{"id":1617,"date":"2025-05-23T09:15:53","date_gmt":"2025-05-23T09:15:53","guid":{"rendered":"https:\/\/arth.in\/new-arth-website\/?p=1617"},"modified":"2025-07-25T08:19:21","modified_gmt":"2025-07-25T08:19:21","slug":"what-to-do-and-what-not-to-do-to-save-lives","status":"publish","type":"post","link":"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/","title":{"rendered":"What to do and what not to do, to save lives"},"content":{"rendered":"\n

When Ratani, nurse-midwife working at ARTH\u2019s Health Center for the last three years, carried out a pelvic examination, she realized that immediate referral would be necessary. Panki, a 26 year-old woman from a tribal community, had come for delivery.<\/p>\n\n\n\n

\n
\n

Ratani recalled, \u201cI\u2019d worn my gloves and checked \u2014 the baby was in a transverse position. The membrane had ruptured, and there was meconium. It was risky. I could feel the baby\u2019s shoulder below, but the head was not in position.\u201d According to Government of India\u2019s \u201cGuidelines for Antenatal Care and Skilled Attendance at Birth by ANMs\/LHVs\/SNs\u201d (2010), women with transverse lie should be referred to a first referral unit equipped with facilities for caesarean section. Delay in carrying out caesarean delivery can result in obstructed labour, uterine rupture, and be potentially fatal for the woman and fetus.<\/p>\n<\/div>\n\n\n\n

\n
\"\"<\/figure>\n<\/div>\n<\/div>\n\n\n\n

During her third pregnancy, Panki had returned to her parents\u2019 house in village Chambua-Sarjela. Her husband worked in a factory 45 km away, visiting the family including two young daughters, once or twice a month. When Panki went into labour, her parents took her to ARTH\u2019s Health Centre, where her husband soon joined them. On examining her, Ratani recognized the problem and took a second opinion from a colleague. The baby was in transverse lie \u2014 delivery at the health centre would be impossible. \u201cYou need to go to the big hospital in Udaipur,\u201d she advised Panki\u2019s father who hesitated, asking if it could be managed there. Ratani explained that the position was risky and the baby was in distress. Understanding the situation, the family agreed. By 12:05 AM, the vehicle arrived and Ratani handed them a detailed referral note. She instructed the family to keep Panki lying down and assured them of ARTH staff support at the hospital. After calling the 24\u00d77 helpline in Udaipur, she went to rest. At the government hospital emergency, doctors confirmed that the baby was in transverse lie. Panki\u2019s father later recalled, \u201cThe doctor told us, it is good that you came in time, otherwise, there was a risk of serious complications\u201d A caesarean section was performed within an hour, delivering a healthy girl.<\/p>\n\n\n\n

A month later, I asked Ratani about that night. She smiled and said, \u201cI had read about such cases in books, but until you actually face them, you don\u2019t truly understand what it means. This was my third encounter with transverse lie. I knew what to do and what not to do. Mother and baby are safe. What more could I have asked for?\u201d A key aspect of ARTH\u2019s Basic Midwifery model, developed in southern Rajasthan since 1999, is the emphasis on timely referral. Nurse-midwives learn to promptly recognize complications and take satisfaction in positive maternal and fetal outcomes, knowing that their referral decisions contribute to timely interventions by emergency hospital teams. They know both what to do and what not to do, to save lives.<\/p>\n\n\n\n

\u2013 Gunjan Khorgade (gk@ccr.arth.in)<\/p>\n","protected":false},"excerpt":{"rendered":"

