The VBAC gone wrong

I know I said I won’t blog but I need to get this out there.  I know a lot of people have already blogged about it but more awareness is not a bad thing. I’ve been sitting on it for a while trying to get the media in on it and help Rashmi. A lot of people showed interest and I am in touch with Rashmi – but she says that she has been advised not to talk to the media right now. I respect that and I hope she finds peace and strength.  The unprofessionalism, the lack of proper care, absolute lack of compassion (You can conceive again?!!).. where does one begin??

So as of now, all this post serves is to warn others who might be forced into VBACs of what just might go wrong if the doctor is not responsible. I’m reproducing the email I received from her friend, below.

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I hardly know Rashmi. In the 30-odd days since I met her, I have grown to admire her courage and strength of conviction.

As many of you know, I have grown up around doctors, and tend to shy away from lending credence to “hospital horror stories”. As you also know, I tend to be a very unemotional person. And very hard to convince.

So it’s taken me a little over a month to agree to post this. A month in which I myself have presented the medical facts to several leading gynaecologists; met the medical services director of Wockhardt in an attempt to convince the hospital to conduct an unbiased investigation; done a lot of independent reading and research of my own. My conclusion: THIS IS JUST PLAIN WRONG.

Please do your bit to see that as many people as possible read it. Circulate it via email, via Facebook, and any other means you can think of. Talk about it. If it can help prevent even one more incident like this, it will have done its job. Hopefully, someone, somewhere will lend their voice to Rashmi’s.

Thanks.
Suman Bolar

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Rashmi’s Story

My name is Rashmi B.T. I am 35 years old, married to an air force officer, Vivek, and have a four year old son, Dhruv, delivered by emergency Caeserean section in 2004. On March 4th, 2009, my life was changed unalterably. I lost a baby that I had carried inside me, completely healthy, for a full 41 weeks.

I understand that doctors are human, that mistakes happen. However, I have come to believe that what happened to me could have been prevented if the doctor and the hospital had provided the most basic level of care and expertise. What’s worse, they refuse to take steps to prevent someone else going through the same nightmare, simply because they want to protect themselves from the possibility of litigation – something I am not interested in unless it is the only way to force them to change their protocols.

The Beginning

In June 2008, Vivek and I learnt that we were expecting our second child. The pregnancy was uneventful. I was healthy and fit. Every prenatal visit and test showed that the baby was healthy and developing well. During my 35th week, I decided to consult Dr. Latha Venkataraman at The Nest, Wockhardt’s Bannerghatta Road maternity facility to see me through the rest of my pregnancy.

Despite the fact that I had already undergone a C-section, she urged me to opt for a V-BAC (Vaginal Birth After Cesarean Section) or in layman’s terms, a normal delivery. She brushed aside my concerns, telling me that a second C-section would be six times more risky and assuring me that a V-BAC would be less risky and almost pain-free.

My due date was estimated as 26 Feb 2009. I visited Dr. Latha on 28 Feb. She wrote on my record: “delivery will be attended by Dr. Latha/Dr. Prabha.” Since I had neither met, heard of, nor been examined by Dr. Prabha before, I was concerned. Dr. Latha explained that Dr. Prabha Ramakrishna is another consultant at Wockhardt, and that it was a hospital requirement for her to write both their names down as possible attending doctors for my labor/delivery. However, she assured me that it was just a formality, and that she would be the one to attend to me when I went into labor.

On 3 March, I visited Dr. Latha again. Since I was so far past my due date, I requested that a scan be done to check on the baby.

When I called her to read out the results of the report, she did not want to know anything other than the liquor content, though I specifically asked her if there was any other information she would require from the scan. She told me I could either wait for labor to start or choose a day to come in and have my labor induced.

The Nightmare Begins
I went into labor at 2am on 4 March, and got admitted to the hospital at 5.15am.

By 7.45 am, I was experiencing contractions less than a minute apart. Dr. Latha came and did a quick examination. I was shifted to the labor ward at 8am where I remained until 1.50p.m., under the sole care of nurse Savitha. Dr. Latha was not present at all.

A junior doctor, Dr. Shirley, was available intermittently. She spent most of the time on her cell phone, talking to her husband. She was keen to see him before he left on an 11-day vacation. A Dr. Chetna substituted for her while when she went to see her husband off.

There was no other doctor present. Dr. Prabha was called each time the fetal heart rate fell (this happened a couple of times). She was seeing outpatients and attending two other deliveries simultaneously, so she was only able to come to the labor ward to see me four times, for less than 5 minutes each time.

At 10am, I was given Syntocinon, a drug used to enhance labor; the dosage was increased at 10.45am. At 12.30, there was vaginal bleeding, and the nurse phoned Dr. Prabha, who advised her to “keep a watch”. The bleeding reduced, but I began to feel pain of increasing intensity during contractions. Dr. Shirley reappeared at 1.00 p.m., examined me vaginally and announced that I was almost fully dilated and would deliver by 1.30pm. I complained several times of excruciating pain but was told that it was normal. At 1.30pm, Dr. Prabha came in and was told by Dr. Shirley that I was fully dilated and would deliver any minute. Despite that, Dr. Prabha breezed off to visit another patient in the OPD.

I felt no urge whatsoever to push, yet was asked to do so. The stirrup on the delivery table kept breaking off – I was told that this is a recurring problem that “needed attention”. At 1.50 pm, the fetal heart rate dropped to 80 beats per minute. Dr. Prabha was called again. She checked the fetal heart rate on the CTG, explained that this was normal when the baby was passing through the birth canal, and asked me to hold my breath and push hard. I felt no sensation in my cervical area, but felt intense pain tearing my stomach apart. I felt like my baby had rolled into my stomach and could see its body pushing up against my ribcage. I was screaming, pointing at my stomach, and telling them that my stomach was hurting, and there was no urge to push. But she told me to “push, push harder”. I then heard Dr. Prabha saying “Get the OT ready”. She told my husband that she was going to attempt to deliver by forceps – if that was unsuccessful, she’d have to do a Caesarian.

The OT wasn’t on standby, wasn’t ready. I was numb with pain. They wanted me to get up and move to the operation table. I couldn’t move. They eventually slid something under my back and I pushed myself on to the OT table, as there was no transfer stretcher available. I complained of severe shoulder and chest pain. No one paid me any attention; everyone was busy preparing the OT, and the anesthetist was attempting to top up my epidural. The fetal heart rate was never monitored in the OT. Dr. Prabha unsuccessfully attempted a forceps delivery at 2.20 p.m., and then cut me open. I heard a deafening sucking sound, after which I must have passed out.
Later, I learnt that my uterus had ruptured along the scar of my previous Caeserian section. My baby was found floating in my abdomen. He had no heartbeat and he wasn’t breathing. He had been deprived of oxygen for a long time – 43 minutes. They “resuscitated” my son and put him on a ventilator.

When I opened my eyes I saw Dr. Latha leave, followed by Dr. Prabha. Dr. Shirley was suturing me while laughing and talking with another nurse. I felt reassured that my baby was okay, even though I had neither seen nor heard him.
“Don’t Worry, You Can Conceive Again”
At 3.30pm, a nurse struggled to take my BP reading; the BP apparatus wasn’t working and had to be replaced. Dr. Latha met Vivek at the NICU and told him that the baby was doing fine and had to be kept under observation. She also told him that my scar had ruptured, but said that I was okay. At 4.30 pm, my husband repeatedly begged the nurses to give me pain relief. I was then shifted to the ward.

At 9.30 pm the neonatologist told Vivek that the baby had been deprived of oxygen for over 40 minutes, possibly resulting in “some extent” of brain damage. This was the first inkling we had that something had gone wrong.

The next morning, I was given a sponge bath at 6am. I then lay unattended until 2.30 p.m., when Dr. Prabha, Dr. Latha, and Dr. Prakash (the neonatologist) saw me for the first time after the operation. Dr. Latha unceremoniously ripped the dressing off my wound without using any gel or spirit, and pronounced the wound clean.

We were told that our baby would be kept under observation for another 24 hours. Later that night Dr. Latha came in at 9.50pm. Her only words to me: “Don’t worry, you can conceive again. Your uterus is intact.”
“Do Japa and Tapa To Get Better””
None of the consultants saw me on 6 March. That night, my milk came in, and my breasts became swollen and painful. I asked in vain for assistance. After repeatedly begging for help, I sent Dr. Latha a text message at noon on 7 March. At 4pm, a nurse told me that the doctor had instructed them to use a breast pump to relieve my pain – however, since the hospital didn’t have one, I would have to go and buy one.

Dr. Latha finally visited me at 7.30 pm. She confessed that she was unaware that there had been a 43 minute delay in performing my C-section. She also admitted that instructions delivered over the phone could never substitute for personal supervision. She said, and again I quote, “Do some pranayama, japa, and tapa to help you get better.”

Throughout my stay, nurses didn’t know what medication I had been prescribed. They kept asking me what medication I was to be given. They had to be repeatedly reminded to give me medication.

For the next 13 days, Arnav was in the NICU on a ventilator. Throughout that time, he was completely reliant on ventilator support, his eyes were dilated and non-responsive to light, and there was no sign of movement. After a week, the neonatologist asked me to express milk and said they would feed the baby with a pipe inserted from his nose to the stomach. I did this for the next six days.

On 16 March, we decided to let Arnav go. We requested that he be removed from life support.

“We Would Do Exactly The Same For The Next Patient Who Walks In”
Vivek and I wanted to learn what had gone wrong with such a healthy pregnancy. Basic reading indicated that scar rupture is a well-known risk when you attempt to deliver vaginally after a first C-section, and must therefore be monitored very closely by a doctor if attempted at all.

We met with the hospital administration and the doctors. All we wanted was an explanation. To hear the words, “I made an error in judgment”. Instead, we were met with a wall of defensiveness. Dr. Latha said that despite knowing the outcome, she would take exactly the same steps with the next patient who walked through her door.

I decided to get a second opinion. And then a third, and a fourth, and a fifth. Three of Bangalore’s best-known gynaecologists (and other doctors too) categorically stated that given my age (35), the estimated weight of the baby (> 4 kilos), and the duration of gestation (>40 weeks), a vaginal birth should never have been attempted, and scar rupture was a logical, obvious outcome.

All reading I have done has backed this up. Even a layperson’s book like “What to expect when you are expecting” (pages 363-364) says that abdominal pain during a V-BAC indicates a scar rupture and outlines the procedure for safe delivery of the baby. Given that I was complaining of excruciating abdominal pain, shoulder pain and chest pain, the doctor should have known my scar was rupturing. I should never have been asked to push; it exacerbated the rupture. Nor should I have been given a drug that intensified my contractions. By Dr. Prabha’s own admission, she did not know about the rupture until she opened me up.

Several doctors have also told us that keeping Arnav on the ventilator for 13 days was an exercise in futility from the first. At no point were we told that he would never survive if taken off the ventilator – had we known that, we would never have subjected him, or ourselves to two weeks of anguish. All we were told was that he “might be” brain damaged to “some extent” but they couldn’t predict how bad it would be.

A Brick Wall of Defensiveness; Discrepancies Galore

When I attempted to engage with the hospital to ask them to change their protocol of treatment based on an unbiased review conducted with the inputs of external gynecologists, I was met with a brick wall of defensiveness. They refused to conduct a fair, transparent investigation, claiming that their internal investigation showed that they had done everything right and that losing the baby was “my destiny”. Dr. Latha went so far as to say that since I am educated, I should have been better informed about the procedure.

I don’t want to sue them for money. I just want them to change their policies and protocols so that this doesn’t happen to someone else. I have been hitting a brick wall for two months, and feel that the only way to make them pay attention is to tell my story to people.

