Antenatal and delivery care at the Methodist Rural Health Care Centre in Mursan, India : A combined observational study of antenatal and delivery care, and a retrospective investigation of birth complications in 2007
This thesis is a combined observational study of antenatal- and delivery care provided by the Methodist Rural Public Health Program (MRPHP), and a retrospective study of delivery complications that occurred during the year of 2007 at MRPHP’s clinic in Mursan. The clinic is located in a rural area in the state of Uttar Pradesh in northern India.
In addition to a five weeks field work at the MRPHP-clinic in Mursan in the summer of 2008, we have gone trough the clinic’s delivery statistics and journal system to study the frequency and nature of delivery complications seen at the clinic in 2007. We have compared the antenatal care and the management of the complications at the clinic with the guidelines given by the WHO and existing literature. We found that the guidelines are followed to a great extend. Some guidelines are not yet implemented, mostly due to the lack of anaesthesiological facilities and facilities for blood transfusion and hysterectomy.
The main causes of maternal death worldwide are severe bleeding, infections, unsafe abortion, hypertensive disorders and obstructed labour. All of these conditions are seen at the Mursan clinic – some of them as acute conditions occurring during delivery at the clinic, and some of them after home-deliveries or home-abortions. Some of the conditions might have led to severe morbidity or death had they not been managed by skilled birth attendants at a well organized health institution.