HYDERABAD: A 32-year-old Hindu woman from the Bheel community suffered multiple traumas last week when she had to first go through a procedure at a hospital in Tharparkar district to deliver the torso of her dead breech baby girl and then she was brought to Hyderabad for another operation to remove the baby’s head from her abdomen.

The first operation took place at Chhachhro and the other at Hyderabad’s Liaquat University Hospital (LUH).

A breech birth is one in which the baby’s bottom or feet come out of the mother first.

The horrifying blunder prompted the Director General of Sindh Health Services, Dr Juman Bahoto, to order separate inquiries into the two cases.

Dr Zahid Mahmood will head a three-member committee to inquire into the mishandling of the case, especially the absence of a gynaecologist and female staffers at the rural health centre (RHC) in Chhachhro.

The woman is currently admitted in the gynaecology unit of LUH under the care of Prof Dr Raheel Sikandar of Liaquat University of Medical & Health Sciences, Jamshoro.

“The woman’s life has been saved,” Prof Sikandar told Dawn on Sunday. The doctor in the unit didn’t opt for normal procedure to retrieve the baby’s head as the mother’s uterus had been ruptured after the procedure at the Chhachhro hospital, Prof Sikandar added.

“The baby’s buttocks and legs were fully developed, but unfortunately it was a dead breech baby,” Prof Sikandar said.

“The foetus was not in a cephalic position. So the head got stuck after delivering the torso because the delivery was done by inexperienced hands,” a notification issued by the Sindh DG Health on Saturday said.

The inquiry was ordered by the provincial health secretary. The DG learnt that the mismanaged case was later referred to Civil Hospital Mithi and again to LUH Hyderabad, endangering the mother’s life. Through another order, the District Health Officer of Mithi was directed to conduct an inquiry and submit a report within 24 hours.

“There are instances in which patients report to hospital when they are in a serious condition,” the DG Health said. In reply to a question whether it was correct the baby’s head was severed at the hospital in Chhachhro, he said “the inquiry committee will look into the matter. Initial reports suggest it’s a case of twin babies”.

He said the woman first reported to a missionary hospital at Chhachhro, which operated upon her and then referred her to the Mithi district headquarters hospital. She was later shifted to LUH Hyderabad for another procedure.

Prolonged psychological trauma

The woman is a resident of a far-flung village in Chhachhro taluka of Tharparkar district. She went through prolonged psychological trauma for the delivery.

She was first taken to some nearby facility in Chhachhro. Some reports suggested she was admitted to the Rural Health Centre, Chhachhro.

The breech baby was delivered there, but its head got trapped in the womb and healthcare providers severed it from the body and shifted the mother to Mithi Civil Hospital for its retrieval.

But the woman’s ordeal didn’t end there. She was ultimately taken to Hyderabad. After putting up with back-to-back delivery pains first in Chhachhro and then in Mithi, she ended up in LUH’s gynaecology unit of Prof Raheel Sikandar.

Prof Sikandar said the baby’s head was entrapped inside and the ward doctor wanted to go for normal procedure, but since the woman had a ruptured uterus, she avoided doing it.

“We decided to open her abdomen surgically and take out the head,”

Prof Sikandar said, adding usually breech babies were delivered and they survive.

“Healthcare providers (in Chhachhro) might have tried to save the baby, but in vain. The baby’s head was entrapped. In such breech baby cases, deaths occur in one minute if they are not fully delivered,” Prof Sikandar said.

A ward doctor in LUH informed Dr Sikandar that the woman remained in labour pain. Doctors at the Chhachhro facility delivered the body and then tried to deliver the the baby’s head for half-an-hour but failed. Subsequently, decapitation was done there before she was sent to Mithi hospital.

LUH staff photographed woman

Although the woman’s life was saved, she still had to bear another trauma in LUH.

Lying on a stretcher, she was brought out of the operation theatre. Some members of the staff took her photos on mobile phone in the gynaecology ward and shared those pictures with different WhatsApp groups. Prof Sikandar regretted it was very unfortunate that a woman who had gone through trauma after trauma was photographed in a distressful condition without consent.

Published in Dawn, June 20th, 2022