When Ratani, nurse-midwife working at ARTH\u2019s Health Center for the last three years, carried out a pelvic examination, she realized that immediate referral would be necessary. Panki, a 26 year-old woman from a tribal community, had come for delivery. Ratani recalled, \u201cI\u2019d worn my gloves and checked \u2014 the baby was in a transverse position. The membrane had ruptured, and there was meconium. It was risky. I could feel the baby\u2019s shoulder below, but the head was not in position.\u201d According to Government of India\u2019s \u201cGuidelines for Antenatal Care and Skilled Attendance at Birth by ANMs\/LHVs\/SNs\u201d (2010), women with transverse lie should be referred to a first referral unit equipped with facilities for caesarean section. Delay in carrying out caesarean delivery can result in obstructed labour, uterine rupture, and be potentially fatal for the woman and fetus. During her third pregnancy, Panki had returned to her parents\u2019 house in village Chambua-Sarjela. Her husband worked in a factory 45 km away, visiting the family including two young daughters, once or twice a month. When Panki went into labour, her parents took her to ARTH\u2019s Health Centre, where her husband soon joined them. On examining her, Ratani recognized the problem and took a second opinion from a colleague. The baby was in transverse lie \u2014 delivery at the health centre would be impossible. \u201cYou need to go to the big hospital in Udaipur,\u201d she advised Panki\u2019s father who hesitated, asking if it could be managed there. Ratani explained that the position was risky and the baby was in distress. Understanding the situation, the family agreed. By 12:05 AM, the vehicle arrived and Ratani handed them a detailed referral note. She instructed the family to keep Panki lying down and assured them of ARTH staff support at the hospital. After calling the 24\u00d77 helpline in Udaipur, she went to rest. At the government hospital emergency, doctors confirmed that the baby was in transverse lie. Panki\u2019s father later recalled, \u201cThe doctor told us, it is good that you came in time, otherwise, there was a risk of serious complications\u201d A caesarean section was performed within an hour, delivering a healthy girl. A month later, I asked Ratani about that night. She smiled and said, \u201cI had read about such cases in books, but until you actually face them, you don\u2019t truly understand what it means. This was my third encounter with transverse lie. I knew what to do and what not to do. Mother and baby are safe. What more could I have asked for?\u201d A key aspect of ARTH\u2019s Basic Midwifery model, developed in southern Rajasthan since 1999, is the emphasis on timely referral. Nurse-midwives learn to promptly recognize complications and take satisfaction in positive maternal and fetal outcomes, knowing that their referral decisions contribute to timely interventions by emergency hospital teams. They know both what to do and what not to do, to save lives. \u2013 Gunjan Khorgade (gk@ccr.arth.in)<\/p>\n","protected":false},"author":1,"featured_media":1618,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-1617","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news"],"yoast_head":"\nWhat to do and what not to do, to save lives - Action Research and Training for Health<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What to do and what not to do, to save lives - Action Research and Training for Health\" \/>\n<meta property=\"og:description\" content=\"When Ratani, nurse-midwife working at ARTH\u2019s Health Center for the last three years, carried out a pelvic examination, she realized that immediate referral would be necessary. Panki, a 26 year-old woman from a tribal community, had come for delivery. Ratani recalled, \u201cI\u2019d worn my gloves and checked \u2014 the baby was in a transverse position. The membrane had ruptured, and there was meconium. It was risky. I could feel the baby\u2019s shoulder below, but the head was not in position.\u201d According to Government of India\u2019s \u201cGuidelines for Antenatal Care and Skilled Attendance at Birth by ANMs\/LHVs\/SNs\u201d (2010), women with transverse lie should be referred to a first referral unit equipped with facilities for caesarean section. Delay in carrying out caesarean delivery can result in obstructed labour, uterine rupture, and be potentially fatal for the woman and fetus. During her third pregnancy, Panki had returned to her parents\u2019 house in village Chambua-Sarjela. Her husband worked in a factory 45 km away, visiting the family including two young daughters, once or twice a month. When Panki went into labour, her parents took her to ARTH\u2019s Health Centre, where her husband soon joined them. On examining her, Ratani recognized the problem and took a second opinion from a colleague. The baby was in transverse lie \u2014 delivery at