There are many discrepancies and attempts to cover up the hospital’s inefficiency (to name a few: baby’s weight recorded as 3Kg despite the fact that he was never weighed; post-facto note of fetal heart rate as 180bpm despite the fact that the heart rate was never monitored in the OT; discharge summary says “live term baby extracted” even though Arnav had no heartbeat or respiration at birth; half-hour discrepancy between CTG trace and labor room clock). I asked questions to which I was given ludicrous answers (Eg: Our pediatrician is very experienced, so he can guess the weight of any baby just by looking at it).

We were charged approximately Rs. 2,20,000 by Wockhardt. Of this, we found over Rs. 7000 billed for things that had never been done (spinal anesthetic, an extra day of room rent, food not consumed). We subsequently found more extraneous charges, amongst them an amount billed for tests that were performed on 18 March, two days after Arnav’s death.

My Story Has Just Begun…
My uterus is still healing. My back still hurts from the trauma. And my heart aches for Arnav, the baby I will never hold.

More than that, I am filled with the fear that this will happen again. After all, Dr. Latha says she would “do exactly the same again” even though she knows the outcome. And the hospital agrees that she – and they – did everything right.

Wockhardt delivers approximately 80 babies each month. With BP machines that don’t work, a delivery room stirrup that’s falling off and that has “needed to be fixed for a while”, nurses who don’t know what medication they are supposed to administer, and one (yes ONE) OT dedicated to emergency deliveries. That OT wasn’t ready when I needed it. What guarantee do you have that it will be ready when you need it? Sure, they claim to have nine other OTs in the hospital – but if they are all as woefully unprepared as the one I was in, my story could be yours.

I want them to change their policies, and I won’t give up until they do.

Thank you for reading.

Disclaimer: We have not contacted Wockhardt for their side of the story yet, and this is Rashmi’s side.

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179 thoughts on “The VBAC gone wrong

  1. I think it will take me several attempts to read her story, its so heart breaking, I keep giving up. Its easier to shield yourself than to know.
    And yes, may be the mother will have more children, she will have to move on…but what about the life thats gone now…a baby struggling for breath in his mother’s womb…this is gonna haunt me for a long time

  2. Thats the most painful story i’ve ever heard.
    I sit here with silent tears for the poor mother who lost a perfectly healthy baby due to the negligence of “responsible” doctors.

    My sister was planning on approaching Wockhardt Bangalore for her delivery…boy am i glad that she changed her mind at the last minute!!!

    ….and then, we talk of “reservations” for medical seats. In turn, losing out on skill and competence, specially when they are required the most!!
    Its sad, really.

    Noor.

  3. Oh my god, this should never have happened. How can the Dr. just say she will follow the same procedure again? Where is the sense of responsibility? its unscrupulous and heart-wrenching, that too after a full term healthy pregnancy. I will make sure all my friends read this.

  4. I dont have any words…..just plain shocked….hope Rashmi’s family gets some justice and peace.

    Thanks for sharing this MM

    -B

  5. Heartwrenching story. The courage Rashmi has shown is commendable. Being a new mom myself (via a c-section), I don’t know if I would’ve had the strength and courage to deal with the same strength as she does, had something similar happened to me. I can’t stop thinking of the insensitiveness with which this was dealt with, by the doctors, nurses, hospital staff and management. I pray for her mental strength and Arnav and her family and for the courage and strength to recover from this disaster that could’ve very well been prevented.

  6. My god. It’s finally happened. You’ve shocked me into silence. This is absolutely outrageous, unacceptable and reprehensible to the highest degree.

    Litigation MUST be resorted to. There is prima facie gross criminal negligence leaping out here, and I can’t imagine any judge would refuse to admit a suit or criminal complaint against Wockhardt. I feel like doing a public interest on their behalf.

    At any rate I will certainly take this up with my folks as well as two senior doctors I know in Bangalore.

  7. This is really horrifying! How can they run a hospital with such negligence and apathy? I hope the right action is taken to stop this.

  8. I just read the story from the mother’s side and it sounds insane. There were so many errors made by the staff, it makes you wonder how they keep afloat and I am pretty sure that such a complication has happened before with them and their negligent care. I hope that they do something to change things at this facility. Someone needs to be held responsible and even fired.They would need to take a stand if they want to continue having mothers putting their faith into their hands. 80 babies a day is a huge number for a facility with broken BP machines.

    sorry for having such a harsh response but women in my family have been through similar experiences and its just not fair that it happens still. its freaking 2009 people not the damn dark ages.

  9. omg,

    this is the first time i’m reading about this..i’m so numb…its shocking! hope she finds the strength to go through this

  10. My god! This is the most painful story I’ve ever read. Still can’t believe the level of negligence and incompetence. As I write this, I have tears rolling down my face. And, I wish I could do something! Will link to your post on my blog, MM. This deserves as many readers as possible.
    And I wish all the peace and love that they need, for Rashmi and Vivek.

  11. we trust the doctors with two lives and this is how they treat us?? reading it till the end was not easy MM.. I am sure God has given Rashmi some tremendous courage to live through it..
    how can such doctors be allowed to practice further??
    How will any expecting mother ever go to the delivery room after reading such an account?

    will it not shake our faith?
    its scary..

  12. Pingback: Medical Negligence « Three Drinks Ahead

  13. WHY IS THIS NOT IN THE NEWS???! Why is it that nothing has been done about it?

    Me: she’s unwilling to do so right now. i asked her.

  14. MM, if Rashmi needs any help at all – in getting through to the media – and I know you’d probably know everyone too – but if you need any help, do let me know.

    Also, I wish she would speak to the media. You and I both know how the media does go wrong a lot of times, but I really feel like this does need to reach a lot more people than it can through blogs/FB.

    Me: I told her yaar. In fact am in touch with her and got 2-3 channels to mail her too. But she’s been advised not to talk about it right now. So I figured I should respect that and just put her experience out here for others to learn from. She’s okay with this kind of awareness being spread

  15. Bloody hell..my eyes are so full of angry tears right now…

    I hope the hospital learns a lesson and doesnt repeat this with someone else.

    And hope she gets the strength to get through this.
    Do some japa?What BS!!!

  16. Can’t we do anything to prevent this further?

    we don’t trust our small town doctors and constantly criticize the facility available there, but these big fancy hospitals… what about them? this is MURDER. the thing should definetly be in news so that those who don’t know about these doctors and are consulting them get warned and are prevented from any mishappening.

    i don’t know what to say, this is so horrifying and maddening.

  17. This is nightmarish!! How dare that doctor kill a baby and be so blase about it. She should be punished.

  18. This is horrifying. We place our entire life in the hands of the doctor…how can they be so callous…. ???

  19. I was so nauseated on reading this story, feels liks someone punched me in the stomach.

    After losing my first baby, I planned to deliver my second in the US. For almost nine months, I planned,’practised’ and educated myself for a VBAC. The docs were all pushing it too. But a midwife said to my husband, “Why’re you taking such a risk? You’ve lost one child, just opt for a C-section and ensure your wife’s and second child’s safety. I was so angry then and several months later at ‘being denied a normal delivery’ and having to undergo another major surgery, but maybe she was an angel who saved me and my daughter?

    Because one of my friends has had her scar start to rupture in Detroit during a VBAC, luckily they detected it, and pulled the baby out by vacuum, and yes they had an OT ready too for an emergency C.

    Another in Atlanta tried so hard for a VBAC, she even had an episiotomy, and then horrors, had to have a C- anyway, she then had to recover (ironically) from a normal AND C delivery. She cursed those US doc for putting her thru’ that when she had to have a C anyway.

    VBACs need a lot of expertise and monitoring for sure…there’s too much hype about the superiority of VBAC over repeat C-sections. In the end, if mom and child are ok, isn’t that what’s impt? I will forward this story to all.

  20. Pingback: VBAC…things to ask your doc if you’re considering one « Sense and Sensitivity

  21. I am shell shocked…Good lord, I have nothing to say… too shocked to react…
    Medicine is the most sacred preofession but if there is such attitude from those who practice it, what is the future?
    BTW, I am new here…intend to keep visitng, though the first post was quite of a shock!

  22. Reputations take a lifetime to build, is it right to destroy them without understanding true facts and make a hospital and its doctors look inhuman? The true facts of Ms Rashmi BT’s case

    Ms. Rashmi B.T. was under the care of a senior gynaecologist in Bangalore for her second pregnancy. She had a breech presentation (where the legs of the baby present itself first instead of the head during the time of delivery) in the earlier pregnancy which required a C-Section. She made a conscious decision to shift under Dr. Latha Venkatram’s care at Wockhardt Hospitals, Bangalore in the 35th week of her pregnancy largely because she was aware that Vaginal Birth after Caesarian Section (VBAC) was an option and wanted to select that option for her second delivery. She had collected information that Dr. Latha Venkatram was one of the senior gynecologists in the city who offered this option to her patients. From the OPD records filed by Dr Latha Venkatram it is evident that Rashmi was counseled and given ample information about the procedure and the risks associated with it and she took an informed choice to select this procedure.
    Vaginal Birth after Caesarian Section (VBAC) is the term used when a woman gives birth vaginally, having had a caesarian delivery in the past. Worldwide VBAC, if possible, is being recommended and preferred over repeat C-Sections as its advantages substantially outweigh the disadvantages. According to the Royal College of Obstetricians and Gynaecologists patient information guideline 2008 “Birth after previous Caesarian Section”, overall three out of four women with an uncomplicated pregnancy would give birth vaginally following one caesarian section delivery. The short-term and long term complications inherent in a C-Section make it preferable that a woman is offered the choice of a VBAC. The American College of Obstetricians and Gynecologists and have set a goal of 37% VBAC deliveries by 2010
    Repeat Caesarian sections are associated with:
    o A possibly more difficult operation
    o Longer recovery period
    o Possibility of injury to bladder or bowel
    o Possibility of blood clots developing in legs and pulmonary thrombosis
    o Breathing problems for the baby. Higher in C-Section than in VBAC
    o Serious risks increase with every Caesarian delivery
    o Higher chance of infection
    o Future complications for the mother who has had repeated opening of the abdomen
    o Higher costs
    VBAC has a shorter stay in the hospital, faster recovery as well as lower cost for the patient. There is a risk of uterine rupture but this risk is approximately 0.5%. In spite of this risk the benefits of VBAC far outweigh the risks. As in all medical procedures there is no way to predict which patient would fall under the 0.5% risk of uterine rupture or any way by which this rupture can be prevented. A VBAC delivery is more demanding of the gynaecologist, as it takes 6-8 hours as compared to a C-Section, which in a planned fashion would be over in less than 40-45 minutes. Also the mother and child need close monitoring it is estimated that one will have to do as many as 200+ unnecessary C-Sections to prevent the occurrence of 1 uterine rupture. In most cases a uterine rupture is not fatal. However in the best interest of Ms Rashmi, Latha Venkatram gave her both the choices and Ms Rashmi chose to opt for the VBAC option.

    Ms. Rashmi B.T. was a fit candidate for a VBAC. She had a breech presentation in the earlier pregnancy which required a C-Section. A breech presentation in the earlier pregnancy which necessitated a C-Section is in fact an indication to offer a VBAC to the patient in the subsequent pregnancies. An age of 35 is not a contraindication to a VBAC. The fact that she was 5 days past her due date was also not a contraindication to a VBAC because less than 5% of patients deliver on their due date.
    During her antenatal visits to Dr. Latha Venkatram, Ms Rashmi B.T. was explained in detail about the pros and cons of VBAC and she agreed to undergo the procedure. The OPD case records have these notations. She was also clearly informed by Dr. Latha Venkatraman that she works along with Dr. Prabha Ramakrishna as a team and either of them would be present during her delivery. Doctors particularly in the area of obstetrics frequently prefer to work as a team since many times an emergency may hold one of them which would make it possible for the other team member to attend to the delivery as the date and time of delivery cannot be predicted. In a VBAC considering that a consultant needs to be around for most of the labor period it is prudent that a team takes care of the patient. Both Consultants of the team Dr. Latha Venkatram and Dr. Prabha Ramakrishna are Fellows and Members of the Royal College of Obstetricians UK.

