In a historic decision, Delhi high court orders maternal death audit


Shanti Devi, a scheduled caste woman, living below the poverty line, was denied her Reproductive rights and tragically lost her life minutes after she gave birth to her premature newborn girl on the 20th January 2010. Shanti Devi due to her poverty and deprivation had not eaten in three days, prior to her delivery. In a historic decision, Justice Muralidhar of Delhi High Court on Thursday 11 February 2010, instructed NCT Delhi to conduct a maternal death audit concerning the death of Shanti Devi, after learning that a request for a post mortem had been denied to Shanti Devi's husband. Justice Muralidhar instructed that Shanti Devi’s premature 7 month newborn (weighing 1.3kg) and only 3 weeks outside the womb, was not to be discharged from Chacha Nehru Bal Chikatsalya Hospital, New Delhi until further notices were issued from the Court. This was in response to threats from the hospital to the newborn's family members that the newborn would be discharged, because the family were too poor to pay for the necessary medical treatment. Justice Muralidhar, further, ordered Counsel for NCT Delhi to advise of all the 'monetary and free rations under any government Scheme and where appropriate orders can be passed to ensure that at the time of discharge all of these are provided to the baby.' Shanti Devi's case was originally filed by the Human Rights Law Network, in Delhi High Court, Laxmi Mandal v NCT Delhi, W.P. 8853/2008, when she suffered grave violations - she was forced to carry her 32 week dead fetus (her third pregnancy) for 5 days, as she was denied emergency obstetric medical care from four different hospitals, because she was too poor to pay the fees demanded. One of the hospitals’ involved, was a private hospital: Saroj Private Hospital which demanded Rs 2.5 lakh, despite being obligated under the Delhi Directives to reserve 10-20% of its beds to treat people living below the poverty line free of cost, in exchange for being awarded prime land at discounted prices. The denial of Reproductive Rights is at horrific levels in India. India has the highest number of maternal deaths in the world at 117,000 women and girls dying from preventable pregnancy-related causes. The maternal mortality ratio (number of women dying per 100,000 live births) in India is higher than 120 countries including neighbouring states of Bangladesh, China, Nepal and Sri Lanka. Factors contributing to these deaths include the failure and the lack of accountability of the full implementation of the Service Guarantees, set under the National Rural Health Mission 2005- 2012, a scheme which is specifically tailored toward poor women, the program places legal obligations on the government to provide a range of free reproductive health services, including but not limited to, registration and monitoring of a pregnancy, antenatal and postnatal care, safe abortion services, 24-hour access to emergency obstetrical care, and timely and accountable referral and transport to women living below the poverty line, in addition to recording and auditing maternal deaths and removing the causes. India is also obligated to fulfill its legal obligations as set under the Convention to Eliminate all Forms of Discrimination Against Women, which states: States Parties shall ensure to women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary as well as adequate nutrition during pregnancy and lactation. [Article 12(2)] State must ensure that women have access to family planning services, availability of information and education related to family planning. [Article 14(2)(b)] Women should ‘have the same rights to decide freely and responsibly on the number and spacing of their children and to have access to the information, education and means to enable them to exercise these rights. [Article 16(e)]” For further information: Sarita Barpanda Human Rights Law Network: