Rattled by the rise in the number of maternal mortality rate (MMR) in Bengal, the state health department advises government hospitals to promote normal delivery and rationalise caesarean cases.

NS Nigam, principal secretary in-charge of health department, issued an advisory on 12 May directing principals and directors of all state-run medical colleges and chief medical officers of health (CMOHs) across the city and districts to promote normal births.

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“Improving maternal health and preventing maternal mortality is an important aspect for the Government of West Bengal. Though considerable and considered investments have been made for improvement of maternal health the recent rise in maternal mortality ratio (SRS 2017-2019) is of great concern. In view of this the following advisory is issued for the facilities providing maternal healthcare services based on experts’ opinion, in depth data analysis, exhaustive field visits and several meetings at state and district level with various stakeholders,” Mr Nigam directed in the advisory.

MMR worsened in states like West Bengal, Haryana, Uttarakhand and Chhattishgarh at a time when Uttar Pradesh, Rajasthan, Bihar and Madhya Pradesh showed major improvement with a decline in their ratio by 30, 23, 19 and 10 points.

Bengal registered an alarming 10-point jump in MMR reaching 109 from 98 while Kerala with lowest ration in the country made a phenomenal improvement from 43 to 30. MMR is a key health indicator that shows the number of maternal deaths per 100,000 live births for a given period.

According to the advisory, the referral facilities will review their caesarean section rates and analyse the trends and causes of C-section versus normal delivery. This should be done as a team involving obstetricians, paediatricians, anaesthetists, nursing superintendents and other concerned staff along with facility-in-charge. Necessary action should be planned if caesarean delivery rates appear to be abnormally high.

Concerned doctors and other medical staff should counsel pregnant women at the obstetrics outdoor departments in respective referral hospital normal delivery, the advisory stated.

It has also advised the hospitals to improve quality of healthcare and strengthen monitoring of obstetric cases. All hospitals overburdened with patients should mandatorily have functional obstetric triage with necessary logistic supports like infrastructure facilities and adequate human resource strength to avoid any delay in management of critical delivery cases soon after the expecting mother is brought to the concerned hospital.

For all delivery cases, partograph must be maintained and violation of this procedure must be taken into account seriously. Labour and postpartum monitoring of mother and newborn should be strictly supervised by skilled and experienced nurses.