Pregnant women, especially those about to give birth, are the worst hit by the ongoing lockdown as well as overwhelmed health care systems.
Last week, a 35-year-old woman from north-east Delhi’s Janta Mazdoor Colony started frantically calling the ASHA (accredited social health activist) when her labour pains started. When she couldn’t through to any worker, she went to the maternity clinic where her antenatal check-up had been done, but that was closed for the day when she got there.
She was told to go to Kasturba hospital, about 6km away. “She did not know how to get there and she was already in a lot of pain. So, she decided to call a midwife home. She gave birth to a baby boy, who died soon after,” said Sulekha Singh, a health activist, who helped the woman take her baby to Chacha Nehru Bal Chikitsalay afterwards.
Pregnant women, especially those about to give birth, are the worst hit by the ongoing lockdown as well as overwhelmed health care systems. With health care workers in several hospitals testing positive for the Covid-19, many women are no longer able to visit the hospitals that provided them antenatal care. While some are forced to travel to far-off hospitals, and brave the risk of a coronavirus infection, others have no option but to birth at home.
Three days ago, a woman from Jahangirpuri did not know where to go when she thought she was having labour pains because the hospital she used to go to – Babu Jagjivan Ram Memorial Hospital – was closed after 75 health care workers tested positive for Covid-19.
The police helped her reach Deep Chand Bandhu hospital where she was told there was still time for her to go into labour and was asked to go home. “Doctors from Deep Chand Bandhu hospital asked her to go to Ambedkar hospital for the delivery, which is closer to her place. But, we had not taken her there earlier as the gynaecology department was closed a day ago because someone had tested positive for Covid-19. The situation keeps changing daily and we have no idea where to take the women,” Singh said.
One of the city’s biggest maternity centre — Kasturba hospital near Jama Masjid – does not allow in patients from containment zones with fever, cough or sore throat.
“There are several containment areas around the hospital, but if anyone from these areas comes to us with even a mild fever or sore throat, we do not admit them because they are likely to have Covid-19. We refer them to Covid-19 hospitals,” a doctor from the hospital, on condition of anonymity, said.
This problem was highlighted when a 25-year-old woman from Nizamuddin Basti – which was declared a containment area after 2,300 Tablighi Jamaat members were evacuated from the Markaz complex — was turned away from Safdarjung. She was referred to Lok Nayak hospital, which denied her admission because she was not Covid-19 positive. She visited at least six hospitals and maternity clinics in the span of 48 hours before finally giving birth outside All India Institute of Medical Sciences.
This case was referred to in a public interest litigation by an organisation called SAMA in the Delhi high court. Responding to the plea, the Delhi high court had ordered, “The Union of India and the Government of National Capital Territory of Delhi shall work in tandem to make sure that no barriers are faced by pregnant ladies and their family members residing in hot spots during the lockdown.”
The busiest gynaecology department in Delhi, at Safdarjung hospital, which sees about 110 deliveries a day, is now creating a separate space for Covid-19 positive deliveries in the super specialty block where it houses other people with Covid-19.
“For now, our labour rooms have been divided into non-Covid and suspected Covid. But, yes, women have been facing problems since the lockdown. Many smaller nursing homes and maternity hospitals are not functioning now. Also, earlier, the bigger hospitals used to accommodate more than one patient on each bed. That is not possible now, because we have to follow social distancing norms,” a doctor from Safdarjung hospital’s gynaecology department said.
That is the reason why doctors at Lal Bahadur Shastri hospital in Khichripur say that there has been a surge in the number of maternity cases at the hospital ever since the lockdown, especially in the last two weeks.
“We usually used to get 20-odd maternity cases daily. But now we are getting about 30-40 cases daily. We have got some maternity cases that were earlier undergoing routine checkups at big hospitals,” a senior doctor, on condition of anonymity, said.
However, all this flies in the face of Delhi government orders. It has directed all clinics, hospitals and nursing homes, including private ones, to remain open for the treatment of non-Covid patients. The hospitals have been threatened with cancellation of licence if not complying with the order.
Hospitals have been asked not to refuse treatment to anyone and ensure pregnancy deliveries, haemodialysis, blood transfusion, chemotherapy, treatment of chronic as well as communicable diseases, such as TB and leprosy.