the health centre would be impossible. \u201cYou need to go to the big hospital in Udaipur,\u201d she advised Panki\u2019s father who hesitated, asking if it could be managed there. Ratani explained that the position was risky and the baby was in distress. Understanding the situation, the family agreed. By 12:05 AM, the vehicle arrived and Ratani handed them a detailed referral note. She instructed the family to keep Panki lying down and assured them of ARTH staff support at the hospital. After calling the 24\u00d77 helpline in Udaipur, she went to rest. At the government hospital emergency, doctors confirmed that the baby was in transverse lie. Panki\u2019s father later recalled, \u201cThe doctor told us, it is good that you came in time, otherwise, there was a risk of serious complications\u201d A caesarean section was performed within an hour, delivering a healthy girl. A month later, I asked Ratani about that night. She smiled and said, \u201cI had read about such cases in books, but until you actually face them, you don\u2019t truly understand what it means. This was my third encounter with transverse lie. I knew what to do and what not to do. Mother and baby are safe. What more could I have asked for?\u201d A key aspect of ARTH\u2019s Basic Midwifery model, developed in southern Rajasthan since 1999, is the emphasis on timely referral. Nurse-midwives learn to promptly recognize complications and take satisfaction in positive maternal and fetal outcomes, knowing that their referral decisions contribute to timely interventions by emergency hospital teams. They know both what to do and what not to do, to save lives. \u2013 Gunjan Khorgade (gk@ccr.arth.in)\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/\" \/>\n<meta property=\"og:site_name\" content=\"Action Research and Training for Health\" \/>\n<meta property=\"article:published_time\" content=\"2025-05-23T09:15:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-07-25T08:19:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.arth.in\/wp-content\/uploads\/2025\/05\/Strategic-interventions-ARTH-3.png\" \/>\n\t<meta property=\"og:image:width\" content=\"940\" \/>\n\t<meta property=\"og:image:height\" content=\"788\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/www.arth.in\/#\/schema\/person\/0a5fca53f9a94baa945b37d6efbdfcfc\"},\"headline\":\"What to do and what not to do, to save lives\",\"datePublished\":\"2025-05-23T09:15:53+00:00\",\"dateModified\":\"2025-07-25T08:19:21+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/\"},\"wordCount\":503,\"publisher\":{\"@id\":\"https:\/\/www.arth.in\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.arth.in\/wp-content\/uploads\/2025\/05\/Strategic-interventions-ARTH-3.png\",\"articleSection\":[\"News\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/\",\"url\":\"https:\/\/www.arth.in\/index.php\/2025\/05\/23\/what-to-do-and-what-not-to-do-to-save-lives\/\",\"name\":\"What to do and what not to do, to save lives - 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When Panki went into labour, her parents took her to ARTH\u2019s Health Centre, where her husband soon joined them. On examining her, Ratani recognized the problem and took a second opinion from a colleague. The baby was in transverse lie \u2014 delivery at the health centre would be impossible. \u201cYou need to go to the big hospital in Udaipur,\u201d she advised Panki\u2019s father who hesitated, asking if it could be managed there. Ratani explained that the position was risky and the baby was in distress. Understanding the situation, the family agreed. By 12:05 AM, the vehicle arrived and Ratani handed them a detailed referral note. She instructed the family to keep Panki lying down and assured them of ARTH staff support at the hospital. After calling the 24\u00d77 helpline in Udaipur, she went to rest. At the government hospital emergency, doctors confirmed that the baby was in transverse lie. Panki\u2019s father later recalled, \u201cThe doctor told us, it is good that you came in time, otherwise, there was a risk of serious complications\u201d A caesarean section was performed within an hour, delivering a healthy girl. A month later, I asked Ratani about that night. She smiled and said, \u201cI had read about such cases in books, but until you actually face them, you don\u2019t truly understand what it means. This was my third encounter with transverse lie. I knew what to do and what not to do. Mother and baby are safe. What more could I have asked for?\u201d A key aspect of ARTH\u2019s Basic Midwifery model, developed in southern Rajasthan since 1999, is the emphasis on timely referral. Nurse-midwives learn to promptly recognize complications and take satisfaction in positive maternal and fetal outcomes, knowing that their referral decisions contribute to timely interventions by emergency hospital teams. 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