Background
Methods
Process of social autopsy data collection
Data retrieve
Data analysis
Results
Mother’s age | In percentage |
< 18 years | 14.3 |
18–29 years | 60.7 |
30 years and above | 25 |
Mother’s education | |
Up to five grade | 25.1 |
Six to ten grade | 32.1 |
11 grade completed and above | 7.2 |
No education | 35.7 |
Age of mother at the time of marriage | |
< 18 years | 78.6 |
18 years and above | 21.4 |
Duration of pregnancy | |
Eight months of pregnancy | 14.3 |
Nine months full term pregnancy | 85.7 |
Outcome of the delivery | |
Live birth | 75 |
Stillbirth | 14.3 |
Not delivered | 10.7 |
Key findings related to convulsion
Case | Key findings on the death issue discussed | Social errors perceived | Responses of the community |
---|---|---|---|
01 | High blood pressure (HBP) with sudden unconsciousness. Mother didn’t receive regular ANC during pregnancy. Labour pains started at 4 am. The village doctor was called and came at 6 am at morning. The Doctor tried to conduct delivery for 2:30 h, then finally referred to facility. Vehicle was not available and family had no plan as to where to go. | Regular antenatal checkup was not received. Village doctor was called for delivery. | All pregnant mothers will receive ANC in future. Family will prepare birth planning. Mothers will deliver babies at the health facility. |
02 | At nine months of pregnancy the patient had sudden convulsion and started to bleed. Mother was then brought to hospital but died before treatment could commence. | Family was not aware of mother’s underlying illness | Regular ANC must be ensured. Community need to be aware of danger signs during pregnancy. |
03 | Had blurring of vision, swelling of leg and face. Mother didn’t receive treatment from health professionals but rather took some medicine from local traditional healer. | Family didn’t make plans to go to medical facility for better management | Community will become aware of sending a mother with complications to hospital for care & delivery. |
04 | Mother was in term. Prolonged labour was for 24 h with convulsion history during pregnancy. Family delayed and as family were undecided where to go the birth took place at home. | Mother was not taken to hospital at right time due to decision delay. | Community will encourage mother to deliver baby at the facility. Danger signs during pregnancy must be known. |
05 | Had HBP, fever, blurring of vision, unconsciousness. Mother hadn’t received regular ANC because of superstition in the family and also in community about hospital services and delivery. | Mother had early marriage, inadequate ANC. Poor perception of health facility within the community. | All pregnant mother will receive ANC in future. Community will deliver baby at the facility. Community will not encourage early marriage. |
06 | Had HBP, unable to be treated due to lack of money, Village doctor was called during delivery, he failed and finally referred mother to hospital. The mother died after just after baby delivered. | Mother was not taken to hospital at right time due to delayed referral. | In future all pregnant mothers will receive ANC. |
07 | Had HBP, decision was delayed to go to facility | Mother was not taken to hospital at right time due to decision delay. | In future all pregnant mothers will receive ANC. |
08 | Had HBP, blurring of vision. During ANC she was advised to come to hospital at the time of delivery but she didn’t. Delivery took place at home and she died soon after. | The mother was not taken to the health facility for delivery | In future all pregnant mothers will receive ANC. Community will ensure baby is delivered at the facility. |
09 | Had swelling of limbs and HBP. Mother hadn’t gone for regular ANC visit. During delivery family called a traditional birth attendant who was unable to deliver. | Mother was not regularly treat by a medical doctor. | All pregnant mothers will receive ANC. Community will ensure baby is delivered at the facility. |
10 | Had high BP, blurring of vision and unconsciousness. Patient was cared for at home by untrained birth attendant. | Family didn’t take decision to go hospital, delivery performed by untrained person. | All pregnant mothers will receive ANC in future. Family will undertake birth planning and for the delivery of the baby at hospital. |
11 | At eight months, had vomiting and HBP. Mother was admitted to Upazila health complex but was unable to be treated there, so referred to the district hospital where she died. | Delay in decisions making by the family | Community should know the maternal danger signs and plan to have delivery at health facility. |
12 | Had convulsion HBP. ANC received three times. Traditional birth attendant was called for delivery. Delay in decision making to take the mother at hospital. | Delay in decision making but finally referred the patient to facility | All pregnant mothers will receive ANC. Family will prepare birth planning. |
13 | Had severe headache and vomiting. Convulsion began at midnight when labour pain started. Family waited till morning and it took four hours to arrive in upazila health complex. Unable to be treated there, she was referred to district hospital but died within 30 min after delivering a still birth. | Delay in decisions making, lack of transport facility and didn’t receive regular ANC. | All pregnant mothers will receive ANC. Family will prepare birth planning. |
14 | Had fever with swelling of limbs. Mother had low weight due to family member not providing Mother with sufficient food. Family thought the coming baby would be large in size and normal delivery could not take place. Villagers had a misperception about care at the health facility. | Family had misperception and had not prepared for the delivery. Mother did not receive any ANC | All pregnant mothers will receive ANC. Family will prepare birth planning. |
