institutional measure for pregnant women
Initiatives taken by many more politicians towards facilitating the pregnant women during their emergency situation amid nationwide lockdown have set a precedent of humanity and respect to the motherhood, but such kind of help could not be evolved as any policy measures for preventing such incidences.
Likewise, the sincerity of the police also surfaced in the news as a number of pregnant women could deliver babies following the timely travelling accessibility from the patrolling police. Despite these direct interventions of the politicians and other agencies towards the emergency hours of pregnant women during the ongoing lockdown, a uniform measure is still awaited from the government side, which may tempt question on silent-mode of government.
Though, passing an order by Delhi high court while disposing of a petition by charitable trust claiming denial of delivery/childbirth services to pregnant women, asking the centre and the Delhi government to ensure that pregnant women in Covid-19 hotspots face no barriers during the lockdown, amounts to be the first institutional measure for childbirth amid lockdown. And, there are also strict guidelines of the court for government to widen any mechanism to deal with emergencies and it must be circulated widely through media, social media and other modes so as to avail the facilities from all levels of the society.
CSOs lend a hand to pregnant women
The civil society organizations (CSO), NGOs and other non-profit organizations have also come forward as helping hand for pregnant women by introducing online helpline numbers, virtual consultation and mobile apps etc which remain engaged to deal with any emergencies during the ongoing lockdown.
Though, such initiatives themselves lack empirical validity at all India level as their coverage is restricted only to metropolitan cities namely Mumbai, Delhi etc. One of the non-profit organizations, namely ARMMAN which operates from Mumbai with 50 specialist doctors remain engaged to take around 250 calls of expected mothers from all over India during the ongoing lockdown, has proved itself an example of respecting humanity and the motherhood.
Now, it is very high time for all including governments to work together and collaborate with NGOs and CSOs to fight against Covid-19 provided that pregnant women face no hardship during their emergency hour.
To conclude it may be urged that India, which registers 51 births each minute, has already been experiencing a lot of hardship in institutional deliveries and travel restrictions due to nationwide lockdown may increase the non-institutional deliveries. Therefore, institutional measures and support for emergency hours during childbirths need to be brought immediately with the provisions of easy accessibility to downtrodden society as the majority of people belonging to rural population are unaware and ignorant of accessing online support or other emergency facilities available to them during the lockdown.
Concrete planning with wide publicities all over India to deal with emergencies related to labour pain and childbirth must be on the priority of all governments before announcing a nationwide lockdown as the uncertainty of transport and admissions in hospitals has put immense stress on expected mothers.
(Dr. Ahmed Raza is Assistant Professor, Author and Political commentator at Department of Public Administration MANUU, Hyderabad)