November 20, 2019
Dr Santanu Sen speaks on the use of oxytocin induction to prevent maternal mortality
Thank you, respected Chairman Sir, and good morning one and all. Sir we live in a matriarchal society. We talk about women empowerment. We all believe that the importance of maternal lives is an important concern for all of us.
Sir recently we have seen that our Department of Health has given a directive in which they have said that a Gujarat Model is to be followed in all States of the country regarding the use of Oxytocin injection. Sir, what is Oxytocin? Oxytocin injection is used to prevent maternal mortality. Sir, after a mother gives birth to a child, Oxytocin is given to her to prevent postpartum hemorrhage. In our country this postpartum hemorrhage is the most important cause of maternal mortality. Even if there is a blood loss of at least 500 ml the mother is sure to die out of this postpartum hemorrhage.
In that particular model, it has been said that Oxytocin is to be injected a little later, not immediately though the WHO recommendation and the convention is the Oxytocin is to be injected immediately. The reason behind which has been so niche, more maternal blood should go to fetal blood which can prevent fetal anaemia and jaundice. That is fine, but we must not live in fantasy, Sir. To do this, you have to have trained sisters and train doctors everywhere. We have to give importance to the institutional delivery first. It is very unfortunate to say that you have asked the other States to follow Gujarat model where the institutional delivery is 87%, in comparison to our State of West Bengal where it is nearly 99%. You are asking to follow Gujrat Model where maternal mortality is increasing day by day, in comparison to our State of West Bengal where the maternal mortality is decreasing day by day.
My suggestion is, maternal mortality is a very important concern. If there is not adequate delivery, because you know in our country significant numbers of home deliveries are taking place till date. The untrained dais and the untrained sisters do not have any idea regarding uterine atony, which might lead to blood loss, which might lead to maternal mortality. Gujarat is even not above WHO. So, when WHO recommends immediate administration of Oxytocin to the mother immediately after the child birth, our Health Ministry is advising to administer Oxytocin a little later, which might lead to maternal mortality.
The government must reconsider the issue. Wherever there is adequate structure available, there we can wait and watch. But, where there is no adequate structure available, specially in the rural India, it must be reconsidered.