India’s Quest For Safe Childbirth For All Mothers
A mother goes through profound and life changing experiences during pregnancy, however, developing countries especially like India are far from the reality even in the 21st century. With the women in the country contributing to almost 50% of the population and being the cornerstone of each family, do not get the due support and attention when it comes to their health
Women’s health deserves a special mention about Maternal Mortality Ratio (MMR) – defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period. India currently stands a disappointing 130th spot when it comes to MMR, way behind the internationally accepted guidelines. This means that a mother dies every 20 minutes in India due to pregnancy and childbirth related issues. While the MMR rates have come down over the last decade, we as a country are working towards reaching the Sustainable Development Goals set by the United Nations. This goal of MMR score of 3.1 by 2030 will include a significant amount of resources, training and mind-set changes to achieve this target.2,3
Recent industry data suggests that 50-98% of maternal deaths are caused by direct obstetric causes like anaemia, ruptured uterus, hepatitis, infection and the most important reason is postpartum haemorrhage (PPH). The vast majority of these deaths (94%) occur in low-resource settings or impoverished localities, and most could have been prevented. Lack of adequate care during pregnancy and delivery due to lack of education or training is another leading cause. Of these causes, PPH results in the maximum cases of death in India. If not managed correctly, PPH could result in death of the mother in 2 hours. It remains the highest contributor to India’s rising MMR with very little innovation towards treatment and prevention. Apart from managing PPH in the right manner, the steps taken to reduce the MMR includes providing a safe environment for child birth, with trained staff to ensure safe delivery. Further research and training for the medical fraternity to ensure standardisation of care provided is also another important method to reduce MMR in the country.4
Over the years, research in the field of managing PPH by well-known gynaecologist, Dr. Mahesh Gupta, has resulted in the development of a unique and simple surgical technique to reduce the risk of Maternal Mortality. This technique is an easy and functional method called COMOC – MG (Compression of Myometrium, Occlusion of Uterine Artery). The life- saving procedure is performed using a special suture needle combination – the suture has a straight needle on one side, and a curved needle with a free-end on the other side. This special suture needle combination was developed by Healthium Group, a global leader in medical devices, based out of Bengaluru, India for the COMOC-MG procedure. It is also patented in India and US. Using this suture needle combination, the COMOC-MG technique can be easily taught to other gynaecologists to ensure that they can save as many lives as possible in case of PPH across the country.
Today when most of the deliveries are happening through C-sections, COMOC MG method will prove to be particularly significant in decreasing PPH and bringing down the MMR in the country. All that a surgeon needs is the suture needle combination and some ground training to gynaecologists, obstetricians, healthcare workers to familiarize themselves with this innovative technique. This too has been addressed in a unique manner using the latest technology. The suture material comes with a leaflet which has a QR code. The QR code can be scanned on a mobile phone, the surgeon can then watch the few, simple and easy steps involved in the technique and perform the life-saving procedure.
As next steps, apart from mass trainings with the support of technology for all the gynaecologists across the country, it’s imperative that the medical fraternity continue to pursue research and publication in the area of MMR to provide better care to the women during one of the most venerable time of their life. The collective effort of gynaecologists across the country, pooling in their learning of many years, will help develop many solutions that could result in ground breaking medical and surgical breakthroughs, saving millions of women across the world!
About the author -
A renowned high-risk obstetric consultant at Indus High Risk Pregnancy Hospital based out of Ahmedabad. Dr. Gupta is a coveted obstetrician and has developed an innovative technique ‘COMOC- MG’ to control PPH amongst women.
