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Standing by: Supporting High-risk Pregnancies in India

india-woman-baby-munni-deviIt was her fourth pregnancy. Munni Devi’s first child died minutes after birth. Then she had suffered two miscarriages. Her new pregnancy brought renewed hope for the 32-year-old and her husband, Jaipal Yadav, a daily wage earner in Kannauj, India. Munni was thrilled.

The happiness appeared to be short-lived.

As Munni entered her fifth month of pregnancy, she started leaking amniotic fluid. Perplexed and confused, she didn’t know what to do. Soon after, she met with her area’s ASHA and Pathfinder International’s Community Coordinator during one of their routine visits.

Hearing her symptoms and looking at her pregnancy history, I knew this was a high-risk pregnancy that needed immediate action,” recalls Amar Pandey, Pathfinder’s Community Coordinator in the nearby village of Chibramau.

He advised Munni to immediately see a doctor at the Community Health Center, the nearest public health facility in her village. He also reported the case to Vishwambhar Mishra, Pathfinder’s District Program Officer in Kannauj, who told him he must monitor her closely.

“One of the key objectives of the project is to identify pregnancies that may be considered high risk and get them treated timely and promptly. I had told all the staff in the field, we have to see to it that Munni carries her baby to term successfully,” said Vishwambhar.

Complications Continue

Munni is one of the many high-risk pregnancies monitored by the staff under the Matrika project, making sure the client receives the medical care she needs.

After seeking adequate treatment from the Health Center, Munni recovered at home. However she continued to leak small amounts of fluid periodically. Every time, the Community Coordinator and ASHA took her for treatment.

“At least seven times we took her to the Community Health Center and three times to the district hospital. Every time she had a problem, her husband informed me. I then used to call [Amar], who would tell us where to take her,” says Ramshree Devi, the ASHA caring for Munni.

Through regular visits with Munni and her husband, the Pathfinder staff and the ASHA kept a close watch on possible complications and danger signs.

This monitoring was important: leaking fluid during pregnancy poses serious risks for the baby. Amniotic fluid, which surrounds the baby in utero, protects the baby from harm and infection.

Panic At The Health Center

On the evening of March 20th—the beginning of the ninth month of pregnancy—Munni’s labor pains started. Her husband took her to the Community Health Center for delivery in a public service ambulance. Her ASHA arrived shortly after, but there was no medical officer present at that time.

A staff nurse on duty checked Munni’s blood pressure and found that she was hypertensive. Citing high risks involved, the nurse advised Jaipal to take her to a tertiary facility.

Jaipal didn’t know what to do. Pathfinder’s district staff, who was in regular touch with him over the phone, advised him to take Munni to Farrukhabad Medical College, 20 kilometers away.

Healthy Mom And Baby


At midnight that night, Munni gave birth to a baby girl through cesarean section in the medical college. Nine days later, she left the hospital with her healthy baby.

“We were so concerned about Munni throughout her pregnancy. I cannot explain in words how relieved I was to see her and her baby happy and healthy,” says Amar.

Thanking the ASHA and Pathfinder for the support they provided, Jaipal said, “My wife and daughter are healthy today because of you and your hard work. I’ll never forget what you have done for us.”

*The Matrika project is led by Pathfinder International in collaboration with the government of Uttar Pradesh and World Health Partners, with funding from MSD, through its MSD for Mothers program.

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