FACED with an unprecedented spike in maternity-related deaths of late, the Ministry of Public Health has decided to tackle the problem head-on by ramping up its public-awareness campaign. According to reports, post-delivery neglect and the lackadaisical attitude of healthcare workers at various public health institutions have resulted in nine deaths within the maternal and child-health fraternity of the Ministry of Public Health.
Minister in the Ministry of Public Health Dr Karen Cummings also told the Guyana Chronicle yesterday that reports reaching her ministry are that post-partum haemorrhage is a common cause of maternal deaths, as is the improper management of patients at some health facilities.
Dr Cummings, who was at the time attending an emergency meeting with regional health supervisors and other healthcare workers at the Cara Lodge here in the city, said the ministry is in the process of developing a three-pronged approach to address the problem, with the help of the media and the public at large.
She said that while measures are being put in place to ensure young doctors are properly monitored, the improvement in delivery of service and a public education media campaign to address specifically maternal health is in the making, whereby pregnant mothers are now being asked to attend maternal health clinics as soon as they discover they are pregnant.
And in light of the rising incidence of maternal deaths, health workers were summoned to an emergency meeting aimed at apprising “the regional supervisors of the current maternal mortality situation, identifying areas of weakness in the system that are contributory to the increase in maternal deaths, and reiterating the pillars of safe motherhood and standards of care for pregnant women.”
In a review of maternal deaths for 2015, Dr. Shivon Lewis explained, with the aid of an audio-visual presentation, “Why the system failed” women who were still in maternal care, resulting in nine maternal deaths which could have possibly been prevented.
She pointed out that the refusal of health workers to follow protocol resulted in the death of a 27-year-old mother who had an uneventful delivery of her baby at a public hospital on July 9, but died a week after she was discharged.
As the doctor explained, the woman had complained to her husband of lower abdominal pains, but was reluctant to visit the health institution nearby, because she thought what she was experiencing was normal for a woman who had just given birth. Unfortunately, she collapsed and died in their bathroom.
The doctor said their findings in that case revealed that the hospital in question needed to be more health-friendly, in terms of making their patients comfortable. She said that had the staff been more welcoming, the discharged patient might have returned to seek medical attention.
She also revealed that instructions are given in a Ministry of Public Health manual to health workers to visit maternal patients within a week of discharge, but this patient received no visit. Had they visited, she said, health workers might have been alerted to her condition and acted accordingly.
In another case, she said because the ante-natal scan was poor, and doctors failed to observe early the patient’s blood pressure had elevated, complications developed which resulted in her death.
“It was not until the third reading that a doctor discovered that the patient had elevated blood pressure,” she said, and that the readings were “excessively high”. By that time, it was too late to save the poor woman.
In the case of the 29-year-old who joined maternal clinic at a local health facility, and even confessed that she was a cocaine user, Dr Lewis said the woman was kept a patient at that clinic when, in such instance, she should have been transferred to a special maternal clinic for high-risk pregnancies at the Georgetown Public Hospital Corporation (GPHC), but was attended to at that ante-natal clinic on at least seven occasions.
She said that on the patient’s last visit, she was already overdue with a gestational age of 41 weeks, but was given a further date to return to the institution instead of a referral to the GPHC. The doctor further pointed out that the patient had met the criteria for an urgent ultrasound.
The doctor said the patient admitted she was a cocaine user and seemed mentally unstable. Although healthcare providers are aware that they must make contact with family of such patients, no one followed procedure.
Until the woman’s pregnancy was 43 weeks old, she visited GPHC while experiencing severe shortness of breath. She died of adult lung distress and severe brain oedema.
Another woman, a 21-year-old, had just terminated a 15-week pregnancy but was diagnosed with jaundice several times during her pregnancy at the same hospital. Although the hospital was equipped with doctors, the patient was never referred to one. She said the woman was not managed well, and when she sought medical attention at the GPHC, the medication that possibly could have saved her life was ordered too late.

A 32-year-old died of severe haemorrhage because of a placenta percreta after completing a disseminated intravascular coagulation (DIC).
She was admitted for elective caesarian (LSCS) at a gestation age of 38 weeks. During this procedure she suffered massive blood loss and eventually died.
The final presentation was of a 37 year old who had tried for years to become pregnant. She was unaware that she was pregnant earlier this year, and visited a hospital complaining of severe lower abdominal pains and vomiting. She was admitted to the hospital and treated for the pains and vomiting, while she was experiencing a ruptured ectopic pregnancy.
“Nobody recognised she had a ruptured ectopic pregnancy, and there was no history-taking by any of the five doctors who had seen her.”
After the shift had changed and the other doctors began work, there was no proper documentation to indicate the state of the patient.
“She was seen by junior doctors who misdiagnosed and mismanaged her,” Dr. Lewis stated.

By Shauna Jemmott