The first five minutes after a baby is born are critical to the quality of life it will enjoy – but so too are the nine months of pregnancy in the mother’s womb, Eastern Cape department of health superintendent-general Dr Thobile Mbengashe said.Mbengashe faces the daunting task of raising and maintaining standards in a department that is the most sued health department in the country, based on the value of negligence claims brought against it.
The bulk of claims against the department involve obstetrics, the branch of healthcare that deals with pregnancy, childbirth and the period immediately following birth.
Many claims passing through the high courts in the province are on behalf of children born with varying degrees of cerebral palsy, a disability usually caused by damage to the brain before or during birth.
In one case, the department agreed to pay R8.5-million in negligence damages to a young cerebral palsy girl who was left permanently disabled by botched maternity procedures at Taylor Bequest Hospital in Mount Fletcher.
“Social determinants of health have an impact,” said Mbengashe, referring to how access to food, accommodation, transport, working conditions, poverty and addictions affected the health of communities.
“The quality of survival at birth is determined during the nine months of pregnancy.
“If the socio-economic conditions are very poor and the foetus doesn’t have the nutrition it requires, regular assessment during antenatal care, and the mother doesn’t come early and is tested for HIV, you will find huge problems during delivery.
“Traditionally, most mothers come to our facilities very late in the delivery process.
“The occurrence of cerebral palsy is related to the period before the delivery itself. The delivery itself helps to mitigate against that.
“The baby has five minutes to make the shift from being in a mother’s womb to another environment and having its own oxygen.”
By the 10th minute, if the baby had not yet responded, the brain would have already suffered damage, he said.
Mbengashe acknowledged “there have been failures in our system” and that treatment standards must be ramped up to avoid staff mistakes.
“We should continue our endeavours to improve service delivery and the quality of mother-and-child healthcare.
“Standard operating procedures must be used consistently.”
Among the initiatives being implemented is a national programme for emergency obstetrics training which will assist especially in far-flung rural hospitals where specialist obstetricians might not be available.
Births lead medical law suits
Mbengashe faces the daunting task of raising and maintaining standards in a department that is the most sued health department in the country, based on the value of negligence claims brought against it.
The bulk of claims against the department involve obstetrics, the branch of healthcare that deals with pregnancy, childbirth and the period immediately following birth.
Many claims passing through the high courts in the province are on behalf of children born with varying degrees of cerebral palsy, a disability usually caused by damage to the brain before or during birth.
In one case, the department agreed to pay R8.5-million in negligence damages to a young cerebral palsy girl who was left permanently disabled by botched maternity procedures at Taylor Bequest Hospital in Mount Fletcher.
“Social determinants of health have an impact,” said Mbengashe, referring to how access to food, accommodation, transport, working conditions, poverty and addictions affected the health of communities.
“The quality of survival at birth is determined during the nine months of pregnancy.
“If the socio-economic conditions are very poor and the foetus doesn’t have the nutrition it requires, regular assessment during antenatal care, and the mother doesn’t come early and is tested for HIV, you will find huge problems during delivery.
“Traditionally, most mothers come to our facilities very late in the delivery process.
“The occurrence of cerebral palsy is related to the period before the delivery itself. The delivery itself helps to mitigate against that.
“The baby has five minutes to make the shift from being in a mother’s womb to another environment and having its own oxygen.”
By the 10th minute, if the baby had not yet responded, the brain would have already suffered damage, he said.
Mbengashe acknowledged “there have been failures in our system” and that treatment standards must be ramped up to avoid staff mistakes.
“We should continue our endeavours to improve service delivery and the quality of mother-and-child healthcare.
“Standard operating procedures must be used consistently.”
Among the initiatives being implemented is a national programme for emergency obstetrics training which will assist especially in far-flung rural hospitals where specialist obstetricians might not be available.
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