    Ms Rashmi B.T was admitted to the hospital early morning on the 4th of March 2009 in spontaneous labour. She was connected to monitors for a close monitoring of both maternal and fetal parameters. She was visited by Dr. Latha Venkatram soon after admission. An experienced nurse and a fully qualified gynaecology registrar were monitoring her constantly. The Consultant Dr. Prabha Ramakrishna was also available on the same floor and repeatedly examined her. She was kept informed about the progress of the labour.
    The labour progressed normally until 1.50 p.m when a sudden decrease in the fetal heart rate was noted (fetal bradycardia). The tracings before 1.50 p.m were normal. The moment fetal bradycardia occurred, the consultant Dr. Prabha Ramakrishna who was on the same floor was called in by the gynecology registrar. When Dr. Prabha Ramkrishna examined Ms Rashmi, the baby’s head position was a little high. She was asked to push to see if the baby’s head would come to +2 position in which case she could do a forceps in the labor room itself and deliver the child. When the baby’s head did not descend as required she asked for the patient to be shifted to the Operating room. After this Ms.Rashmi was not asked to bear down any further.

    Shift to the OT was rapid since the dedicated Operation Theatre for Caesarian sections is situated within the labour room complex and this theatre is not used for any other procedure. Within 7-8 mins the patient was in the theatre. The anesthetist had a choice of going in for an emergency general anesthesia which has inherent risks for a pregnant woman or to go in for epidural anesthesia. Since the patient was already receiving pain medication (epidural analgesia) it was decided that for the safety of the mother increasing this analgesia to achieve anesthesia was the preferred option. In the OT the fetal heart rate was recorded as 180 b.p.m on the Doppler. On the OT table an examination was done and it was found that the head had receded and a forceps delivery was not attempted. An immediate emergency C-section was then performed.
    The anesthetists, Neo-Natologists and the surgical nursing team had assembled in the theatre within a few minutes of the emergency being declared. The hospital has full- time anesthetists, Neo-Natologists and a surgical nursing team working round the clock to attend to all kinds of medical emergencies.
    At the time of birth the baby did not have a heart beat or respiration. Resuscitation was started and the heart beat started about half a minute later. The child was immediately shifted to the Neonatal ICU and put on the ventilator. The baby’s weight at birth has been recorded in the NICU as about 3 Kg. The only reason an exact weight could not be taken in the NICU was that the child was already attached to various lifesaving equipments and the neonatologist had to make the closest estimate. However it must be noted here that a birth weight of 4 KG is not a contraindication for a VBAC.

    In the neonatal ICU the clinical team met the family on a daily basis and kept them informed about the status of the baby and the prognosis. The poor prognosis was explained to the parents on the 2nd day itself. An opinion from an external eminent neonatologist was also sought who concurred with the poor prognosis. All decisions regarding further care were made only after extensive discussions with the parents of the baby. Dr.Prakash Vemgal our Neo-Natologist is not only highly experienced but has also gone through some of the highest training in Neo- Natology in high patient volume and reputed international centres.
    The doctors and the management (including senior management personnel) of the Wockhardt Hospitals group spent long hours with the parents understanding and trying to address their concerns. As is the normal practice in such a case a complete internal review was done. The family sent to us a detailed list of areas they wanted us to look into during our investigation. We did go into each of these areas and sent them a detailed reply addressing most of these issues including taking the opinion of two leading and senior external gynecologists of the city who do substantial VBAC work. It is unfortunate to note that inspite of providing her all clarifications Ms Rashmi has been projecting an extremely poor image of Dr. Latha Venkatram and the hospital.
    Our internal review involved discussions with our own team of gynaecologists, meetings with two external gynaecologists who practice VBAC and the entire clinical care team. Our findings after this detailed internal review are summarized below.
    a. Ms Rashmi BT was a fit candidate for a VBAC. She would have been offered this procedure as a first choice by any gynecologist or hospital which practices advanced obstetrics anywhere in the world. Her age or the week of pregnancy were not contraindications to go in for a VBAC.
    b. She had made a conscious and informed decision about going in for a VBAC. She had changed her senior gynecologist whom she was consulting until the 35th week of her pregnancy primarily because that gynaecologist was not in a position to offer VBAC.
    c. The OPD case notes of which she was given the duplicate copy recorded that she was willing for VBAC and she was informed about all risks of her decision.
    d. Both the mother and the child had been monitored carefully right through the labour
    e. All medications used for progressing labor were prescribed agents and safe for use in VBAC
    f. She did have a uterine rupture which in VBAC carries a risk of 0.5%. This rupture could in no way be predicted or prevented. In spite of the rupture the gynecology team was able to save the uterus for future child bearing.
    g. The Operation theatre was ready at the time it was required.
    h. All the staff were present in the Operation Theatre within a few minutes of the emergency being declared
    i. While the baby was in the NICU Dr.Prakash Vemgal the head of Neo-Natology met up with the parents at regular intervals and kept the family clearly informed about the status and prognosis. All major decisions were taken only after discussion with the parents.
    j. Senior management of the organization met up with the family on multiple occasions to understand and address their concerns
    A minute by minute account of her story as is being spread through the various emails circulated by various people who were neither physically present during her admission to the hospital nor were involved in her care process exhibits to us a determined effort to harm the reputation of the gynecologist and the hospital without having any understanding of the clinical facts of the case.
    Is medicine now going to be judged through the lens of only opinions running across chain mails or through the untiring efforts of institutions and doctors which toil endlessly to save lives but remain spectators to their actions being judged by emotive outbursts?
    We do understand the pain and suffering of Ms Rashmi BT. As a hospital every life is precious to us but we are also are in the world of medicine where unfortunate rare complications can be counteracted but every procedure cannot be made risk free. There are many lives which we save each day when all has been given up and each such case teaches us that to pursue medicine is to pursue the limits of the unknown but does that mean that we become victims of public misinformation
    We have taken all necessary care and followed every medical protocol that any reputed institution across the globe would have followed. However it is unfortunate that even though Ms Rashmi has not been a victim of any medical negligence she has chosen by this random spread of irrational mails to use a redressal system that is purposely harming the reputation of Dr Latha Venkatram, Dr.Prabha Ramakrisha and our institution.

    The case can be subjected to analysis by any competent authority.

  23. This is one of the most heart-breaking things I have ever read! I feel so sad and helpless reading this.

    Please tell her, that the only way to get the hospital to change its policies and to get an apology that she so richly deserves, is if she takes this to the media. She should publish this letter, as is, in all the leading dailies and magazines in the country.

    My heart and my prayers go out to her…

  24. I find it hard to go beyond, ‘Don’t worry, concieve again’… My heart goes out to Rashmi and her family. I can only hope spreading this aroud will save a few from a similar ordeal.

  25. When I consulted a doctor for a VBaC, he spent an hour talking to me. I was very keen on it, and he was most supportive. Told me endlessly that for VBaCs it is imperative that a fully qualified OB/GYN stay IN THE ROOM with the patient from the onset of the labor to the delivery. Even if that means 18 hours of sitting on a chair. Which is why many hospitals/doctors in the U.S don’t offer VBaC. A doctor’s office/residence needs to be within 7 minutes from the hospital in order for them to qualify to do a VBaC. Amazingly enough, the doctor I met seemed so committed that I had convinced myself to go ahead with a VBaC. Just as we were leaving, my husband asked him – “What would you do?”. He turned to him and said – “If it were my wife I would reco a repeat C sec”. That made our decision for us.

    I have agonized over this forever MM, and my heart bleeds for Rashmi. This could have been my story, in more ways than one! Tragic. I hope she has the strength to get through this.

    Me: you know – I thought about it too. I wanted a VBAC so badly and as I read this the horror sinks in as I realise it could have been me. thankfully my doctor didn’t allow it for the very reasons listed. the morning of my csec she told me that she’d just seen another doctor’s VBAC patient rupture – and despite being a doctor herself, i could see the horror in her eyes.

  26. u know, though u’ve posted the hospital’s reply – i just dont believe it.

    after my own experience of a C section at this “supposedly” good hospi, and all their goof ups and cover ups – i find it difficult to believe/trust hospitals in general.

    they r just not going to acknowledge that they made a mistake. they’ll cook up reports & records to cover their tracks. how can anyone actually verify whether xyz report/measurement was actually done when required, or the papers just filled out afterwards.

    I wish there were a way to bring such callous hospitals to book.

    Rashmi atleast had the courage to speak up. Many more women go through callous & indifferent treatment from hospital staff during & after delivery. Many not to this extent. And if the child is all right, we put up with it…

  27. This was heartbreaking and the worst was that it in spite of the lenghty comment up here from Wockhardt, Rashmi’s version is only too believable. It was inhuman what she had to suffer through. I hope her courage carries her through this painful trauma.

  28. @ WockhardtHospitals

    Thank you for sharing your internal review. However please do note that apart from the advisability of a VBAC, which is prima facie a controversial issue, your explanation does not appear to present a different set of facts, but merely a different interpretation of the same set of facts set forth by Ms Rashmi.

    Could you please clarify when exactly, according to your internal review, the uterine rupture occurred? That seems to be of paramount importance here, yet it has not been discussed at any length.

  29. Thanks a ton MM for posting this story. Though the rest of us had blogged about it, only this time, and only in response to your post, did they come back with their own story, which nonetheless has too many holes to be even discussed.
    For instance, if the fetal heart rate was being constantly monitored, at what point did it slip to 0 from 180?
    If the mother was being constantly monitored, how come the rupture and the abdominal pain went unnoticed?
    But chuck it, i dont want a rejoinder from Wockhardt. My own previous experience with them tells me enough. They are free to give this story to whoever they want.

    Me: You’re right – even their explanation lacks conviction – even if there is some truth to it.

  30. I read the hospitals note with interest. I’m sure the truth lies somewhere in between but while the patient made an ‘informed decision about VBAC’ we still expect the doctors to give us the right advise. Even if patients point of view maybe half correct, the hospitals view is half wrong. I do believe that the death of the baby could have been avoided.

  31. I come to your blog on and off..today as I started reading this..I called my husband half way through it because I knew I could not read it alone! I just had a miscarriage 3 months back and it was my first pregnancy..I am still traumatized by the whole experience..even when I was 2 months along..on the other hand I just can not imagine Rashmi’s situation!!! I have no idea how she is coping with it. Please extend her all my wishes and prayers! I read Hospital’s reply and frankly it sounded such a BULLSHIT!!

    Me: oh Good Lord. I’m so sorry. Please dont read all this. Its not what you need right now.

  32. Hi everyone,

    I have personally met with the medical services director and the customer services head of Wockhardt regarding this case. Disagree with Wockhardt’s rebuttal on a couple of points:

    1. Rashmi did not shift to Dr. Latha in her 35th week because she “wanted” a VBAC. She shifted because she was until that time in Jammu, where her husband was posted. A cousin of Dr. Latha’s referred her to Dr. Latha. Rashmi had never heard the term “VBAC” until Dr. Latha brought it up.

    2. Although the ROCG does prescribe certain guidelines they are meant for women with the build of a Caucasian, not for Indian women; also, we lack the kind of processes and facilities that are available in the West, as this case clearly indicates.

