Mumbai: Late last month, senior IAS officer Manisha Mhaiskar, who is coordinating the expansion of healthcare infrastructure in Mumbai’s B.Y.L. Nair Hospital, got a message on the ‘Nair Covid’ WhatsApp group — that the hospital had successfully delivered its 200th Covid-negative baby to a Covid-positive mother.
She immediately replied, meaning to say “amazing”, but the auto-correct function changed it to “Amazon”. For Mhaiskar, the error was serendipitous, as the 200th baby turned out to be a girl child, whom she and the staff of the Covid-exclusive Nair Hospital now call ‘Baby Amazon’.
“Most people know Amazon as the e-commerce site. But, the autocorrect error was fortuitous as the amazons were a tribe of warrior women in Greek mythology,” Mhaiskar, a principal secretary on deputation to the Brihanmumbai Municipal Corporation, told ThePrint.
As of 8 June, the obstetrics and paediatrics team at Nair Hospital has delivered 276 Covid-negative babies to Covid-positive mothers, including a set of triplets, with the number jumping by about 12-15 every day.
Mumbai, which recorded its first Covid-positive case on 11 March, has registered a total of 50,878 cases, of which 26,178 are active as on the evening of 9 June.
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What led to the ward being set up
In the first week of April, a mother-to-be who was suspected to be Covid-positive and in her ninth month of pregnancy, approached Nair Hospital after running from hospital to hospital which weren’t willing to admit her. She ultimately bled and died, and lost her baby.
“That incident really got to us. We had just two suspect wards at the time. Initially, we set up operating tables and cradles in the suspect ward itself. These were all suspected Covid-positive women. Some were confirmed Covid-positive. We did deliveries successfully in the most awkward manner with lights used for ENT cases,” said Dr Surbhi Rathi, professor of paediatrics.
Mhaiskar added: “In early April, around the time when I took charge, we realised that there was a major gap for Covid-positive pregnant women. No hospital was willing to take them. We gradually set up a major ward at Nair Hospital for such women. The hospital takes Covid-positive women who are either close to their estimated delivery date or have some complications.
“We have also tied up with nearby maternity homes as step-down facilities so that we have beds available for the more urgent cases.”
Shortly after the hospital started a proper 30-bedded ward, Dr Rathi said there was a flood of women. “We were struggling to fit patients in. Additional cots were set up in the paediatric ward. We then started another 20-bedded ward to take the load,” she said.
On 18 April, Nair Hospital was declared a Covid-only hospital, and eventually, set up a large 120-bedded ward for Covid-positive pregnant women. Rathi said at any point of time, the ward has about 60 women who have just delivered their babies and 30 women who are about to deliver.
Eight obstetricians, under head of gynaecology Dr Niraj Mahajan, work round-the-clock in six-hour shifts, with two doctors to each shift.
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Mothers allowed to breastfeed newborns
When the initial deliveries took place, Dr Sushma Malik, head of paediatrics and neonatology at Nair Hospital, developed a protocol for deliveries, the handling of newborns and their discharge, Rathi said.
The protocol dictates that the newborns are not separated from their Covid-positive mothers after delivery. Mothers are allowed to breastfeed, as that helps boost babies’ immunity. The hospital administers the BCG vaccine, also an immunity booster, to every baby, and the babies are discharged along with their mothers, barring complications.
Asymptomatic Covid-positive mothers are allowed to take their newborns home just four or five days after delivery.
The hospital has had three newborns die so far out of the 276 deliveries, but these deaths were due to non-Covid reasons like extreme prematurity or other infections. On average, one baby out of the 12-15 daily deliveries requires neonatal intensive care, monitored by Dr Malik.
“A few babies have tested Covid-positive about five to six days after delivery. But, from what we have observed, it was more due to the handling of those babies by multiple relatives than any particular setting of the mother,” Dr Rathi said.
“But, these babies too have recovered,” she added. “Ultimately, all babies born here have been Covid-negative at birth and at discharge.”
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This is the sort of positive news we want to hear during Covid times ! The organisation of the facility at Nair Hospital for Covid positive pregnant women, the well thought out structured protocol for delivery and neonatal care, including breast-feeding and BCG immunisation, the commitment, and remarkable daring to face the challenge- in short the whole success story makes me so proud of you. My congratulations to the team !