The zealous action of the Mayiladuthurai district health officers in Tamil Nadu, in lodging a police complaint against a family for having a home birth has come under severe criticism as there is no law for the same. The couple, Belicia and John Christopher of Erukkur village near Seerkazhi in the Mayiladuthurai delivered their second child at home on October 4, as they wanted to try a traditional method rather than an institutional delivery. Officials from the Health Department who failed to convince the couple to move to the hospital after the delivery, took the drastic decision of lodging a complaint with the police, three days after the birth, charging them with abuse and neglect of the infant.
Speaking to TNM, advocate and women’s rights activist, Sudha Ramalingam said that there was no law against home births. “This cannot be criminalised. Instead of prosecuting them, we should educate people and sensitise the issue and make them understand that modern scientific methods are important, and homes are not sterilised like hospitals to deliver babies. Arresting and prosecuting the couple are not the remedies to this issue," Sudha said.
While Union and state health departments have chosen awareness campaigns as a platform to convince couples to opt for institutional deliveries, the Health Department officers from Mayiladuthurai seem to have opted to lodge a police complaint after the couple’s repeated refusal to go to the hospital and further, refusal to get the newborn vaccinated.
“There was a time when the city corporations had Child Welfare Centres, where the midwives (maternity assistants) received calls and visited the houses and assisted the women to deliver babies. Home births were very prevalent till the recent past, and delivering at home was not new. But in the time of scientific advancements, should we opt for a home delivery is a million-dollar question. As far as vaccination is concerned, we should not only think about the health and betterment of the kid, but also about society. In the future, if the child contracts any communicable diseases, it will become a problem for everyone,” Sudha added.
According to John Christopher, he and his wife chose to have a home delivery for the birth of their second child. The police action that followed was something the couple least expected. “My wife had a Caesarean delivery during the birth of the first child, and she suffered a lot then. I assisted my wife with the delivery of the second child, and they are both healthy,” he said. Health officials were however upset that the couple had skipped all the check-ups prior to the delivery and refused to shift to the hospital post-delivery. The officials who arrived at the house on October 4, soon after the delivery of the child left after failing to convince the mother to go to the hospital. They came back in the night, on October 5, accompanied by the police, but left early morning, after the couple refused to budge on getting admitted to the hospital. Furthermore, the couple also refused to agree to get the newborn vaccinated. The couple fled their village to their relative’s place after police and health officials continued to visit them every day.
On October 6, Mayiladuthurai’s Block Medical Officer Dr Ramesh lodged a complaint against the couple and NGO Nalam’s secretary Sudhakar who was present in the house when health deparment officials tried to convince the couple to visit the hospital. Based on the complaint, the Anaikaranchathiram police booked this trio under various sections of the IPC including 294B (abuse), 317 (endangering the life of a newborn), and 353 (deterring a public servant from discharging his duty). The couple who were affected by the frequent intervention from the officials filed a petition to the State Human Rights Commission on October 10. Sudhakar said that the Health Department officials had also taken a signed statement from the couple stating that they would be solely responsible, if the mother and child were to face any health complications in the coming days.
Principal Secretary of the Health and Family Welfare Department, Dr P Senthilkumar defended the decision of his staff to file a police complaint, stating they had no better options to safeguard both mother and child. "We cannot put mother and child at risk when they fail to immunise their baby. There are the possibilities of re-emerging diseases that once disappeared,” he said. He also said that nearly 99.99% of deliveries in Tamil Nadu were institutionalised. “We have the infrastructure where village health nurses visit pregnant women and do check-ups after the concerned parents register themselves in Primary Health Care centres. Even in very rare cases of home births, we immediately shift the mothers and babies to the hospital for further medical assistance," he explained.
Farmers and Communist Parties' cadres protested against the actions taken by District Administration
Explaining the risks posed by home births to both mother and child, Dr R Premalatha, president of Obstetric and Gynaecological Society of Southern India (OGSSI), said there are certain circumstances to decide whether it is a low or high-risk pregnancy during pregnancy and in the labouring hours, risks posed to both mother and child during a home delivery. “At that point, we cannot rush the child bearer to the hospital as it poses a high risk to both child and mother. That is why we always insist that mothers should opt for medical health care services. There are no strong networks in India, where midwives can visit the homes and deliver the babies and shift to health care facilities for emergency operative vaginal delivery or for management of post-delivery complications like bleeding and shock,” she explained.
“Morbidity risks, hygiene of the place, infections, and the situations where vacuum and forceps are used to deliver babies should be in consideration before going for natural childbirth at home. We should educate the people about the need for healthcare professional supervision during pregnancy and delivery and also about the layer of complexity that may occur during the delivery,” Dr Premalatha said.
Meanwhile, the Communist Party of India (Marxist) (CPI(M)) and Communist Party of India (CPI) staged a protest against this action and demanded the police officials withdraw the cases booked against them. More than 150 party cadres from CPI(M) gathered in front of the Revenue Department Office in Mayiladuthurai and demanded the withdrawal of cases against the trio. “Where was the need for police to visit their house at midnight? Many couples in Kollidam, Kuthalam and Seerkazhi prefer home births,” said Mayiladuthurai CPI(M) district secretary, P Sreenivasan. The CPI staged a protest regarding the same issue on October 20.
There have been instances in the past where fatal complications have risen from home births. On December 18, 2021, Lokanathan and Gomathi tried to deliver their baby by watching YouTube tutorials. After a long struggle, Gomathi delivered a stillborn and her condition started to deteriorate as she bled profusely. Later, she was admitted to Vellore Medical College.
In 2018, 28-year-old-Krithiga died on July 22, after her husband Karthikeyan and two other friends attempted to perform a home birth at the friends’ house in Tirupur. The group allegedly prepared for the delivery by watching YouTube videos. Police arrested Karthikeyan and his friends and booked them under section 304A (causing death by negligence). The complaint filed by Krithiga’s father with the police said that after giving birth to a baby, her health declined and her husband took her to the hospital. On reaching the hospital, the doctors declared her dead on arrival and handed over the body without a death certificate or an autopsy report.