Healthier Children Are The Future Of A Nation

Rainbow Children’s Hospital was set up in Hyderabad on 14 November 1999. In 2006 it became the first children’s hospital with a perinatal sub-speciality. The obstetrics, foetal medicine and gynaecology departments were also set up then and have together made a huge impact on child care in Andhra Pradesh and Telangana. The hospital developed numerous support services to optimise outcomes for expectant mothers and newborn babies like pre-pregnancy counselling, childbirth education classes, etc. In a conversation with BW Businessworld, Dr Pranathi Reddy, Clinical Director, Obstetrics and Gynaecology, at Birth Right by Rainbow Hospitals, emphasises the importance of integration of obstetric care services with childcare. 

Excerpts:

Please share your vision of integrated obstetrics services in a children’s hospital? 

First, let’s start with the scientific evidence. And there’s enough evidence actually that childhood and subsequently adult health is shaped right from the foetal (unborn baby) period. Therefore, for the child to be born in the best of health, supervision and care should start from the foetal period and it seems like a no-brainer that the best place for a child to be born is at a paediatric hospital because the first breath that the child takes should essentially happen in a hospital that will care for him or her for the rest of childhood. This can only happen if obstetrics (childbirth and pregnancy) is integrated into the children’s hospital. Childbirth alone cannot take place without providing the antenatal and foetal medicine services.

Do we need more children’s hospitals integrated with women’s healthcare? 

Absolutely. I think that makes a lot of sense. And it’s not something new. We always had this concept of maternal and child health. It was always there. And now it’s just a revival of that in a more scientific and structured manner. If you look at pregnancy and childbirth, this is actually a very important event in a couple’s life. All of us agree that it’s like a transition. And this transition into parenthood is like entering a territory, which is not familiar to them. I always feel when I cut the umbilical cord, I am cutting so much of my connection with this couple and leaving them to navigate uncharted territories on their own. They need to go look for services for their child, which is a very sensitive area. Hence if this child is born in a hospital, which can provide multidisciplinary care for the baby, I think that makes more sense. Therefore, world over perinatology is now becoming a sub-speciality of paediatrics. Rainbow Children’s Hospital was among the first corporate hospitals in the country to make this integration. And when we talk of perinatal services, there are three pillars, namely foetal medicine where we look after the unborn baby, obstetrics where we look after the mother during pregnancy and childbirth, and finally neonatal services where we look after the newborn baby. And if these can happen in a seamless manner under one roof, it provides a lot of comfort to the couple, both from a clinical perspective and even from a societal perspective.

Are there any challenges in the integration process? What do you think is the future of women and child healthcare in India?

At this point in time, the biggest challenge is raising awareness that integration is the best way forward. Governments, healthcare providers and people in general have to understand that this is based on science and has the additional advantage of convenience. Understanding the connections between a mother’s health and that of her newborn is crucial for addressing maternal and infant mortality and morbidity. The majority of maternal and infant deaths occur during pregnancy, childbirth or the immediate postpartum period. Ensuring that both mothers and babies receive timely, high-quality care during these critical periods is essential. And this can happen only with integration of services. Apart from awareness, there may be financial, human resources and societal challenges. It is no doubt expensive to set up a large multi-disciplinary perinatal service. Hiring and retaining clinical talent in the fields of obstetrics, foetal medicine and neonatology, who are willing to work together, is also no mean task.

From a societal perspective, women may find more personalised attention when they deliver in a maternity home, where only birthing occurs. And people may hesitate to come to bigger hospitals because it may seem overwhelming when it’s a multidisciplinary children’s hospital. And with regards to the future of a child and women’s healthcare, essentially in India, I think things are on the right track on a lot of counts at this point. The Government of India has taken significant commendable measures in this area and the private healthcare industry has also evolved with regard to maternal and child health. However, the journey is still long and it needs relentless consistency of perinatal healthcare models, both in the public and private sectors, to even reach sustainable development goals. 

Do you also think that maternal and child health needs more focus? And where do you think the change will 

come from? 

Yes, definitely maternal and child health is the beginning of establishing any form of good overall healthcare for a nation. If you shape a child’s health, you’re actually shaping the future of the nation. And the shaping of a child’s health starts right from the foetal stage when the baby is born or when it is in the mother’s womb. So definitely, if we focus on these areas, I think we will produce a healthier population going forward. Pregnancy is the time when I think you have a very captive audience to improve the overall health of the woman. You will find that pregnant women, their partners / husbands, families and healthcare providers are willing to invest a lot in improving a woman’s health during the period of her pregnancy. It is such an important period in their lives and they are willing to go to extra lengths to make it safe and successful. And therefore, pregnancy is the captive period that healthcare services and governments should use to optimise a woman’s health, be it through vaccinations, be it in improving her general health, be it in improving anaemia or be it in improving nutritional deficiencies. Everybody is a willing partner at this point of time — the healthcare providers, the woman herself and the family. And this is also a time when a woman definitely and voluntarily gets in contact with the healthcare system. She comes for checkups. In our country, it’s still rare for people, particularly from a rural background, to go for regular health checkups. So, a lot of focus needs to go into pregnancy care in our country, because it is a period when there is genuine opportunity to improve women’s health. And obviously, if you improve a woman’s health and take care of the foetal life, you will also produce healthier children who are the future of this nation.