1. DEADLY DELAYS Dr . Sujnanendra Mishra MD(O&G)

3. Skilled Attendance at Birth upgrading of midwifery skills can respond to this situation by strengthening maternal and newborn health services and Reduce MMR &IMR . IMPOSSIBLE can be I M POSSIBLE

4. NO DELAY, ANY MORE………

5. Delay means death

6. Why did She die? Ante partum hemorrhage due to placenta praevia, which means that the placenta, or what we call the “afterbirth”, was situated too low down in the uterus. A woman with this condition will inevitably develop bleeding in the latter part of pregnancy or before delivery

7. Delay in Blood Transfusion Delay in initiating Proper care

8. Delay in reaching Hospital It took Padmini four hours to reach hospital from the time she started bleeding severely, because transport was not readily available to take her to the hospital. Doctor had left hospital when she reached. The sisters started infusion and informed doctor staying few km away and asked the relatives to arrange BLOOD,

10. Delay in Antenatal Care She was not a very healthy woman. Even before pregnancy, she suffered from chronic iron deficiency anaemia caused by malnutrition and parasitic infestations. That severe anaemia must have contributed to the fact that she could not endure the additional severe blood loss. Her reserves of blood were already at a very low level.

11. She is 39 years old Five of her children are still living, three off them are males. TOO OLD TOO MANY She should not have opted for another child.

12. TOO far from PROVIDERS

13. HOUSEWIFE TO A POOR AGRICULTURAL LABOUR

14. She was an illiterate woman and she lived with her husband in a remote village.

16. POVERTY ILLETERACY LACK OF KNOWLEDGE SOCIAL INJUSTICE She dies Non-availability of blood and care

17. SHE COULD HAVE BEEN SAVED . CAN PREVENT SUCH DEATH …………… A care provider,

18. The Road to Maternal Death.

28. birth preparedness and complication readiness