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How Covid positive expectant moms beat the virus
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When Nair Hospital became the saviour for an expectant mother
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When Nair Hospital became the saviour for an expectant mother

How Covid positive expectant moms beat the virus

Lata Mishra

Mumbai Mirror
Mar 15, 2021, 12:32 IST
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The Mumbai hospital stepped up when every other hospital in the city was turning away Covid positive pregnant women. This is the story of a remarkable effort made by a brave team of doctors and nurses

The middle-aged man was on the verge of breaking down. Seven hospitals had refused to admit his pregnant wife because she was Covid-19 positive. Crucial time had been lost - time that should have been used to put her on a ventilator to stabilise her plummeting oxygen saturation levels. Twenty-four hours later, despite all efforts by doctors at B Y L Nair Hospital in Mumbai’s Parel, the woman died. The baby could not be saved either because a caesarian was not possible with the acute respiratory distress the mother was in.

Dr Ganesh Shinde, Head, Obstetrics and Gynaecology at Nair Hospital, said he will never be able to forget the man’s face. This was in mid-April last year. Covid-19 was raging through a shut-and-locked-down Mumbai. The city’s entire health infrastructure was struggling to get a grip on a crisis, the sort of which it had never seen before. But the encounter strengthened Dr Shinde and Nair Hospital’s resolve to double its efforts to create a ward exclusively to handle pregnancies involving Covid-positive women and a neo-natal ward to take care of the newborns.
It was around April 14, 2020 when Nair hospital started getting Covid-positive women for deliveries
It was around April 14, 2020 when Nair hospital started getting Covid-positive women for deliveries
For a large part of the lockdown, Nair was the only hospital in all of Mumbai taking care of over 1100 Covid-positive expectant mothers. It has so far carried out 764 such deliveries, including 303 caesarean sections. According to hospital’s records, 45 babies were born Covid positive, possibly the earliest cases anywhere in the world of intrauterine transfer of the infection. Three of these babies – two born premature and the third with underlying health complications – died. The 45 babies were part of a research study by the hospital in conjunction with the Indian Council of Medical Research (ICMR). The study included using data collected by Nair doctors to establish whether the virus is linked to higher rates of miscarriage, premature births or maternal mortality. The paper on this research is likely to be published in a top European medical journal soon.
Tanushri Bhanage with Sarthak. Photo by Raju Shinde
Tanushri Bhanage with Sarthak. Photo by Raju Shinde

A boy and a friendship for life

On May 15 last year, Tanushri Bhanage, 33, nine-months pregnant and due to for a caesarian section on May 20, tested positive for Covid-19. Her husband, Dattatrey Bhanage, 34, was very keen to admit her to a private hospital. He called six or seven hospitals, but none of them were ready to admit a Covid-positive expectant mother. One hospital that agreed demanded Rs 10 lakh for six days with half of the mount to be paid before admission. That is when a BMC employee advised him admit her to the BYL Nair Hospital, the only hospital in the city authorised to take care of Covid-positive women who were pregnant. Late that night, the ambulance carrying Tanushri to Nair picked up another pregnant woman, Vaishali Khedekar. Vaishali too was Covid-positive. While Dattatrey’s first impression of Nair was not very good – too crowded and too many people coughing – his wife said the doctors were very caring and that she felt well looked after. Tanushri delivered a boy on May 20, a day after Vaishali had given birth to a boy. The two are are best of friends now. Even after Tanushri was discharged, Dattatrey continued visiting the hospital every day, carrying home-cooked for Vaishali. He did this till Vaishali’s husband, who was quarantined after testing positive, was allowed to visit his wife. Tanushri and Dattatrey have named their son Sarthak, which translates in English to ‘meaningful’.


There has been no study conducted in Mumbai to find out how many Covid-positive women died during pregnancies (before Nair kicked into action), and how many babies were lost to miscarriages during the lockdown. But Dr Shinde and Dr Sushma Malik, Head, Paediatric Department, know it was chaotic and dangerous last year. "It was around April 14 when we started getting Covid-positive women for deliveries. Most of them were referred to Nair after being turned away by four or five hospitals. We lost eight mothers only because they arrived at our hospital very late and in a critical condition," recalled Dr Shinde.
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The hospital had received a letter from the municipal corporation on April 12 asking it to create an independent ward for Covid-positive expectant mothers and a neo-natal facility for newborns. It was given a week to get it all together. But by April 14, both Dr Shinde and Dr Malik knew that they did not even have a day. Both knew they would have to attend to every Covid positive pregnant woman that approached the hospital because no other hospital in Mumbai would.
Dr Neeraj Mahajan, nodal in-charge for the centre for Covid positive mothers and newborns at Nair, said the first challenge was to create space for makeshift labour rooms and post-delivery care wards since the hospital’s existing Gynaecology wards were full with non-Covid patients. "Overnight we created a 30-bed ward in another building and within a week it was full. Two more wards with 30 beds each were created in the next few days. By the end of April, not a single bed was available in any of the three wards," he said.
Nair Hospital saw 750 deliveries in the pandemic
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Nair Hospital saw 750 deliveries in the pandemic

As cases kept mounting, the hospital realised it would have to move non-Covid patients out of its gynaecology ward. "There was wave after wave of expectant mothers arriving. Cases from all over the Mumbai Metropolitan Region (MMR) were being referred to Nair. We had not imagined so many pregnant women would catch the infection. Soon, every bed in our main gynaecology ward was taken by Covid positive women," he said.
Before the pandemic, Nair Hospital handled, on an average, 15 deliveries per day. The number doubled during the lockdown. "And since all these involved Covid positive women, the time and the effort it took went up too. It was a stressful time. But as we look back, we feel proud that we did not budge," said a doctor who did not wish to be identified.
Dr Malik said taking care of pregnant women and newborns was a challenge at that time because there were no set treatment protocols in place. "Today doctors don’t hesitate to work in Covid wards, nurses don’t have any apprehensions, and there is more than enough supply of PPEs and other protective gear," she said, adding that things were very different in April.
How Nair hospital staff counselled pregnant mothers who were Covid positive
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How Nair hospital staff counselled pregnant mothers who were Covid positive

At 60, Dr Malik - despite her age and underlying health conditions (BMC’s Pandemic GR said that those above 55 were exempted from work), chose to be at the forefront. Around 60 doctors, including 40 resident doctors, worked under her without a day’s break to ensure that every expectant mother and newborn was taken care of.
Dr Malik said that although it has not been conclusively proven that babies can contract Covid-19 in the womb from an infected mother, it was a challenge to take care of the newborns in the absence of any established paediatric drugs to deal with the virus. "Though a majority of these babies were asymptomatic with minor cough, cold or fever, we didn’t know how the virus would affect them. Since there were no established drugs to treat them, we had to continuously monitor them and provide only symptomatic treatment. We unfortunately lost three babies," she said.
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Dr Mahajan said that till November last year the hospital was receiving an average of 20 Covid positive expectant mothers a day. "It is only in the last three months that the number has come down. Consequently, the hospital reduced the Covid-19 beds in its gynaecology ward from 120 to 22. However, on March 8, as cases in Mumbai began rising again, we were asked once again to increase the beds to 60," he said.
Dr Mahajan said Nair’s gynaecology and paediatrics wards have not registered a single death in the past six months and are now ready to handle a new wave of patients. "But I do hope people take better care of themselves by wear masks, maintaining social distancing and washing their hands frequently. I would not want a repeat of last summer."

Videos by Raju Shinde, Produced by Vinay Arote, Mansi Bhasin

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