16 women die during C-section

A staggering 16 women died during C-section or caesarean section at various hospitals in the country between February and March, and that worries maternal health experts while the Directorate General of Health Services (DGHS) said this was unfortunate.

Eight women died in three hospitals in Chattogram. Those are International Medical College Hospital, City Corporation’s Memon Maternity Hospital and Chattogram Maa-O-Shishu Hospital. Three women died in Ibne Sina Hospital in Sylhet while five died in three hospitals in Cumilla and these are Popular Hospital, Mukti Hospital and Medi Care Hospital.

The obstetricians and gynaecologist organisation Obstetrical and Gynaecological Society of Bangladesh (OGSB) president professor Farhana Dewan told Prothom Alo on 29 March, “Expectant mothers came to the hospital for safe delivery, but we are worried over the series of deaths during C-section. The specific reasons for these deaths are still unclear. But we learned several common signs. It becomes vital to find out the actual reason and steps must be taken to stop such deaths.”

The health ministry has been raising awareness among people on childbirth at hospitals, clinics or health complexes for more than two decades. Since childbirth at home poses the risk of death due to a lack of adequate skilled health workers, a growing number of women are giving birth at hospitals or clinics. According to the latest data from the Bangladesh Bureau of Statistics, 33 per cent of children are still born at home. Maternal health experts said the recent death of women during C-sections may have an adverse effect on people coming to healthcare facilities.

The recent maternal deaths in Chattgram, Sylhet and Cumilla were discussed at the national meeting of the OGSB on 27 March. A senior maternal health specialist who was present at the meeting told Prothom Alo on condition of anonymity, “It cannot be accepted that a woman will die at the hospital while giving birth to a baby. Hospitals were supposed to be fully equipped, and this did not happen in a single hospital, it happened in several hospitals. It is necessary to investigate how the same incident happened at such a number of hospitals.”

A source of the physicians said an informal meeting was held on the same issue on the morning of 25 March with the participation of anesthesiologists, gynaecologists and surgeons. Another meeting was also at the office of the Chattogram’s civil surgeon. Both meetings emphasised investigating the causes of maternal deaths.

Chattogram civil surgeon office confirmed Prothom Alo that four women died during C-sections at the International Medical College Hospital, three at Chattogram Maa-O-Shishu Hospital and one woman died at City Corporation’s Memon Maternity Hospital and Mother and Child General Hospital. Two new mothers are undergoing treatment at a private hospital in the city following the complications that arose at the C-section.

Chattogram civil surgeon Mohammed Elias Chowdhury told Prothom Alo, “Questions arose on why patients are dying only after giving birth to a baby as other patients undergoing surgery face no complications. The kidney of most patients who had died failed beforehand.”

The conditions of four patients at the International Medical College Hospital became critical and they died after they were shifted to other hospitals for better treatment.

Certain Rima Akter died on 4 February, Popy Akter on 8 February, Rehena Akter on 18 March and Farzana Akter died on 19 March.

Rehena Akter from Faridar Para area of Baddarhat was admitted to the International Medical College Hospital with labour pain on 16 March. She gave birth to a girl in the afternoon of that day, but started suffering breathing problems in the evening and was at the hospital the whole night. As her condition deteriorated, she was shifted to the city’s National Hospital.

Rehena Akter’s husband Ilias Chowdhury told Prothom Alo, “When my wife was admitted to the National Hospital, her condition was very critical. They took a clearance on a white paper and admitted her to the intensive care unit (ICU). At that time, physicians informed us her kidney had failed she underwent dialysis, but her condition deteriorated and at one stage, she was kept on life support. She was pronounced dead at 2:30pm on 18 March. The International Medical College Hospital killed my patient.”

Sumaiya Tarin, 19, also gave birth to a baby through a C-section at the International Medical College Hospital. After that, her kidney failed. She was undergoing treatment at private Park View Hospital now. Prothom Alo spoke to her at the hospital on Thursday. She said she was at the ICU for a day and is now undergoing kidney dialysis three days a week.

Sumaiya Tarin’s husband Azim Uddin said they admitted her wife at the International Medical College Hospital on 15 March. The next day she gave birth to a baby through C-section, but her condition deteriorated on 17 March. Physicians at Parkview Hospital now said her kidney is not working.

Prothom Alo could not reach director Amir Hossain and deputy director Abdur Razzaque of the International Medical College Hospital over the telephone for comment.

The general secretary of the operation committee at Chattogram Maa-O-Shishu Hospital, Rezaul Karim told Prothom Alo, “Two to three incidents took place at our hospital. So, we examined the medicines applied to the patients to find out why it happened, and we initially found some problems. We, however, informed the civil surgeon about the matter.”

DGHS director (hospital and clinics) Moinul Ahsan told Prothom Alo on Thursday night an eight-member committee led by the principal of the Chittagong Medical College was formed to probe into the maternal deaths in Chattogram.

The issue of maternal death in Sylhet came to the fore at the OGSB meeting on Wednesday. Scourers at the OGSB, Sylhet chapter said three women died after C-sections in March.

Prothom Alo reached the public relations officer of the Ibn Sina Hospital over the mobile phone on Thursday morning. The officer promised the Prohom Alo to provide the name and contact details of the hospital director before hanging out the call and received no call throughout the day. The officer replied no SMS either.

Meanwhile, OGSB president professor Farhana Dewan said a maternal death was reported from Popular Hospital in Cumilla and two women have been transferred to two hospitals in the capital after their condition worsened following C-section.

Prothom Alo correspondent in Cumilla, however, said five have died following C-sections at three private hospitals. One each in Mukti Hospital and Medi Care Hospital, and the last maternal death was reported from Popular Hospital on 26 March.

DGHS director general Abul Bashar Mohammed Khurshid Alam told Prothom Alo, “These incidents are unfortunate. We initially learned that there were trained and experienced anesthesiologists, gynaecologists and surgeons at every hospital. Will they make such a number of mistakes? On the other hand, questions arose on the quality of the medicine used for the patients. We have talked to the Directorate General of Drug Administration to learn about the quality of used medicines and saline.”

Meanwhile, on Wednesday, the health ministry warned physicians of the usage of a certain medicine, which anesthesiologists mainly apply to the patients before the surgery. The DGHS director general told Prothom Alo they doubted the quality of that medicine. It has been learned after talking to several specialists and anesthesiologists of OGSB and officials of DGHS that patients’ urine stopped within several hours of C-section and that is being considered at general sign. The kidneys of some patients failed suddenly, and some patients faced difficulty in breathing, but almost all patients died at ICU facilities.

Public health expert Be-Nazir Ahmed told Prothom Alo, “C-section is a life-saving method. So, the death of the mother during C-section is very tragic and concerning. A national committee must be formed immediately to investigate the incidents and a national guideline must be formulated. All possible initiatives must be taken to save the lives of the mothers.”

This report appeared in the print and online editions of Prothom Alo and has been rewritten in English by Hasanul Banna