    3. The so-called “notations” in the OPD file indicating that risks, pros and cons were discussed with her is simply a scrawl on a prescription pad which says “VBAC discussed with patient”. In fact, I had asked Dr. Lloyd Nazareth, the Medical Services Director, the specific question: “What is the process Wockhardt follows for ensuring that a patient has understood the risks of a particular procedure? For example, do you hand out a pamphlet that explains the process and then take a signature saying “read and understood”? His answer: “We have no such process. In this case, the words “procedure discussed” have been written on a prescription pad by the consultant gynaecologist, and we as hospital management take this to imply that the consultant has explained a procedure in-depth, discussed its risks, and addressed a patient’s concerns regarding the procedure.” I then asked how the word “discussed” could measure the quality of a discussion, and got no response. The hospital lacks basic processes for obtaining a patient’s informed consent.

    I won’t even bother further refuting Wockhardt’s response, except to ask why the poster has not addressed the following issues:
    Fraudulent billing; post-facto notations on patient records (in different colored inks, no less!); lack of basic working apparatus…

    Makes me want to either laugh, or be sick.

    Me: thanks for stopping by Suman. I really appreciate hearing from someone who is personally in touch with Rashmi too.

  33. but whyyyy is she not willing to let the world know what kind of hospital that is??! I googled the hospital, and all that comes up is their website and all sorts of info about how they are the greatest and the best in healthcare, when clearly, they’re anything but! It’s only if we google more specifically do we get linked to blogs that have written about this incident. This happened in March, it’s June now. The world should know, don’t you think?

    Me: she *is* willing to let the world know which is why she sent the mail out and asked people to forward it. but she isn’t willing to talk on TV or go to court – for whatever her personal reasons. I didnt press her for reasons – just sorta respected how much she was willing to share.

  34. gives me gooseflesh…
    imagine a reputed hospital like wockhardt n what parameters of a patient’s safety n we complain about the lack of medical facilities in small towns of india..to top that a bill of 2.20 lakhs for a dead baby and the mental trauma..great
    the expalnation of the hospital as published by you is not very assuring..
    the patient goes to the doctor with her set of apprehensions, what she understands or not depends on how skillfully the doc explains each thing to her.if my doc assures me that i will sail thru A particular procedure without risk then obviously i ll trust her n think that she is in chrage of me n she will weigh the pros n cons n take decisions keeping me informed with the whys n the hows.
    may be it was just case gone wrong with the hospital or may be one case which reportedlly went wrong but what about the mental scarring that the patient n her family went through.n why were the hospital staff repeatedly telling her not to worry n that she can conceive again.
    i am in my 3rd trimester n live in a small town of UP.n it is really scaring me that if things can go wrong in a city like bangalore with a senior gynae. what is there in store for me.
    one more thing- if the hospital finds it so unnerving that a patient registers with them when she is near term why dont they make a rule denying such entries.they shoukd take the cases which have been with them for a particular time frame only.

  35. This was really heart wrenching. Although I’m still 19 and non-married. But it has pained me so deeply, words just can’t explain.

    May God give her the strength.Amen

  36. Wow, this reeks of malpractice every which way – unfortunately something I am familiar with.

    I almost lost my firstborn, but was “lucky” to get away with a permanently damaged arm or a Brachial plexus injury as it is known.His entire left arm was paralysed at birth. Given that the options could have been CP,a greater brain damage or death, we considered ourselves lucky. We fought this tooth and nail because I (a small indian married to a large Viking) should never have been allowed to have a normal delivery to begin with. We were never informed of the risks, Arvind came 10 days after his due date, and the labour was completely mismanaged.

    What we did see in the two years since was that doctors will do anything to save their hides..their reponse to us was to drown our case with tomes of medical literature and that you couldn’t possibly understand without a medical background. Fortunately, I come from a family of doctors and excellent ones at that, but inspite of a spirited fight, we came up short. This in spite of the fact, that this particular hospital has been in the press for all sorts of malpractice cases.

    My point was Reshmi’s. I didn’t care so much about the financial but so much as I wanted them to have propoer procedures in place. I wanted them to factor ethnicity and related stuff into their assessments. It didn’t work unfortunately.

    On the sunny side though,living in Norway, national healthcare covered Arvinds two exhorbitant operations (200.000 dollar a pop) abroad and done by the finest in the field, in London and Bergen. We never had to pay a cent and he has regained movement and the use of his arm like any other child. He will always have a minor deficit though.

    My heart bleeds for children I know in India who will never have these options, and have to simply with the mistakes made by a negligent doctor. And even more for those children who never make it out alive. This was just so hard to read:-( Too close to what could have been.

  37. I read this yesterday and was too shocked.
    The hospital’s response just to me shows that they are not ready to review why it happened as they have the attitude that “we cannot do any wrong.”
    And what kind of a reponse is “you can conceive again” from the medical staff. And what kind of a response is do japa and tapa?
    I read those as callous.
    I wish medical liability suits against doctors were more common in India. It seems they have nothing to fear now.
    I was unsure as to why Rashmi went to this doctor so late in her pregnancy. But thanks to the clarification from Suman Bolar about this. The hospital put a spin on that too.
    The time you spend on spinning the story can be spend on taking a second hard look at why this happened.
    43 minutes without fatal heart beat does not show that an OT was on the ready.
    And to think that these hospitals charge an arm and a leg for such procedures and this is the level of care.
    And the hospital is very silent on the allegations of the falsely done up bills.
    And Dr. Latha if you read this may be you should go upto the Himalayas and do some tapa. Like forever.

  38. And drop in fetal heartbeat was noticed at 1:50 and the baby was delivered at 2:30 or so? That doesn’t show “within minutes” as the hospital says.

  39. This was such a horrific story. It hit really close to home – as both my babies were delivered in the most dramatic of circumstances. Not to mention the horrors i underwent during the one miscarriage that i had.

    What is really scary is that i had a first c-sec, then a miscarriage and then the third was born by VBAC (a term i had never heard of till this moment). The drama surrounding each of these are stories by themselves; but the disturbing part is that i was not told anything about the possible risks of a VBAC (that completely unfamiliar term again :(). Considering how everything possible that could go wrong – did – during both the deliveries – i can only say i was extremely lucky (?!!) and blessed – for the doctors that i went to each time (though the doctor for the first delivery i met only the morning after my membrane ruptured prematurely and the second did not warn me of the risks inherent in a VBAC !!!).

    I have two healthy children (touchwood) and can only be really horrified for Rashmi as it could so very easily have been my story out there.

    I hope she has the strength to fight the hospital and WIN!!!

  40. And how exactly does one concieve and carry the child to term after a uterine rupture? Isn’t that dangerous for the mother’s health? I know there will be statistics saying its ok, but so are uterine ruptures in VBAC, and Rashmi is unfortunately one of them.

    Rashmi, God please give you strength to get you through this unfortunate incident. I cannot begin to image how hard it must be for you!

  41. This is so totally horrible.. I hope Rashmi finds the strength to go through all this. And something really must be done regarding accountability in hospitals…am sure trhis isnt a one off case.

  42. Disastrous!! its so shocking to read this. I just hope Rashmi will fight it back till the end. Her loss is irreversible but surely her fight will make sure others do not a similar story to tell.

  43. We write to you in connection with the story of Rashmi BT’s experience at Wockhardt hospitals. While we are firmly behind her at this time of extreme grief as an institution we thought it appropriate to bring it to the public domain our version and what we believe actually happened The below mail gives you the complete details of the case.

    However in case anyone of you does not have the time to go through the same in detail we would like to let you know that Wockhardt Hospitals had followed all the necessary medical protocols that any reputed institution across the globe would have followed. We have always tried to question the limits to which medical science can progress and have been also largely responsible for the positive changes that the Indian healthcare industry has been witnessing in recent years. It is but unfortunate that certain risks in medicine cannot be completely mitigated how much ever one might strive.

