Safe Motherhood Day: Tania couldn’t be saved, many more in such negligence

A number of physicians and nurses surrounded 20-year-old Tania’s bed at Dhaka Medical College Hospital. They were trying to relieve the pain of this seven-month-pregnant agonising mother.

But she could not be saved for the insufficiency of care compared to the crisis. She died at the gynaecology ward of the hospital on 23 May.

This correspondent was present there during the incident. The physician on duty, Naznin Sultana told Prothom Alo that Tania was admitted to the hospital at 4:00 pm and she died at around 5:00 pm. She died of Antepartum Haemorrhage (APH) or excessive bleeding during pregnancy.

The slight bump on Tania’s skeletal figure bore sign of another life inside of her. Along with the mother that child also passed away. Only her hair, which was fluttering in the wind blown by the electric fan, seemed alive then.

While standing beside that girl’s bed, many questions were peeping in the mind. Why she had to die exactly?

It was found that getting married still as a teenager, getting pregnant twice within less than two years, not getting medical care on time as well as the overall lack of care and negligence accounted for her death. According to physicians, however, Tania’s complications were preventable.

In Tania’s in-law’s words, Tania did not receive proper treatment as they had to change hospitals repeatedly on their way to Dhaka from Chandpur.

According to physicians, many families bring pregnant women to hospital at the eleventh hour and by then it becomes difficult to save the mother and the unborn child.

This correspondent bore witness to such sight as she went to Dhaka Medical College Hospital on 23 May to gather information regarding the National Safe Motherhood Day, observed on 28 May. The theme of the day was, ‘get medical care four times during pregnancy, and ensure safe motherhood’.

As per the data of Dhaka Medical College Hospital, a total of 3,295 babies were born in the gynaecological department within four months from January to April this year. As many as 36 mothers and 102 newborns of them died while the number of stillbirth was 522.

Bangladesh Sample Vital Statistics data from 2021 shows that 168 mothers die while giving birth to every 100,000 live children in the country.

Tania’s father-in-law Billal Hossain told Prothom Alo that their house is in west Kaunia of Chandpur’s Faridganj upazila. When Tania started bleeding excessively, they took her to a local private hospital at around 12 on the night of 22 May.

From there, they went to the government hospital (250-Bed General Hospital, Chandpur, but his wife said Upazila Health Complex) in town. The next day on 23 May, they had brought her to Dhaka Medical College Hospital as per the physicians’ advice.

When asked why the husband, Shohag Hossain, 23, wasn’t there, Tania's father-in-law said that his son used to work in a T-shirt factory but has been jobless for a year. He’s trying to go to Saudi Arabia and couldn’t come with them as he had to go to deposit the money.

In response to the query if Tania had been fed properly during pregnancy the father-in-law said, “What could we do, when she didn’t want to eat! Whatever we had in the house was given to her.”

He said that two years back, Shohag and Tania had an arranged marriage. Tania was a SSC examinee at the time of the wedding, but didn’t continue her studies anymore after getting married.

Tania’s mother-in-law Hasina Begum, also present at the hospital said that Tania gave birth to a stillborn child through surgery (caesarean section) last year.

She became pregnant for the second time, just one and a half month later. A couple of weeks ago, Tania was admitted to hospital once more for bleeding.

Obstetrical and Gynecological Society of Bangladesh (OGSB) president Ferdousi Begum said that the placenta attaches to the wall of the uterus.

If the placenta detaches from the uterus or the baby moves up pushing the placenta downwards inside the uterus for some reason, bleeding starts.

Calling maternal death such as Tania’s ‘Medical Injustice’ professor Ferdousi Begum remarked that it’s the responsibility of the family and the state to take care of a pregnant woman. In Tania's case, negligence began at home and followed in the hospital.

A second child has to be conceived at least two years after the first childbirth. Her body didn’t get ready for a second pregnancy. There was no time to waste in the treatment of haemorrhage.

Actions have to be taken right at the district hospitals. Blood transfusion and stopping the haemorrhage are the first and foremost steps. Sometimes only the mother is saved by operating quickly.

While it’s advised to seek medical care at least four times during pregnancy, this rate is quite low in the country.

The rate of seeking pregnancy-time medical care for four or more times has dropped to 41 per cent, a decrease of 5 per cent, said the Bangladesh Demographic and Health Survey (BDHS) report of 2022.

The rate of receiving quality medical care during pregnancy is only 21 per cent.

Programme manager at the directorate general of family planning Md Manjur Hossain said that the government is running extensive campaign involving public representatives and local dignitaries to create awareness about seeking medical care at least four times during pregnancy and giving birth in hospitals.

Seeking medical care at least four times helps identify potential complications and necessary measures can be taken, he added.