The civic body is doing a phenomenal job on reducing maternal mortality. It has a quality assurance committee, which audits all maternal deaths in the city. Then it keeps making recommendations to reduce maternal mortality. Since the committee is appointed by the state government, its recommendations supersede evidence-based recommendations made by bodies like RCOG and ACOG, or even by local experts like faculty of tertiary level hospitals attached to medical colleges. The other day a meeting was called to educate all stakeholders on methods to reduce maternal mortality. Amongst the most important recommendations were the following.
- Use a stethoscope: a white haired member stated that gynecologists did not use stethoscopes, and if only they used one, maternal mortality would fall.
- Switch on the brain: same member also said that gynecologists switched off their brains when they reach home, and did not switch them on again when they went back to work. If thy switched the brains on again, the maternal mortality would fall.
- A special officer appointed exclusively for maternal and child health administration stated that if one did not perform a sterilization operation on a woman undergoing a cesarean section for complicated conditions like placenta percreta or any other serious disease, mothers would not die.
- They distributed printed guidelines arranged by an administrative boss, but without any signature of the same or any other authority. Amongst other things, the recipients were told not to induce labor in a patient with a previous cesarean section, as it caused uterine rupture. A cesarean section should be done instead. If any such woman required augmentation of labor, oxytocin should be used with extreme caution and with very close monitoring, as it ruptured uterus. Misoprostol was not to be used for cervical ripening prior to induction of labor.
