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Table 2 Maternal deaths as a consequence of convulsion

From: Exploration of social factors associated to maternal deaths due to haemorrhage and convulsions: Analysis of 28 social autopsies in rural Bangladesh

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.