15 | Had leg swelling, convulsion before delivery and HBP. Normal delivery conducted at facility. After a few hours of the delivery mother was returning back home when convulsions developed whilst travelling. Mother died within five minutes after arriving home. | Mother did not attend regular checkup during pregnancy. | Regular ANC must be ensured. Danger signs during pregnancy need to be known. |
16 | Mother had severe convulsion before delivery. Delivery conducted by the TBA at home. Mother died just after the delivery. | No ANC was received and family was not aware about maternal complications. | Regular ANC must be ensured. Community will deliver baby at the facility. |
Key findings related to bleeding
Case | Key findings on the death issue discussed | Social errors perceived | Responses of the community |
---|---|---|---|
01 | During delivery family members called village doctor and traditional birth attendant. Delivery conducted after 17 h of labour pain. After delivery placenta was retained and bleeding started. Patient referred to district hospital. Mother died just after arrive at hospital. | Mother didn’t receive any ANC and family didn’t prepare any birth planning. | Each expectant mother should receive regular ANC, prepare a birth planning and ensure delivery at a health facility. |
02 | The mother delivered a live birth by traditional birth attendant but the placenta was not removed and started bleeding. Family called village doctor and he gave some injections. After a while he referred the patient to the facility, but the patient died before arrival at hospital. | Family delayed in decision making and didn’t baby not delivered at health facility. | Each mother needs to deliver baby at health facility by trained provider. |
03 | The mother delivered a live birth by traditional birth attendant, profuse bleeding just after delivery. Family called village doctor and he gave some saline and injections. Life was lost within 30 min after treatment initiated at home. | Didn’t have birth planning and baby delivered by untrained birth attendant at home. | Each mother needs to deliver their baby at health facility by trained provider and prepare birth planning. |
04 | When labour pain started, family members called village doctor and a traditional birth attendant. Profuse bleeding started just after delivery. It took 4 h at home to take the decision to take the patient to the health facility. The mother died just after 30 min of arrival at hospital. | Family didn’t take decision at right time and there was a lack of transport to carry the patient. | Prepare birth planning and ensure health facility delivery. Make the community more aware about maternal danger signs. |
05 | The mother delivered a live birth by traditional birth attendant at home but placenta retained and started bleeding, TBA tried for two to three hours but the mother died on the way towards health facility. | Family delayed their decision making for seven hours. | Mother should receive regular ANC, prepare birth planning and ensure health facility delivery. |
06 | The mother delivered a live birth by mother in law and sister in law at home. Placenta was retained and bleeding started. Relatives failed to manage the bleeding, called the village doctor but the patient died at home without any treatment | Family made mistake of trying to deliver at home and delayed for hours the decision to seek help. | Mother should receive regular ANC, prepare a birth planning and ensure facility delivery. More community awareness of maternal complications. |
07 | Traditional birth attendant delivered baby at home, bleeding started just after delivery. Mother become unconscious after some time and TBA couldn’t manage complications. It was dark night and no vehicle was available to transport the patient to the health facility. Mother died at home. | Family delayed making the decision and there was a lack of transport to carry the patient at night. | Mother should receive regular ANC, prepare a Birth planning and ensure health facility delivery. |
08 | The mother delivered a live birth by traditional birth attendant at home in presence of village doctor but bleeding was profuse after delivery. Family unable to carry patient at right time and due to the lack of vehicle at night it took four hours to bring the patient to the health facility. | Family delayed making the decision and there was a lack of transport to carry the patient at night. | Mother should receive regular ANC, prepare birth planning and ensure facility delivery |
09 | The mother delivered a live birth by traditional birth attendant at home. After 9 days she developed convulsion with bleeding. Mother admitted to hospital and treated, the family took the mother back to a village doctor’s home. Mother died at village doctor’s home | Family made wrong decisions and were not aware of maternal complications. | Mother should receive regular ANC, prepare birth planning and ensure facility delivery. |
10 | Mother delivered a baby by an untrained birth attendant at home and severe bleeding started after delivery due to retain placenta. | Mother delivered a baby by an untrained birth attendant at home and severe bleeding started after delivery due to retain placenta. | Each mother should receive regular ANC, prepare birth planning and ensure facility delivery. |
11 | Mother didn’t seek treatment due to lack of enough money. The family also had misconception of hospital treatment. Bleeding started after delivery of a still birth and mother died at home without any treatment. | Mother not treated at health facility and didn’t receive regular ANC | Each mother should receive regular ANC, prepare birth planning and ensure facility delivery. |
12 | Mother delivered a live birth by traditional birth attendant at home after a prolonged labour, bleeding started just after delivery. Family was not prepared to carry the patient to health facility due to lack of vehicle and money. | Lack of birth planning and delivery conducted at home. | Each mother should receive regular ANC, prepare birth planning and ensure facility delivery. |