    Please do read our version and if you find it convincing forward the same to whoever you might think appropriate.
    Reputations take a lifetime to build, is it right to destroy them without understanding true facts and make a hospital and its doctors look inhuman? The true facts of Ms Rashmi BT’s case
    Ms. Rashmi B.T. was under the care of a senior gynaecologist in Bangalore for her second pregnancy. She made a conscious decision to shift under Dr. Latha Venkatram’s care at Wockhardt Hospitals, Bangalore in the 35th week of her pregnancy largely because she was aware that Vaginal Birth after Caesarian Section (VBAC) was an option and wanted to select that option for her second delivery. She had collected information that Dr. Latha Venkatram was one of the senior gynecologists in the city who offered this option to her patients. From the OPD records filed by Dr Latha Venkatram it is evident that Rashmi was counseled and given ample information about the procedure and the risks associated with it and she took an informed choice to select this procedure.
    Vaginal Birth after Caesarian Section (VBAC) is the term used when a woman gives birth vaginally, having had a caesarian delivery in the past. Worldwide VBAC, if possible, is being recommended and preferred over repeat C-Sections as its advantages substantially outweigh the disadvantages. According to the Royal College of Obstetricians and Gynaecologists patient information guideline 2008 “Birth after previous Caesarian Section”, overall three out of four women with an uncomplicated pregnancy would give birth vaginally following one caesarian section delivery. The short-term and long term complications inherent in a C-Section make it preferable that a woman is offered the choice of a VBAC. The US Federal Government in its healthy people report 2010 proposed a target for VBAC of 37%.
    Repeat Caesarian Sections are associated with:
    o A possibly more difficult operation
    o Longer recovery period
    o Possibility of injury to bladder or bowel
    o Possibility of blood clots developing in legs and pulmonary thrombosis
    o Breathing problems for the baby. Higher in C-Section than in VBAC
    o Serious risks increase with every Caesarian delivery
    o Higher chance of infection
    o Future complications for the mother who has had repeated opening of the abdomen
    o Higher costs
    VBAC has a shorter stay in the hospital, faster recovery as well as lower cost for the patient. There is a risk of uterine rupture but this risk is approximately 0.5%. In spite of this risk the benefits of VBAC far outweigh the risks. As in all medical procedures there is no way to predict which patient would fall under the 0.5% risk of uterine rupture or any way by which this rupture can be prevented. A VBAC delivery is more demanding of the gynaecologist, as it takes 6-8 hours as compared to a C-Section, which in a planned fashion would be over in less than 40-45 minutes. Also the mother and child need close monitoring it is estimated that one will have to do as many as 200+ unnecessary C-Sections to prevent the occurrence of 1 uterine rupture. In most cases a uterine rupture is not fatal. However in the best interest of Ms Rashmi, Latha Venkatram gave her both the choices and Ms Rashmi chose to opt for the VBAC option.
    Ms. Rashmi B.T. was a fit candidate for a VBAC. She had a breech presentation (where the legs of the baby present itself first instead of the head at the time of delivery) in the earlier pregnancy which required a C-Section. A breech presentation in the earlier pregnancy which necessitated a C-Section is in fact an indication to offer a VBAC to the patient in the subsequent pregnancies.
    An age of 35 is not a contraindication to a VBAC. The fact that she was 5 days past her due date was also not a contraindication to a VBAC because less than 5% of patients deliver on their due date.
    During her antenatal visits to Dr. Latha Venkatram, Ms Rashmi B.T. was explained in detail about the pros and cons of VBAC and she agreed to undergo the procedure. The OPD case records have these notations. She was also clearly informed by Dr. Latha Venkatraman that she works along with Dr. Prabha Ramakrishna as a team and either of them would be present during her delivery. Doctors particularly in the area of obstetrics frequently prefer to work as a team since many times an emergency may hold one of them which would make it possible for the other team member to attend to the delivery as the date and time of delivery cannot be predicted. In a VBAC considering that a consultant needs to be around for most of the labor period it is prudent that a team takes care of the patient. Both Consultants of the team Dr. Latha Venkatram and Dr. Prabha Ramakrishna are Fellows and Members of the Royal College of Obstetricians UK respectively.
    Ms Rashmi B.T was admitted to the hospital early morning on the 4th of March 2009 in spontaneous labour. She was connected to monitors for a close monitoring of both maternal and fetal parameters. She was visited by Dr. Latha Venkatram soon after admission. An experienced nurse and a fully qualified gynaecology registrar were monitoring her constantly. The Consultant Dr. Prabha Ramakrishna was also available on the same floor and repeatedly examined her. She was kept informed about the progress of the labour.
    The labour progressed normally until 1.50 p.m when a sudden decrease in the fetal heart rate was noted (fetal bradycardia). The tracings before 1.50 p.m were normal. The moment fetal bradycardia occurred, the consultant Dr. Prabha Ramakrishna who was on the same floor was called in by the gynecology registrar. When Dr. Prabha Ramkrishna examined Ms Rashmi, the baby’s head position was a little high. She was asked to push to see if the baby’s head would come to +2 position in which case she could do a forceps in the labor room itself and deliver the child. When the baby’s head did not descend as required she asked for the patient to be shifted to the Operating room. After this Ms.Rashmi was not asked to bear down any further.
    Shift to the OT was rapid since the dedicated Operation Theatre for Caesarian sections is situated within the labour room complex and this theatre is not used for any other procedure. Within 7-8 mins the patient was in the theatre. The anesthetist had a choice of going in for an emergency general anesthesia which has inherent risks for a pregnant woman or to go in for epidural anesthesia. Since the patient was already receiving pain medication (epidural analgesia) it was decided that for the safety of the mother increasing this analgesia to achieve anesthesia was the preferred option. In the OT the fetal heart rate was recorded as 180 b.p.m on the Doppler. On the OT table an examination was done and it was found that the head had receded and a forceps delivery was not attempted. An immediate emergency C-section was then performed.
    The anesthetists, Neo-natologists and the surgical nursing team had assembled in the theatre within a few minutes of the emergency being declared. The hospital has full- time anesthetists, Neo-natologists and a surgical nursing team working round the clock to attend to all kinds of medical emergencies.
    At the time of birth the baby did not have a heart beat or respiration. Resuscitation was started and the heart beat started about half a minute later. The child was immediately shifted to the Neonatal ICU and put on the ventilator. The baby’s weight at birth has been recorded in the NICU as about 3 Kg. The only reason an exact weight could not be taken in the NICU was that the child was already attached to various lifesaving equipments and the neonatologist had to make the closest estimate. However it must be noted here that a birth weight of 4 Kg is not a contraindication for a VBAC.
    In the neonatal ICU the clinical team met the family on a daily basis and kept them informed about the status of the baby and the prognosis. The poor prognosis was explained to the parents on the 2nd day itself. An opinion from an external eminent neonatologist was also sought who concurred with the poor prognosis. All decisions regarding further care were made only after extensive discussions with the parents of the baby. Dr.Prakash Vemgal our Neo-natologist is not only highly experienced but has also gone through some of the highest training in Neo- natology in high patient volume and reputed international centres.
    The doctors and the management (including senior management personnel) of the Wockhardt Hospitals group spent long hours with the parents understanding and trying to address their concerns. As is the normal practice in such a case a complete internal review was done. The family sent to us a detailed list of areas they wanted us to look into during our investigation. We did go into each of these areas and sent them a detailed reply addressing most of these issues including taking the opinion of two leading and senior external gynecologists of the city who do substantial VBAC work. It is unfortunate to note that inspite of providing her all clarifications Ms Rashmi has been projecting an extremely poor image of Dr. Latha Venkatram and the hospital.
    Our internal review involved discussions with our own team of gynaecologists, meetings with two external gynaecologists who practice VBAC and the entire clinical care team. Our findings after this detailed internal review are summarized below.
    a. Ms Rashmi BT was a fit candidate for a VBAC. She would have been offered this procedure as a first choice by any gynecologist or hospital which practices advanced obstetrics anywhere in the world. Her age or the week of pregnancy were not contraindications to go in for a VBAC.
    b. She had made a conscious and informed decision about going in for a VBAC. She had changed her senior gynecologist whom she was consulting until the 35th week of her pregnancy primarily because that gynaecologist was not in a position to offer VBAC.
    c. The OPD case notes of which she was given the duplicate copy recorded that she was willing for VBAC and she was informed about all risks of her decision.
    d. Both the mother and the child had been monitored carefully right through the labour
    e. All medications used for progressing labor were prescribed agents and safe for use in VBAC
    f. She did have a uterine rupture which in VBAC carries a risk of 0.5%. This rupture could in no way be predicted or prevented. In spite of the rupture the gynecology team was able to save the uterus for future child bearing.
    g. The Operation theatre was ready at the time it was required.
    h. All the staff were present in the Operation Theatre within a few minutes of the emergency being declared
    i. While the baby was in the NICU Dr.Prakash Vemgal the head of Neo-Natology met up with the parents at regular intervals and kept the family clearly informed about the status and prognosis. All major decisions were taken only after discussion with the parents.
    j. Senior management of the organization met up with the family on multiple occasions to understand and address their concerns
    A minute by minute account of her story as is being spread through the various emails circulated by various people who were neither physically present during her admission to the hospital nor were involved in her care process exhibits to us a determined effort to harm the reputation of the gynecologist and the hospital without having any understanding of the clinical facts of the case.
    Is medicine now going to be judged through the lens of only opinions running across chain mails or through the untiring efforts of institutions and doctors which toil endlessly to save lives but remain spectators to their actions being judged by emotive outbursts?
    We do understand the pain and suffering of Ms Rashmi BT. As a hospital every life is precious to us but we are also are in the world of medicine where unfortunate rare complications can be counteracted but every procedure cannot be made risk free. There are many lives which we save each day when all has been given up and each such case teaches us that to pursue medicine is to pursue the limits of the unknown but does that mean that we become victims of public misinformation
    We have taken all necessary care and followed every medical protocol that any reputed institution across the globe would have followed. However it is unfortunate that even though Ms Rashmi has not been a victim of any medical negligence she has chosen by this random spread of irrational mails to use a redressal system that is purposely harming the reputation of Dr Latha Venkatram, Dr.Prabha Ramakrisha and our institution.We will not stand to be mute spectators to this form of intentional disreputation.
    The case can be subjected to analysis by any competent authority.

  44. “The American College of Obstetricians and Gynecologists and have set a goal of 37% VBAC deliveries by 2010.”
    Really compelling…That gives the hospital the license to make guinea pigs of patients irrespective of their suitablity to the procedure.
    MM, Rashmi hasnt paid them anything, has she? Its probably the best way to make this heard, have the hospital press charges for non-payment, since Rashmi is not planning to file a litigation suit.
    Rashmi, your courage is truly admirable. godspeed and godbless.

  45. Thanks for sharing this with us MM! I hope Rashmi finds the strength to fight it out. She will definitely be in my prayers. Will definitely send this link across to my friends and spread the word around.

  46. Gave me the goose bumps when I read it.

    About “you can conceive again..”, people try to get way too practical just bl%%^y too soon. I have heard people say that to the parents who lost their twin kids. Absolute b@$&@^!$ who can trivialize loss so immediately.

  47. I am horrified!!!My mom is a gynaec and since childhood I have seen her go on emergency calls to other hospitals where silly docs would do something wrong and beg her to come in to help. All I want to say is that that though the expertise is immense these days with so many hospitals everywhere and quilified docs from world’s best universities working in india, the care is absolutely missing. They act in a procedural way and treat patients as subjects instead of real human beings. Very saddened and helpless. I dont want to just sit here and pray for Rashmi and others, much more needs to be done. This is not just rashmi’s story, not just a story of a vbac gone wrong, this is the reality of medical care everywhere in india.

  48. Thanks MM for sharing this and wishing peace of mind for rashmi

    We thought of going to Wockhardt for our second one.And this leaves me numb.

  49. this is horrid all the way MM!!! such callous attitude. i have been the kind who said trust the doctors, they obviously know better!

    but thinks like this shake the belief and faith to its very foundations. sending lotsa prayers Rashmi’s way!

  50. Tears started flowing in. Its sad to know that such an incident has happened even during these days where you can find the best of medical facilities available in Bangalore. Bangalore is called to be to most prime city in world.
    Whatever happened wrong from the parents end or from the hospital / doctor’s end has happened. No one can compensate for the life of Arnav.

    My only thinking is what wrong has Arnav done to the doctors or to his parents. NOTHING right but still because of some mistakes on both the ends he had to give his life for all these. Sad to hear this.

    But one thing is true ” ALL DO MISTAKES BUT TRY TO TAKE SOME PRECAUTIONARY STEPS WHEN YOU ARE HANDLING WITH A LIFE”

    My sincere request to all the parents and doctors please take precautionary steps before attempting for anything while handling with a life.

  51. This is such a tragic outcome of a normal pregnancy and my heart goes out to Rashmi and her family.From the Paeds point of view,there’s nothing worse than telling a mom that her normal-looking beautifully grown baby is brain-damaged due to intra-uterine hypoxia.
    Reading the hospital’s response,they seem confident that they have covered themselves legally,(tho’ I’m sure budding lawyers will be able to poke holes in some of their explanantions)but as one astute commenter pointed out,the truth is in what has been left unsaid or in between the lines.(BTW,do all these pvt hospitals read blogs???)
    Their billing sounds outrageous and should be fought every step of the way.
    It also sounds to me as if some kind of stat had to be met,hence the pro-VBAC stance-as a doctor,I had 2 c-sections-the first for very early fetal distress and the second as it was just a year after the first .There are inherent risks associated with every single procedure in medicine but as someone who works on the Paeds side of things,I’d rather deal with a baby post c/s done in advance/early rather than a baby who has been subjected to all kinds of hypoxic incidents before they finally decide to cut.My 2 cents worth.

  52. Some questions if you please:
    1. If the heart rate of the child at 1:50 were less than normal, how did the baby get to be born at 2:30? That does not sound like 7-8 minutes. Or is Wockhardt going to refute the birth time too?

    2. Even a layperson knows that VBAC cases are not induced nor is the labor speeded up. The stronger than normal contractions caused by Syntocinon increases the chances for a rupture. How come Wockhardt does not talk about this?

    Past due date , 4 kg birthweight + vaginal bleeding + induced labour + fetal bradycardia a couple of times before the actual rupture, how could all these have been ignored? No I am not a Dr, but I have pushed my own Dr for a VBAC and even tried laboring for a few hours. The moment the heart rate began to fall occasionally to 100, I was sent to the OT. Now that’s what I call being cautious.

    I wish you would understand the purpose behind Rashmi “spreading” this story.

  53. Thanks so much, MM for publishing. I read Wockhardt’s response and am not sure whether to laugh in their faces or be sick. Really hope Rashmi gets her justice.

  54. Dear Rashmi,

    Big hug to u. I shall add you in my prayers. May God give you the strength to get thro this.

    Love
    Jo

  55. As a woman who will have children someday, I’m scared; as a Bangalorean, forewarned; and as human just aching for Rashmi.

    I hope she finds the courage to move on. And I pray that doctors stop playing with lives that are trusted into their hands.

  56. In a way Wockhardt might be said to have a point when it decries this “random spread of irrational mails”. Unfortunately, what it does not admit is that the medical fraternity itself is responsible for sabotaging proper fora like the Medical Council. And about general fora like law courts, the less said the better.

    Surely Ms Rashmi is not circulating this e-mail because she enjoys creating problems for Wockhardt! She is doing it because she knows her chances of getting justice through proper channels is about negligible. When the system is so heavily skewed against us ordinary individuals, surely they don’t expect us to play the ‘fair game’ accept this skewing in good faith?

    On second thoughts, what ordinary individuals? Arent’ we forgetting we English-educated elites comprise the uppermost 10% or so of Indian society? And if we are so helpless, should we not spare a thought for the other 90%?

