Many pregnant women in their advanced stages of labour travel to hospitals in unsafe modes of transport such as autorickshaws or cars, unaware of the potential dangers to both mother and child.
There have even been a few instances of pregnant women coming by bus to the Coimbatore Medical College Hospital (CMCH).
This, says M. Suthandra Devi, Professor and Head, Department of Obstetrics and Gynaecology, CMCH, is unsafe. “Travelling in a private vehicle during the advanced stage of labour could cause several complications. The jolts and vibrations of travel could cause rupture of membrane or umbilical cord prolapse. The delivery could even occur in the vehicle itself.”
Disturbances while travelling in crowded public transport vehicles could also cause fits in pregnant women with high blood pressure, which may be life-threatening.
At such times, travelling in a well-equipped ambulance will ensure that trained emergency medical technicians (EMTs) will attend to the woman, administer intravenous fluids or oxygen if required, and render other medical assistances.
Further, it will ensure that the woman is transported in a safe position and reach the hospital quickly. Safe travel for pregnant women in advanced stages of labour is vital to prevent perinatal mortality, maternal mortality and maternal morbidity, adds Dr. Suthandra Devi. A third of these are referrals and arrive at the hospital largely through ambulances. However, of the rest, many are out-patients who admit themselves directly.
Of the 88,000 emergencies handled by the GVK EMRI ‘108’ emergency ambulance services since its launch in Coimbatore on November 18, 2008, pregnancies alone constituted nearly 17,000, says GVK–EMRI ‘108’ ambulance services Regional Manager (Western Region) H. Mohan.
Of these, around 1,000 cases were of pregnant women directly taken from their houses to the hospitals. In the rest of the cases, the women were taken through inter-facility transfers from a primary or a secondary healthcare centre to a tertiary centre.
“Our EMTs are trained at Kasturba Gandhi Hospital for Women and Children, Chennai, in handling pregnancies. They have also given training at labour rooms. All ‘108’ ambulances are equipped with the delivery kits and the medication for pregnant women besides the instruments to monitor the foetal heart beat rate to ascertain its health.”
Further, the ambulance staff in rural areas follow up on the high risk pregnant women, some of whom may have suffered miscarriages earlier, and visit them before the expected date of delivery to inform them that they could utilise the ‘108’ ambulance free of cost to reach the hospital safely.
While awareness had increased a lot in rural areas, ambulance utilisation remained low in urban areas. Safe transport of pregnant women was vital to reduce Infant Mortality Rates, said Mr. Mohan.