Snapshots From An Indian Maternity Ward Including the Death of An Infant Boy
I had finished examining the female ward of the Sarojini Nagar Community Health Centre in Lucknow. Just as I was leaving the ward, my eye caught the form of a woman on a bed at the far end of the room. I don't know what it was that made me turn back.
She was lying with a 'dupatta' (long stole) wrapped around her head that partly covered her face. An elderly woman was sitting by her side. "What did she get?" I asked. All the beds were occupied by women with their newborns. I tried to spot the little bundle by her side but could not. "Bachcha mar gaya (The child died)," the elderly woman said softly. The 'dupatta' covered head turned in my direction. I saw a pair of shy eyes looking at me. A small crowd had collected around the bed. I was flanked by the young woman duty doctor and an earnest looking man, the Medical Officer. A little stir in the crowd marked the entry of the Chief Medical Officer (CMO) of Lucknow, a middle-aged man whose raw silk shirt stood out in the world of uniforms.
"When did she come in?" I asked. There was silence. I asked for her register. Someone handed me a sheaf of papers. I read that she had come in the previous night at 10 pm. The record of the case stated 'Intra Uterine Death'. Time of death was recorded as 7.45 am. "What stage was the pregnancy?" I asked. Someone in the crowd muttered, "Six months."
I suddenly realised then that I was talking about a human being lying right before my eyes and it shamed me that we were talking above her head. "Are you her mother or mother-in-law?" I asked the older woman accompanying her. "Mother," she replied. "How many months?" I asked. "It was her ninth," was her reply. I then learnt from her that the girl was Reshma, 20 years of age, married to one Harish Yadav from the nearby village of Anaura.
I directed my next question to the duty doctor. She quickly said that she was not on duty at the time of her admission. "But now you are. Do you know this case?" I asked. There was silence. "When did you stop feeling the baby's movement?" I wanted to know from Reshma. The duty doctor supplemented my queries; she obviously had not found out on her own. "During the day there was no movement, only pain. So I came to the hospital at night," replied the young woman. I then asked her how many check-ups she had had, she replied that she had undergone three check-ups at this very facility and was told that everything was normal.
Then she added, "This was my second pregnancy. I have a girl at home. This was ... a boy." I touched the 'dupatta' covered head. I wanted to give some comfort. The crowd around me had grown. I then asked the CMO whether verbal autopsy was done there. He did not reply. I am sure he realised the import of my query but what I really wanted was to offer something concrete to this 20-year-old who had just lost her child.
"Reshma, we have just approved a 'yojana' (scheme) for new mothers; it will benefit girls like you, yes even if the child does not survive," I told the young woman. Even as I spoke I realised the futility of my words for someone who was wrapped in her grief. How long will it take before this scheme becomes mainstream in Primary Health Centres in Lucknow, the capital of Uttar Pradesh, one of India's poorest states, to say nothing of backward districts like Gonda, Shravasti or Ghazipur?
While glancing at Reshma's case sheet, my eye caught a line scribbled in the corner: 'Body of male child handed to parents at 7:45 am'. I felt my eyes stinging with tears. Hiding my emotions I turned to the doctors and staff. "Remember the name Indira Gandhi Matritva Sahyog Yojana. Make sure you implement it in the spirit in which it was conceived," I told them. Only recently in the Planning Commission we had approved the scheme and very carefully kept the provision of including mothers who had experienced stillbirths.
I had gone to Lucknow on August 18, to attend a Consultation organised by the Population Foundation of India (PFI) on Health, Population and Social Development in North Central States, Chhattisgarh, Madhya Pradesh, Uttarakhand and Uttar Pradesh. The PFI was founded by Mr J.R.D. Tata and Dr Bharat Ram in 1970 as industry's effort to look at issues of population stabilisation. This was the third and last Regional Consultation - the earlier ones had been held at Bhubaneswar and Pune. All day we had discussed what the states were doing in this regard and what industry and civil society were offering. During presentations and discussions, it was clear that population stabilisation depended crucially on our ability to ensure the survival of the newborn. For achieving that, one had to begin with girl child survival, her nutrition, education, age at marriage, first pregnancy, ante-natal and post-natal care and the spacing of the children.
But Reshma of Anaura village had no idea that these were the essential ingredients of motherhood.
Feroz Abbas Khan's film, 'Hauley Hauley' (Slowly, Slowly), produced by PFI, transposes these concepts on to the canvas of life. I saw it at the end of my day in Lucknow. If only the millions of young people in this country could see this fine delineation of harmony and happiness in families that comes from according primacy to women and the girl child within society.
But Reshma, who was never taught to value herself, will now return home unhappy, unwell, unwelcome. She gave birth to a dead male child. She somehow bears the blame for that. The only way she can exonerate herself is to once again go through the ordeal and ensure that a male heir is born alive.
And thus the cycle goes on. Our policies will have to strategically change this reality by taking within their ambit the many Reshmas in the country and their families.
(The writer is a Member of thePlanning Commission.)
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