    On my part I’ll be happy to help out with whatever legal research is required (that’s about all I can do). If anyone among you is taking up the matter seriously, do feel free to contact me.

  57. Even though you’re on a break, MM, do keep us posted if any development takes place in this case.

    I, for one, really wish that Rashmi has the support of her family and friends and is able to bring a case against the hospital. Perhaps she is too traumatised at the present to take such a step? Although her version and the hospital’s version are different, it makes me wonder what kind of ‘protocols’ were in place that ignored vaginal bleeding at 12.30 and didn’t take her up immediately for section until much later. And of course, there are lots of other things there in that detailed email and hospital’s response that don’t add up. That make you wonder what was going on.

  58. I am so disgusted! Wockhardt is said to be in collaboration with Harvard Medical School and all. They should be questioned. They should be made to suffer for keeping such poorly trained staff, and being understaffed after making the patients pay so much.

    Unless the hospital stands to lose something, and their names are dragged into every newspaper and media report with this story, nothing will make them realize what they have done.

    Unless there is a serious escalation, no one sees what has happened and why it is wrong.

  59. Hi MM,

    Thanks for posting this and letting us in on this horror that has happened to Rashmi. It can so easily be any one of us, the thought makes me shudder!!
    My thoughts are – have we come to a time where there is no value for a life anymore? Hospitals like Wockhardt and famous doctors, for all they are worth, should remember one basic fact – it is someone’s life that they are involved with. It might be just one of the 100s of cases they handle and several deliveries that happen everyday, but for that parent it is their child, a life the mother has happily nurtured inside her for 9 long months. Do the hospitals and doctors even spare a thought for such feelings?

    Hospitals are organizations which are bound by moral responsibilities, it is not just service given in exchange for money, it goes much beyond that and the doctors are expected to know and respect that. More than anything that has happened, what seemed to me the most callous was that doc’s reaction!! Does she even have a conscience when she says – “Do some pranayama, japa, and tapa to help you get better”? Horrendous! :(

  60. Thanks for alerting all mothers on this and bringing in awarenesss among all. Dear Rashmi, really hope you get justice.

  61. Hi

    Rashmi was at my house today. To answer some of your questions:

    1. A lot of people have asked how they can help. Today Rashmi gave me something concrete. She needs a gynaecologist, or two, or three, willing to review her case IN WRITING. Please spread the word via email and in the blogosphere. This is essential as a first step to holding the hospital and the doctor accountable. And I think that for her, that is the real issue. She cannot believe that Dr. Latha Venkataraman is still at liberty to administer VBACs.

    2. She’s more than willing to share her story. The press, however, has its own agenda, and she isn’t looking at 15 minutes of blazing fame and sensationlism. Instead, she is looking at reaching out to as many people as possible – letting them know what they can expect from one of Bangalore’s so-called “premium” hospitals, making sure that no one else goes through what she went through, is still going through. Her story as you have read it is a bare-bones version… the “long” version is worse. Much worse. When she encounters a journo she is comfortable with, I know she will tell her story via that medium too.

    3. As Peccavi says above, the term VBAC is alien to most people. I had never heard of it before. As I said in my previous post: contrary to the hospital’s assertion above, “VBAC” is not a term Rashmi knew AT ALL. To her, as a layperson, the phrase was “normal delivery” versus “Caesarian”. I find the hospital’s attempt to lay this at Rashmi’s doorstep disgusting.

    4. @ Abhik Majumdar: Thank you for your offer. Rashmi will probably get in touch with you of she needs to. You hit the nail on the head. She isn’t interested in maligning anyone. She had no choice. She tried for a month to work it out with Wockhardt. I have personally been witness to the hospital’s stonewalling. There’s email from them that documents their unwillingness to conduct an unbiased review with leading gynaes, citing specious reasons.

    5. The question no one has asked: how is Rashmi? Emotionally, much better. The overwhelming support of doctors, lawyers, and just ordinary people from all over India who have read her story have gone some way towards repairing the damage to her spirit. Her faith in human decency is being restored. Her faith in doctors, however, has not – she still complains of shoulder and neck pain, an aching pelvic region, and is reluctant to visit a doctor. She has promised to do so this week. Let’s see…

    Me: Hi suman – thanks for joining us and confirming all this. Gives the mail more validity than a lot of other email forwards. I do hope Rashmi is feeling better and that some day she will go to court and give the hospital what they deserve.

  62. MM,

    My sincere, heartfelt condolences to Rashmi for her loss.

    That said, I’m with Perakath on this – this needs litigation – the hospital has an obvious financial motive in continuing to present their version of the case, and in covering up wrongful procedures.

    I have many doctors in my family as well, and those in the US complain often of the burden of malpractice insurance here, but until hospitals and systems show better signs of accountability, litigation is the only recourse patients have.

    I can understand Rashmi’s desire to not lose her privacy (perhaps, am guessing here), but if she can find it in her to file a case, she should. That is the only way to get the hospital to acknowledge its responsibilities.

    M

  63. Oh and BTW, Wockhardt has gone to Digg with their version… The URL is digg.com/health/Rashmi_BT_Real_Story_Revealed

    Diggers, if you feel, as I do, that their response smacks of the special fragrance of CYA… please BURY it!!

  64. @suman : thanks for the update.

    As for “The question no one has asked: how is Rashmi?” I don’t think anyone had the guts to even ask that question, I know I didn’t.

    Me: you’re right. not after reading this. :(

  65. Pingback: For Rashmi « Girl on the Bridge

  66. I hope Rashmi can carry on. If this happened to her, then it most likely happened to a few others who aren’t as brave as Rashmi is. I hope she can carry on and rip the hospital apart and have them do their japa and tapa in jail.

    Where are the mofo news channels on this? I hated them then and more now.

  67. Whatever Wockhardt hospital says…a life that was life for someone is missing here.

    if basics protocol that was to be followed was not followed..it is negligence. and cannot be and should not be forgiven in this case.

    @ Rashmi: I think this happening must be transparent to public and then your attempt to make the hospital change their protocol will take affect.

    personally, reading your words has given me a tear in my eyes and tremendous anger too for the hospital staff.

    God Bless…

  68. Well, I’ve asked around a bit, and I’m now quite prepared to believe that the hospital was at least acting in good faith. Other doctors I know have backed them up on the advisability of VBACs, said their explanation is entirely plausible, and that Rashmi’s case was regrettable but most likely not due to negligence. I’m still waiting to hear from the most senior ob-gyn I know, but I just thought people should know that and not get carried away with emotion, as I did with my first comment.

    Abhik (#62)– if you’re a lawyer, your faith in our judiciary is lovely to see.

    Me: did you pass on all the details perakath? timings etc? or just randomly ask them about VBACs? because of course VBACs are very viable. I know I begged for one. But my doctor was sensible enough to point out that i’d barely taken a one year break and had too narrow a frame to risk it with a decently sized baby and might end up with uterine rupture. its better to play it safe, isnt it?

  69. It’s extremely sad to hear when these things happen. I have covered a similar case of another hospital in Bangalore. My colleagues feel really bad that there is nothing that can be done as most people walk away from this instead of filing a case.

    I understand this is a moment to grieve, and in no way am I saying you need to stir yourself up and file a case, but there are so many incidents of this, but just because no one goes back to court, these cases are lost.

  70. @ Perakath. PM me. I’d like you to give the OB-GYNS you’re in touch with the actual physical records… as I did. Here are some questions that I’d like to encourage people to ask the hospital:

    1. Why is Dr. Latha’s notation in the OPD record regarding Dr. Prabha as her “co-consultant” made only on the 28th of Feb., AFTER Rashmi’s predicted due date? Would that be a good time for a patient who is past her due date to switch her obstetrician, or even make enquiries about the qualifications and credentials of the co-consultant?

    2. Since Dr. Latha is such an experienced VBAC practitioner who follows ROCG and other foreign-body guidelines, please publish the guidelines she followed, and match Rashmi’s records against them.

    3. Rashmi’s key question: “If I have paid for doctors who were fellows and members of the Royal College of Obstetricians, why was the registrar attempting to deliver me?”

    4. Another key question from Rashmi: “Why did an experienced doctor like Dr. Prabha not recognize signs of uterine rupture? I was yelling with pain in the labour ward and kept pointing at my stomach and telling her that there was a ripping pain in my stomach. I complained of shoulder pain and chest pain in the OT she still did not recognize the rupture. She admitted that she knew of the rupture only when she opened me? Why?”

    5. Registrar Dr. Shirley had announced that Rashmi would deliver by 1.30 p.m. What was Dr. Prabha doing in OPD at that time? Uterine rupture does not happen suddenly but over a period of time… during which Rashmi was attended by a registrar who is NOT an ROCG-qualified doctor.

    6. Why did it take 43 mins to conduct an emergency C-section? Baby fetal heart rate was down to 58 bpm at 1.50 p.m. and baby was extracted at 2.33 p.m.

    7. Why was the fetal monitor not connected in the OT? Is this what VBAC guidelines specify?

    8. If the baby had a heartbeat of 180 bmp, how is it possible for the outcome to be a baby without heartbeat and respiration at birth?

    9. Would an internal review with your own gynecologists and external gynecologists who are close aides of Dr. Latha be unbiased? Why have you refused to conduct a transparent review that includes the inputs of Dr. Prakash Kini and Dr. Narayanan, two obstetricians widely recognized as Bangalore’s seniormost obstetricians, as requested by Rashmi?

    10. Finally: Please have this case put up for review in the next conference of BSOG and FOGSI and have the proceedings covered by the press.

  71. @Perakath:

    It could be quite possible that their explanation is correct. But I think the general concern is, did the doctors consider uterine rupture as a possibility at all? If they had identified it as a potential risk(however far fetched they might have considered it to be before delivery) should they not have made ready a secondary course of action.This I feel might be a more responsible way to have gone about a vbac.

    I feel the timeline given by Rashmi indicates that they were in no way prepared to handle any contingency that may arise. I am sure if they were looking for a possible uterine rupture from the beginning this could have been avoided. When uterine rupture is a possible risk in vbac, should they not have been monitoring that?

    I dont think most people are questioning why Rashmi was chosen as a candidate suitable for vbac, but rather why was it not closely monitored to determine if it was progressing correctly or not. Rashmi’s mail seems to indicate that they were not taking the whole thing seriously.

    But then only an independent investigation can indicate where it all went wrong.

  72. /Please do your bit to see that as many people as possible read it. Circulate it via email, via Facebook, and any other means you can think of. Talk about it. If it can help prevent even one more incident like this, it will have done its job. Hopefully, someone, somewhere will lend their voice to Rashmi’s.//
    So you are suggesting that there shall be no more normal deliveries for mothers who has had a previous LSCS

    And then there is a hue and cry that doctors are doing caesarean section and not allowing normal deliveries “for money sake”
    The tendency to blame each and everything that a doctor does is very sad

  73. //During my 35th week, I decided to consult Dr. Latha Venkataraman at The Nest, Wockhardt’s Bannerghatta Road maternity facility to see me through the rest of my pregnancy.//
    So who was this lady consulting till that time
    Why did she change the doctor
    Was it because the previous doctor said “Caesarean only” and she changed because this doctor agreed for a VBAC

  74. //We stick to Rashmi’s version. We believe her.//
    So you are suggesting that there shall be no more normal deliveries for mothers who has had a previous LSCS
    And then there is a hue and cry that doctors are doing caesarean section and not allowing normal deliveries “for money sake”
    The tendency to blame each and everything that a doctor does is very sad
    //During my 35th week, I decided to consult Dr. Latha Venkataraman at The Nest, Wockhardt’s Bannerghatta Road maternity facility to see me through the rest of my pregnancy.//
    So who was this lady consulting till that time
    Why did she change the doctor
    Was it because the previous doctor said “Caesarean only” and she changed because this doctor agreed for a VBAC
    Questions to Rashmi
    1. Was she aware of the risks of VBAC
    2. Did she ever opt for LSCS
    3. If so why she did not consult a doctor who could have done LSCS
    It is a common thing we see on the roads when a two wheeler and a pedestrian dash, the illiterate rowdy mob just thrash the two wheeler driver
    When a two wheeler and a four wheeler dash, the four wheeler is immediately thrashed, even without trying to find who is at fault
    Similarly in this case as Rashmi has lost her baby, everyone is training the guns on the hospital, conveniently forgetting other facts

  75. //Me: did you pass on all the details perakath? timings etc? or just randomly ask them about VBACs? because of course VBACs are very viable. I know I begged for one. But my doctor was sensible enough to point out that i’d barely taken a one year break and had too narrow a frame to risk it with a decently sized baby and might end up with uterine rupture. its better to play it safe, isnt it?//

    Yes

    It is better to play it safe and do another LSCS

  76. At times it is difficult to believe who is saying the truth and what is exactly behind all this . To be fair just as Rashmi had the right to explain her side of the view. The Hospital should be given their chance of getting heard. At times I feel the kind of details regarding the time someone spent on the phone and what they talked to and about what seems to give me an errie feeling !

