When ambulances turn labour rooms

About 600 deliveries have taken place in ambulances

108 ambulance waiting in front of district head quarter hospital in Khammam.

The 108 call on October 14 to rush a 23-year-old pregnant woman from her home in Namavaram to Suryapet Area Hospital 21 km away, seemed like just another assignment for first responder Jataning Saidulu. But halfway through, the EMT had to don the obstetrician’s gown for his ‘patient’.

Over 1,300 women in the State this year have given birth assisted by GVK EMRI’s Emergency Medical Technicians (EMT). These deliveries did not happen in a hospital, where they were expected to occur. About 600 deliveries took place in the ambulance while the rest occurred at the women’s house due to advancement of labour. Emergency personnel say they are trained to handle most such cases.

“We often take along a female relative to comfort the expecting mother. But before we attempt to deliver the child, if the situation warrants it, an assessment of the labour has to be made within minutes,” said 30-year-old Saidulu.

GVK’s EMRI provides its EMTs a two-month training before deployment. The staff are trained within a hospital setting to observe births, while they learn to assist. However, the EMTs and the women they ferry are sometimes thrown into uncharted waters when the labouring mother is turned away from a primary health facility.

“Sometimes, a PHC or a smaller hospital may turn the woman away simply because she may not have medical reports or the hospital lacks facilities like anaesthesia specialists and blood banks. Complications like hypertension, eclampsia, anaemia or the need for a C-section, given the baby’s position, are other reasons to rush to a higher health centre,” an EMT from Mahabubnagar said, requesting anonymity.

Inter-Facility Transfers

This year, the EMRI has recorded cases of 52 women who were referred to a higher centre after being rushed in an ambulance to a primary health facility. Twenty of these cases were reported from Mahbubnagar alone. These cases are termed Inter-Facility Transfers (IFT) in medical parlance.

Before they could reach a secondary or tertiary hospital, these women gave birth with EMTs’ assistance, calling into question the competence of the primary hospitals. The EMTs said in case of a complicated delivery that they are forced to perform, they contact a physician at the call-centre in Hyderabad who instructs them while they work.

Principal Secretary for Health and Family Welfare, Rajeshwar Tiwari, said IFT was being lowered through tracking of high-risk pregnancies at village and mandal-level.

“We are now tracking high-risk pregnancies, which need to be handled at the secondary or higher centres. Dedicated transport services are also made available. The families are told beforehand where the delivery will take place. But in some cases, labour can set in before the expected date,” he said adding that the State’s efforts have contributed to lowering Telangana’s infant mortality rate by three points.