A day after a baby’s head was separated from its body during childbirth at a public health centre (PHC) in Koovathur, Tamil Nadu, the state’s Health Department has issued orders for doctors to be present at all deliveries conducted in a PHC.

“This particular case occurred at an additional PHC, doctors there work from 9 am to 5 pm and there are staff nurses on call following that. The nurse who was handling the woman’s delivery has conducted several deliveries and is someone qualified to do so,” Dr VK Palani Deputy Director of Health Services (DDHS) said to TNM.

However, in view of the incident, all PHCs in the state have been ordered to ensure that a doctor is present during any deliveries which are conducted, he added.

“We have given strict orders to all the PHCs in the state, additional and otherwise, to ensure that doctors are called in even after hours to attend to deliveries. Earlier this was not a protocol, because the staff nurses are more than well equipped to handle these cases,” he said.

The case

On Wednesday morning, Bommi T, a native of Cuddalore, was taken to the additional PHC in Koovathur after she began experiencing labour pains. She had come to her maternal home for childbirth. When she was taken to the PHC, the nurse in charge who examined her noticed that there were no signs of life from the unborn baby. Upon further examination she suspected that  the child had died in the womb and began to take the necessary steps to deliver the baby. During this time, the head of the baby was delivered while the torso remained in the woman.

After this, Bommi was rushed to Chengalpattu Government Hospital where doctors took her up for an emergency surgery and removed the torso of the baby.

She was then admitted for treatment and support to the hospital. Dr Usha Sadasivam, dean of the hospital, confirmed to TNM that as of Thursday morning, Bommi’s condition is stable and there is no danger to her at present.

Allegations of medical negligence

While officials have stated that it appeared as though the child had been dead in the womb for around 48 hours, relatives of Bommi are alleging that it was negligence on the part of the hospital staff which led to such an incident. They stated that there were no doctors present at the hospital and claim that this is the reason that the child died.

However, an inquiry conducted by a team of officials from the health department, consisting of the state health secretary and the deputy director of health services, concluded otherwise.

“When the dean of the hospital examined the baby’s body, she noticed there was some peeling of the skin and a few other signs to indicate that the baby had died in the womb itself. This and other examination findings point to some decay having taken place, that may actually have caused the baby’s head to have separated from its body,” stated Dr Palani. He further added that Bommi had conceived the child hardly two months after a previous abortion, which he says is a risk factor.

Bommi, the wife of Thiyagarajan, a daily wage labour, was also underweight and anemic according to Dr Usha, which further complicated her condition. Doctors also noted that Bommi had not gained much weight during the pregnancy and that the child was underweight. All of these factors could have led to the intrauterine death (IUD), according to doctors.

A post mortem is currently underway at the Chengalpattu Government Hospital to determine what caused the baby to die.