    Whatever the issue,, Rashmi’s lost has been tragic and we should try to give her more privacy at these times

    Also if the billing was indeed false,why did it have to be paid ? I am sure that could have been settled at the hospital itself.

    By paying the money and yet cribbing about it seems to very surprising.

    being a doctor myself I know how emotive these issues can be sometimes. Our prayers are with Rashmi however to accuse some Hospital of fradulent billing,bad doctors and inadequate infrastructure i think is generalizing this issue too much..

  77. //Yes – and if that had been communicated by Dr. Latha Venkataraman in the first place, Rashmi would never, ever, have accepted this procedure. No mother would.//

    Yes and No

    The Yes I Agree was for the “if that had been communicated by Dr. Latha Venkataraman in the first place, Rashmi would never, ever, have accepted this procedure.”
    The No is for ”No mother would.”

    I have show you places where the mothers are explained the complications of LSCS and VBAC and they choose VBAC
    I agree that Rashmi may not have opted for this, but you cannot decide on the basis of all mothers
    Heck
    Even Pregnancy is associated with complications. Don’t go to the extent and tell no mother will accept to be pregnant

  78. To clarify about the billing issue: Certain charges were indeed challenged at the hospital at the time of discharge. Of course after going through a harrowing experience such as this, one is not exactly checking the bill line by line, nor does one have the energy to dispute every little thing. You just want to get the hell out. That said, Rashmi refused to pay for certain things – the extra day’s room rent, for example. The huge amounts stood out and got noticed. The smaller ones did not, and were only noticed later. But they all added up.

    Me: I know exactly what you mean. Hospitals have a habit of doing this. billing little extra bits that you’re just in too much of a rush to waste time disputing. all you want is to get the hell out of there.

  79. Sad. Unimaginable…I am livid! I plan to have a second baby asap and story has made me seriously worried! Am spreading it around MM. Thanks Rashmi, for being so brave and sharing it with us all. U r doing us an invaluable service, God bless you with Peace and strength.

    Rdgs
    harshia
    dubai

  80. Pingback: “Do Japa and Tapa To Get Better” at Blogbharti

  81. Dr. Bruno, the main issue here is not whether VBACs are more dangerous than LSCS, nor the ridiculous statement that no mother will accept to get pregnant because of the risks of pregnancy.

    The idea is that if the doc had recommended a VBAC, the hospital should’ve had the necessary expertise (to recognise when a rupture is happening), OT back-up, gynec in constant attendance and Rashmi should not have been asked to push when there were obvious signs of rutpure and fetal distress. Nor should there have been so many delays.

    VBACs are ok, but they have to be done with caution and care, just like an LSCS would. As mentioned in my previous comment #23, my friend did have the beginnings of a rupture during a VBAC, but the gynec recognised it and swung into action (vacuum and the OT was very much ready AND well-equipped). Result: live baby and a successful VBAC. everybody happy.

    And Rashmi and the rest of us are not mud-slinging. We’re asking questions so that other moms and babies will not suffer the same fate. Is the hospital’s reputation more important than that?

    Your example of two and three wheelers does not make any sense. Nobody is physically beating up anyone here. A mother has lost her baby. She has a right to find answers and make her story known.

    Doctors may be human and fallible and yes, pregancies and deliveries have regrettable complications and outcomes. I know that personally, my first baby died, and I did not blame my doctors at all…they made every effort. They were wonderful human beings and compassionate and allowed other docs to review the records. They were open to questioning, and I was very well-satisfied that they tried their best.

    But the review process is REALLY important for the doctor and Wockhardt hospital to find where they might have slipped up and prevent that slip-up from causing another woman to lose her child. This is not a doctor-versus-patient war.

    And it’s really silly to say (in the other blog) that patients should find out side-effects, risks and complications from the Net. As Suman says, then why do we need docs? Let’s just have home deliveries…what do you say? Another ridiculous overstatement?

  82. MM (in response to #75):
    Yes, I sent the entire text, and later sent the hospital’s reply as well. We’re having a discussion about it on my school batch mailing list (which incidentally Yuva ought to be part of). And I don’t think you can compare your case with Rashmi’s. Each one is different, after all.

    Suman (#77): No offence ma’am, I don’t mean to battle with you– but except for number 6, I can think of immediate counters to every point you’ve raised in that comment. Surely the hospital and its lawyers can do so too. As Yuva (#78) said, there can be no closure on this issue without adjudication by a competent authority, and I don’t mean an external review panel.

    I appreciate your efforts at publicity and your fight on behalf of Rashmi, but it seems strange to me what you/Rashmi are looking for– publicity; but not too much. Admit guilt, Wockhardt; yet not in Court.

    Yuva (#78): I think the issue is not whether to have proceeded with a VBAC or not; that’s evidently a judgment call in each case. Wockhardt is probably unassailable there: for each doctor who has one opinion, you can easily find another to say that the other option would’ve been better.

    Rather, the real issue is whether the hospital was negligent in not determining the uterine rupture as soon as it reasonably ought to have. (Suman’s point #6 in comment #77.) To me that appears to be the ONLY issue where the hospital MAY be pinned down as negligent. And unfortunately that can’t be determined through emails and blog posts. Which is why I say there cannot be closure out of Court.

    Prono– your name sounds more Bengali than Tamil!

    Me: which is the entire point na perakath? that they should have recognised the uterine rupture immediately since its such a huge and common risk. that the labouring should have been done either in an OT or near an equipped OT. these are things even i was told when i was begging for a VBAC. i had blogged about this a lot during my pregnancy with the bean. but then thats because i am a nosy so and so. so i was well aware of the risks. not every other mother is. and the child being deprived of oxygen for 43 minutes? how is there an explanation for that if you’re monitoring a labour. and while regular labour is not monitored – a VBAC definitely is. every second is precious

  83. Oh, achha– Bruno! I read ‘Pruno’ and thought that couldn’t possibly be someone’s name…

    ME: oh you were reading the tamill? am impressed. okay i know in tamil there is no B – right? someone told me that Bata is written as Pata in tamil – you just need to know what the word is

  84. MM (#91)– If that’s the entire point, then I’m sorry, it got completely lost in a whole lot of other stuff– bills, advisability of VBAC, doctor-patient communication, offhand remarks by doctors. All important issues, but not from the point of view of negligence as alleged. Communication gap somewhere, perhaps.

    Could I ask, as Wockhardt did, where Rashmi got this figure of 43 minutes from? What proof is there of that?

    Please tell me if I’m pushing it too far. There has to be an eventual point to the commenting!

    Me: there’s no defined end really. you and i have always found one na?! so long as you dont go back to your blog and whine that i played the mommy card and beat your argument! ;)

    I wont argue on RAshmi’s behalf since i dont know where she got that figure. i thought i read it somwhere .perhaps suman can help us since she’s checking comments.

    let me make it clear that i have no idea how accurate rashmi’s account is. after all there are usually 3 sides to every situation. i just feel very bad for someone losing a healthy full term baby over something as ridiculous as a failed VBAC is just frustrating. the point of having a delivery in a hospital is for a safe delivery. if they lost a healthy baby because they pushed the VBAC too far and didnt intervene fast enough – thats horrifying. a VBAC is usually supported by a ready OT. Maggie and Poppins both tried for VBACs as you can read – and were rushed in for safe deliveries. the hospital has to be on its toes. it might be routine for them – its a real live baby and a heart full of dreams for the family.

  85. Oh, right– Wockhardt’s neonatologist told them “over 40 minutes without oxygen”. My bad.

    Me: hah! *forgets her dignity and age and sticks tongue out at perakath*

  86. #93– Good answer. While not ready to lay complete blame at Wockhardt, I feel very bad for Rashmi too. It must be terrible for her, and every lady who loses a child. And she has had the courage and strength to at least stand up for her belief that the hospital was wrong; for a selfless motive, no less. I hope my comments haven’t discouraged her or Suman.

    What I would have been most annoyed at in this situation, personally, would be being asked to pay 2.2 lakhs for a dead baby. I might well have walked out without paying and said, “Talk to my lawyer.” Viz. me, of course.

    (Look, a joke about a sensitive subject. Ohmygoodness.)

    Me: no its not a joke. its a very valid point. i’d be suing their pants off if they lost my child – let my stomach rip open because of their carelessness and then had the bloody gall to ask me for money.

  87. If Wockhardt people are reading– would it kill you to settle for an independent review, and make an ex gratia settlement to Rashmi without admission of guilt? At least waive her bill as a goodwill gesture?

    Let me tell you, the path you’re following now is winning you NO admirers, not even people like me who think you have a case. It’s tremendously bad PR for you; personally I will always associate your brand with Rashmi’s incident. Your business head should know better.

    me: yeah – you’re right. they could have spared themselves the bad press with a quick settlement of some sort. an apology even (makes a huge difference when a life has been lost) even if you’re not apologising for being the cause of the death but perhaps for not being able to save it. waiving the fee as a goodwill gesture. so much.

  88. While there are always both sides of the story, after our experience in getting our baby delivered at the Nest, it is not very hard for me to believe that this would happen at @wockhardthospitals. In fact, I had given written feedback to @wockhardthospitals after our experience at the Nest. It appears that it really depends on the Doctor – while I have couple of doctors whom I trust, there are couple of them who have no clue about their business. So as an organization, @WockhardtHospitals doesn’t seem to add any value and in fact making their services suspicious by having some poor Docs on their list. What I really found missing in their staff was an empathy for the patients and their relatives who are naturally concerned even if it is child birth, which is a natural thing. Anyone from @wockhardthospitals can contact me for my feedback again @ p_jayadeep @ yahoo dot com.

    Me: I’m sure its given plenty of good deliveries too Jayadeep. its a well known place. THis is just one case of negligence where perhaps thanks to the system of a couple of doctors being in charge – there was miscommunication and this particular patient suffered. so if they have loopholes in the system, they need to apologise and learn from it. no point being aggressive in their replies. for instance, you’ve had a good experience – but its sad that yours will be buried under rashmi’s bad one. they should have worked faster and made amends.

  89. uh, hello wockhardt representative. let me let you know RIGHT NOW that you have no right, no matter what details any other person gives out, TO PUT PERSONAL MEDICAL INFORMATION ABOUT SOMEONE IN A PUBLIC FORUM. If the patient decides to do so, that is her right. But you are committing a terribly illegal act by doing what you did. You have absolutely no right to disclose any personal information about any patient, past or present, in any public forum. She should sue your asses off on this point ALONE.

