CHO CLEARS UP ISSUES ON MATERNAL DEATH INCIDENCE

KORONADAL , August 19,2013- the City Health Office (CHO) releases official information  amidst media torrents of sensationalized news and commentaries coming out blaming the midwife, Ms. Luisa Viray of the City Health Office for the  death of the 16-year old girl sent to the city’s lying in clinic, August 7, for delivery but who died while on the way to the Provincial Hospital for referral.
OIC-City Health Officer Dr.Jean Genevieve Aturdido,in an interview, said that the City Government of Koronadal was saddened by the death, however, she was firm that due courses of action were duly observed and that  the city government  should not be blamed  for the said maternal death incidence.
Basing on the report rendered to her office, Dr. Aturdido recounted the incident, saying that Janet  Jacaban, a resident of Purok Sueno Brgy. Morales, together with her live-in partner, and the sister of her live-in partner came to the nearby healthcare facility at Barangay Morales to deliver her first baby.
After proper assessment, the midwife advised the patient to proceed to the hospital but the family refused instead they told the midwife that they would go home and would recourse to get the service of a traditional birth attendant locally known as “paltera”. Seeing the indication of the family’s unwillingness to carry Janet to the hospital, the barangay health worker of  barangay Morales accompanied them to the city lying-in center.Ms. Luisa Viray, the midwife on duty immediately conducted a thorough assessment on the condition of the patient at about 12AM of August 7. After evaluating the condition of the patient, the midwife referred them to the hospital but for the second time the family rejected the medical advice so the midwife counseled the patient and the family members present on the risk, but still they refused to heed the advice so the midwife resorted to let them sign a waiver. Janet signed the waiver, witnessed by the BHW of Brgy.Morales and her sister-in-law. At 9AM, Janet had active labor for about 4 hours. Using the pantograph, the midwife was able to monitor the progress of the labor and all came out normal until it reached 8 cm. At  1:45 PM  the bag of water ruptured and an oxygen was applied. At 1:55PM.  When the baby’s head became visible to the midwife, actual delivery started so the midwife started guiding the mother in pushing the baby out. But when the patient failed to push the baby out and has shown intense pain, immediately Viray decided to run the patient to the provincial hospital. Upon reaching the hospital, both the mother and the child were declared dead-on-arrival.
“Advise kodayonsa live-in partner kag nanay na i-refer dayon sa hospital, nagsiling dayon ang live-in partner nga wala gid sila kwarta. Maski wala kamu kwarta malakat kita sa hospital, nagpatawag ako tricycle. Gindala namon ang pasyente sa hospital , nakatakodang oxygen, upod and security  guard nganag-uyatsa oxygen tank”, Viray said.
Dr.Aturtido said that in spite the efforts of the city government through measures and programs to include reaching out those who are most at risk especially in the rural barangays and indigenous communities, raising public awareness on maternal health, intensive trainings of the city health workers and midwives, and strengthening of the local health facilities, pregnant women dying is still inevitable. She further said that all pregnancies are considered risk.
“Usually when a girl who is too young gets pregnant and has no reliable prenatal check-up. There is a significant risk of  maternal and infant mortality”, Dr. Aturdido further said “Early pregnancy puts girls at great risk for premature child-bearing, disability and death”, she added.
In the Maternal Mortality Review, Ms. Myllene Sellote, the data collector reported that during labor, Janet’s mother was at the bedside while the patient was attended to and she was able to witness the progress of the labor and the sudden deterioration of the condition especially upon the rupture of the bag of water. Further, she even saw the non-cooperation of the patient to push the baby out. It was because of this condition that prompted thepatient’s mother to decide on admission at the hospital.
In an interview, a witness testified that Janet died on their way to the hospital. It was stated on the death certificate that the main cause of death wascardiopulmonary arrest with unknown cause secondary to uterine pregnancy. Further, the family stated that they had no plans to file a case to anyone especially the attending midwife, Luz Viray.
Meanwhile, Aturdido further said that the risk of maternal death increases significantly when women refuse  to deliver at an appropriate health facility.
All barangay health workers has always stressed in their respective barangay education campaign the need for better reproductive health care at the local health center for the protection of  the health of the mother and the baby.  In the case of Janet, she incurred only 2 records of prenatal visits during her entire pregnancy. According to the family, Janet stayed at General Santos City but no records had been traced to prove her regular prenatal.
When asked if the midwife can refuse to accept the patient, Dr. Aturdido said that they have a standing order never to reject anyone who is in need of medical attention instead proper medical assessment and counseling shall be done. After proper evaluation, the patient can be referred to a higher level of care.
Dr.Aturdido reiterated the health goals of the city government prioritizing SAFE DELIVERY meaning no woman should die due to inadequate access to health services at the barangay and city level. Meanwhile, she calls for all sectors to work together to help address adolescent reproductive health issues and teen pregnancy because of their health and other relevant implications.

By: Carol Mariano

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