From baby bumps to bribes: Shady business haunts BBMP's maternity homes

BBMP’s maternity homes are intended to provide free services to women in close proximity to their residences. However, a reality check conducted by Navya P K reveals that they are significantly underutilized due to irregularities in doctors’ availability, corruption, and lack of facilities.

BBMP currently operates 21 functional maternity homes in the city, with an additional five temporarily closed for repairs. Two years ago, the government approved additional doctor positions, ensuring that each maternity home now has at least one gynaecologist, and in some cases, a paediatrician and an anaesthetist.

Nevertheless, when DH visited Cox Town and Austin Town maternity homes in the afternoons, the gynaecologists were unavailable. Despite their work hours being from 9 am to 4 pm, the hospital staff at both locations stated that the doctors had left to attend official meetings.

Doctors unavailable

At Cox Town maternity home, Shivamma, a patient’s aunt, expressed frustration as a first-time visitor. She described the experience as burdensome, stating, “This is the third day I’m taking time off work to come here. There’s no clear flow of information, and they keep asking us to come the next day.” She added, “I’m getting my niece’s blood report today, but since the doctor is not here to check it, I’ve been asked to return tomorrow.” Due to difficulties in taking time off from work, Shivamma and her niece plan to visit a private hospital next time.

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The unavailability of doctors outside of the 9 am to 4 pm work hours also deters many women from choosing maternity homes, according to Roopa C, a Community Health Associate at the NGO Centre for Advocacy and Research. When a patient arrives at night for delivery, nurses typically handle the procedure, with the doctor providing instructions over the phone.

“Doctors should come to the hospital in such scenarios, but they don’t,” she said.

In cases of complications, maternity homes have ambulances to transport patients to referral hospitals. BBMP has six referral hospitals, each of which is linked to 4-5 maternity homes. "However, if an ambulance is not available at the time, the maternity home should make arrangements to transport the patient to the referral hospital and inform the doctor there in advance. Unfortunately, this link is missing," Roopa said, citing cases of women who weren't provided this facility.

The lack of scanning facilities at maternity homes also increases patients’ expenses. Although patients are supposed to have scans done at referral hospitals, pregnant women often find the travel burdensome and instead opt for a private lab near the maternity home. Shivamma mentioned that her niece paid Rs 1,300 for her scan at a private lab.

The need for multiple scans during pregnancy drives up the cost for patients. Additionally, maternity homes do not offer all tests, as pointed out by Roopa.

Corruption

Corruption is a significant concern. A relative of a patient at Ganga Nagar maternity home mentioned that despite the good services provided by the hospital, they typically pay around Rs 2,500 to the nursing and housekeeping staff, even though the services are supposed to be free.
She explained, “We pay them for our own happiness. But if we pay, they treat us better, like family.”

Two previous users of Ganga Nagar maternity home reported that the staff asked them to pay Rs 3,000. While one of them negotiated the amount down to Rs 1500, the other paid the full amount.

Roopa stated that bribes of Rs 3,000-4,000 are common in maternity homes, and the quality of care varies based on these payments. “People agree to pay this since they may have to return to the hospital later.”

Although free services and the preference for vaginal deliveries attract many women to maternity homes, the data from BBMP shows that the numbers remain low.

In the year 2022-23, only 13,540 deliveries occurred across all maternity and referral hospitals. These numbers represent only 49.5% of the 27,322 people who had registered for ante-natal checkups (ANC) in these hospitals.

Data from 2016-17 onwards demonstrates that this pattern holds true most years - only a small proportion of those who come for checkups end up delivering at these facilities. Even during the surge in ANC registrations to over 57,000 in 2020-21 due to Covid-19, the number of deliveries was only 18,337.

Dr Nirmala Buggi, BBMP Chief Health Officer (Clinical), explained that one reason for this is that many women return to their natal homes for delivery and choose to shift to another hospital.

Dr. Buggi mentioned that some maternity homes have higher delivery numbers than expected, while others are underperforming. “We have prepared a proposal and allocated a budget this year to hire more paramedics.”

While maternity homes typically handle only vaginal deliveries, five have been upgraded to handle C-sections, according to Dr. Buggi. Eight facilities are set to undergo upgrades. “We cannot have full-time staff in maternity homes, but the upgraded centers will be able to handle pre-planned C-sections during the day.”