Leading the way: The maternal mortality rate in Tamil Nadu is the second lowest in India, just behind Kerala and Andhra Pradesh. — AP
Dr Teres Cuba looked at a mother who had just given birth to a baby, lying on the stretcher. A nurse yelled that she was losing blood quickly.
Realising this was a case of postpartum haemorrhage, Dr Cuba asked the nurse to administer oxytocin, massaged the patient’s uterus and checked for continued bleeding. The mother’s life was ultimately saved.
That the mother on the stretcher was a mannequin, and that this was a simulation exercise in a training programme to handle obstetrics emergencies, did not diminish Dr Cuba’s sense of achievement.
“I want to be as good as I can get at dealing with obstetric emergencies – practice makes perfect,” the 38-year-old said.
As a medical officer in a primary healthcare centre in Tamil Nadu, she is at the front line of the state’s drive to improve maternal health outcomes.
The training Dr Cuba and her colleagues took part in was organised by Singapore’s healthcare group SingHealth and non-profit Singapore International Foundation (SIF).
Mission-minded doctors like Dr Cuba have bolstered Tamil Nadu’s drive to eliminate maternal deaths during childbirth.
The state in India’s south has steadily shrunk maternal mortality in the past decade, now recording 35 deaths per 100,000 live births. This is the second-best performance in India after Kerala and Andhra Pradesh, both at 30 deaths per 100,000 live births.
Having more doctors, nurses, training courses, medical centres and equipment and ambulances, has made a difference, as have grassroots awareness campaigns.
In addition, socio-economic advantages like better women’s education, family support, sanitation and good roads have contributed to this track record, thanks to decades-old governance priorities of the southern states.
“There are more than 100 child deliveries in our centre every month, and high-risk situations happen regularly,” said Dr Cuba.
More than 3.7 million babies were born in the five southern states in 2024. After decades of reducing fertility rates, which are now the lowest in the country at around 1.5 to 1.6 children per woman, the states have been turning their attention to preventing maternal deaths.
Since 2002, Kerala has confidentially reviewed maternal deaths – including those at private hospitals – with a “no name, no blame” approach, to identify and address the factors like lack of training or delayed support that led to the fatalities.
Tamil Nadu has seen improvements by “properly implementing existing national protocols and augmenting it with state-level schemes”, said Dr J. Nirmalson, joint director of the state’s department of public health and preventive medicine (maternal and child health).
Out of around 903,000 deliveries in Tamil Nadu in 2024, almost 100% happened at hospitals, Dr Nirmalson said.
The state of 72 million people also conducts eagle-eyed household monitoring to encourage hospital births.
SingHealth and SIF have worked with the Tamil Nadu government for a decade to hold workshops to enhance maternal and child health services.
“Our special focus has been to train obstetricians, gynaecologists, nurses and midwives to be prepared for pregnancy emergencies and review the protocols across primary, secondary, and tertiary healthcare institutions,” said Corinna Chan, CEO of SIF. — The Straits Times/ANN