  90. Medical Council of India, Code of Ethics Regulations 2002, Chapter 2.2 and Chapter 7. these people are way out of line responding in public fora with personal information. FYI.

  91. I don’t know what to say MM. I’ve had miscarriages and I know how excruciating they were, but Rashmi’s and Vivek’s agony must be a thousand-fold. Especially so for the reason you pointed out in one of your comments – a failed VBAC, and given how involved they were in what was going on with them. I hope, with Rashmi and a lot of your readers, that something good comes of this. Better controls and procedures at hospitals – at least. My deepest condolences and the very best wishes to Rashmi and her family.

  92. Hey MM, i come here everyday to see if something new has come up. Yes, it appears that something has. Am glad that the issue is not dying its own death.

    Having said that, I am sad about the kind of responses that are coming up against the bloggers who support Rashmi. It is sad because it is myopic. My post on the subject is being spammed, and today there was a comment with a personal attack on Suman. That is unnecessary, and hopelessly dumb. Because, like i have already said on the Wockhardt blog, we dont actually need to talk, we can just send emails to people we know, and we can decide to not let that money go to Wockhardt.

    I know that personally, i will tell everyone in bangalore about this. I will go one step further. If anyone i know is even considering going to any of the doctors mentioned or to the hospital in question, i will do whatever it takes to stop them from going. Why? Because they have said categorically that they have done everything right and that they will do this with the next patient too. Do i want that next patient to be someone i know? Take a wild guess!!

    Why am i posting this here? Just an outburst methinks. Sorry for hogging the comments space.

    Me: sadly – people are unable to take a debate. most of them get personal -you shouldnt be surprised. and you’re welcome to have an outburst. i would be mad in your place too

  93. MM

    I am in my 4th month and these posts scare me!!! but this not about me, but about rashmi, my heart goes out to her and i think 2 biggest issues here are

    1) why was some lady who was only put on as a consultant after Rashmi’s due date doing the VBAC and where was Dr Latha at that time

    2) and why did it take so long after the heartbeat dropped to get the baby out?

    I have no medical / legal or media experience but am here to help in any other way i can.

    I do have family here in US who are gynaecologists if you would like them to take a look at the records, i would be more than happy to talk to them

    mini

  94. I cant even imagine how ppl at that hospital sit at ease! seriously is there no legal infrastructure in our country capable of suing them out of their senses for this negligence?! unbelievable.

  95. @ Perakath, and anyone else questioning timings: All timings (and a host of other details not available in the original “Rashmi’s Story” note) are available in her records. I also wish to ask another question: why, if you have thought up answers to them, hasn’t Wockhardt deign to respond?
    “I appreciate your efforts at publicity and your fight on behalf of Rashmi, but it seems strange to me what you/Rashmi are looking for– publicity; but not too much. Admit guilt, Wockhardt; yet not in Court.”

    I have said this before – when Rashmi first approached me on Apr 2, I met her as a stranger, gave her a patient hearing and – I’m ashamed to say – believed that she was speaking out of anger and grief. I encouraged her to sort things out with the hospital, and to mail them about her concerns. Instead of replying in writing, they asked her to meet with The Medical Services Director and Customer Services Head. As her husband had already returned to Jammu, I accompanied her. That meeting made my hair stand up on end, and that is when I started digging, talking to other doctors, and researching. It took me a month to come to the conclusion that W is in the wrong on several counts. During that time, I kept asking Rashmi what she wanted. Up until yesterday her answer remains the same – “How could Dr. Latha say she will provide exactly the same course of treatment to another patient who walks in with a case like mine even though she knows the outcome. This cannot happen again. I want to prevent it from happening again.” For almost two months, she made an honest effort to get the hospital to conduct a transparent review that included inputs from external gynaes of her choice (hence Wockhardt’s assertion about endless meetings). I have in my possession email in which they have refused to do so citing specious reasons. Their investigation simply consisted of them telling Rashmi “we spoke to so-and-so doctors (both close associates of Dr. Latha Venkataraman) and they said we followed medical protocol.” We asked to see the written review; there wasn’t one.

    No offense taken – like I said, please, please PM me. A lot of things to talk about, including your possible responses to the questions raised.

    @Mini: Yes! Yes! This is what Rashmi has been asking for. Thank you.

    @smallsquirrel: Very good point.

  96. Why is this becoming about whether Rashmi should have had a LSCS or not? Let her have picked the VBAC, so what? Countless women do – I did. In my case, thank god, I had a cautious doctor who was constantly monitoring me so the moment I had fetal bradychardia I was sent to the OT.

    Question is: Did the good doctors at Wockhardt do the same? Or were they negligent?

    Someone else posted this link but I am posting it again here:
    http://www.worldserver.com/turk/birthing/CatherineGrace.html

    Please do read. This happened in 1986 in the US and the similarities between this case and what happened to Aarnav are chilling.

    As for you Dr. Bruno, I do understand what you are trying to say. And to answer your questions, if not FB/internet etc how else are we mere human beings supposed to spread the message against the considerable might of an institution like Wockhardt.

    Just like you feel empathy towards your fellow doctors and take up cudgels for them are we as fellow mothers not allowed to take Rashmi’s side? We are not raising a hue and cry, we are asking questions about our own babies and our health. Is that wrong? How sad for your medical community that finally we have ways and means to reach out

    Me: ah Poppy – its always lovely to be on the same side of an issue as you. Very right and very good points.

  97. Suman– I have an exam tomorrow; will get in touch after that.

    Me: Oye P – keep us in the loop, man. After all we got into it because we’re interested in her case and care. So dont you dare take this private! Suman – do keep us in the loop – we’d like to hear the questions and answers too…

    All the best with that paper, P.

  98. Oh my god, I can’t believe this..!! Rashmi,our deepest condolences.

    So far my experience with this hospital was really good. My second delivery was at this hospital and we were really impressed with the nursing staff. About the doctor refered here, though she is highly skilled, I must say that some times she takes things very lightly. I remember, in the morning 09:00am when the labour pain was at the peak, without doing any internal examination she blindly told that delivery will happen in the late afternoon. But I delivered at 10:08am itself.
    The nursing staff could told me after touching my tummy that delivery will happen in an hour itself.

  99. This is really heartbreaking MM. I read this yesterday night and it’s been playing on my mind ever since. Truth be told, I tried imagining how I’d feel if I was in Rashmi’s place and fact remains that I could not. It is horrifying – and I can only imagine the kind of agony that Rashmi must be going through.

    And like Poppy says – the question here is not whether Rashmi opted for a VBAC. Well, even if she did, the doctors whose care she was under should have had a more professional approach to this. The negligence is quite apparent and like always – there is no accountability. Therein lies another major issue – they KNOW that no official body is going to go after them.

    And to think that they actually had the gall to respond saying this was a means to get publicity !!

    My heartfelt prayers and best wishes to Rashmi – honestly, I do hope and pray that she finds a closure to this.

  100. he negligence is quite apparent and like always – there is no accountability. Therein lies another major issue – they KNOW that no official body is going to go after them.

    I am sorry to say but most of us seem to go overboard for this emotive story

    Those who understand medecine ..should know that this is not negligence.. This is a medical complication which at times no doctor could find a remedy

    To take this case as an example of negligence is grossly wrong and unfounded for .

    Also i feel there is a lot of hatred developing for people who supports the hospitals view and Suman also accused some bloggers of being one and same .

    This untolerance for hearing the opposite side is not desirable. Bloggers are meant to engage in health debate and not start calling names.. I am somewhat appalled by some of the bloggers who seem to be opposed to medical examination of the facts

    Me: I’m confused Satarupa – in the first line you said the negligence is apparent and in the third para you said calling it negligence is grossly wrong. Would you mind clarifying?

  101. To clarify: I didn’t make an accusation. I was engaged in a live thread with Bruno when I found, two minutes later, the exact same comment he had posted on another blog. When I looked up that poster’s profile (Neil), it led me back to Bruno’s web page. After I pointed that out, Neil’s profile was plocked from public view. However, look at ththis thread, and you will see that Simplypallu confirms that they are the same person: http://simplypallu.blogspot.com/

    I am not intolerant of other views. And the fact have indeed been – and are still being – examined on their medical merits alone via case records. That, however, leaves the SERVICE component… which is what we ostensibly pay top dollar for at hospitals like these.

  102. It’s really sad to hear something like this.
    No one has the right to question the enormity of the tragedy involved.

    But isn’t it fair to listen to both sides before coming to a conclusion? Being ‘powerful’ doesn’t make someone automatically wrong either.

    Lata Venkatraman was our doctor when our little girl was born. She was very patient every time we visited her, very professional and both of us were very happy with her.
    We were earlier consulting another famous Gynaec who was very brusque and who we later found out had a preference for costlier C-sections, major surgery.

    Doctor Lata, on the other hand, was very much in favour of natural childbirth and gave us a lot of valuable advice like Lamaze classes. We were extremely happy about switching over to her.
    But yes, the initial part of our reasonably-quick delivery was handled (very well) by her colleague (I think the same Dr Prabha) and by the time Dr Lata came in, it was almost over.

    Maybe we were just lucky and it was also nearly free of cost for us (insurance). So I can’t really imagine what our reaction would have been if something like this had happened with us.

    But the fact is she is a very senior and respected doctor, a very nice person and we did have a very positive experience with her. So I thought I’d add my 2 cents since she is someone we have such good memories of.

    Would prefer to stay anonymous to avoid legal hassles though.

    Me: I’m glad she was a good doctor to you – but that doesnt mean she may not have made a mistake this time – of course that is yet to be proved in court. Anyway – I do wish you would come out of anonymity and help Rashmi or contact her. Sometimes a little gesture goes a long way and its sad that we only fear the legal repercussions to ourselves. When in fact you are supporting Wockhardt so there should be none for you really.

  103. suman .. Just becoz Neil’Profile was blocked does not mean that they are the same person. This is an personal attack on a fellow blogger. and Just becoz anyone does not agree with the same views does not allow us to be revengeful or accuse someone suporting the hospital to be the same person

    Also it is not for us to investigate and find out the profile of anyone against us or for us. I am sure we are not like GEOGE BUSH who said either the world are with us or with TALIBAN.

    We are not in a witchhunt.. we are here to debate facts placed before us.

    However some facts like the minutes ,seconds the operation and surgery was not done cannot be taken at face value so they cant be said as right or wrong

    Tomorrow if your company does not like the service you deliver and seeks explanations from you,I am sure you would in full measure explain why this is not the case and you are actually doing a good job

    Likewise while you have laid facts before us. The hospital too has given us their story. However other cannot decide for you,they can only pity on Rashmi and You and debate endlessly in blogs..

    Me: so do you think its a huge coincidence that you and the hospital have the same IP address Satarupa? Just wondering. And finally if you’re addressing another blogger in the comments, lets be respectful…

    People ARE debating facts – those placed by both Wockhardt in the comments and Rashmi on the post. Why is it that the timings given by Rashmi and her family cannot be believed? how else would any medical case be argued?

    Anyway – I suggest that if you want to address Suman you take it up with her personally. I have no desire to be involved in any flaming

  104. All the big name like Wockhardt have become place of money making.They do not bother for the patient their only concern is to make money by any means.

  105. Heartbreaking story.

    When demand for healthcare outstrips supply and with a society that tolerates the pervasive culture of corruption and greed even the richest doctors cut corners since they can get away.

  106. Satarupa, I believe Rashmi because of this fact:
    “At 9.30 pm the neonatologist told Vivek that the baby had been deprived of oxygen for over 40 minutes, possibly resulting in “some extent” of brain damage.”

    What were the doctors doing in those 40 minutes? Why did the doctors not do anything when rashmi had stomach pain along with blood discharge. Why did they know only after operation tht she has uterine rupture? Were they not able to find its symptoms? Why?

  107. @ Satarupa: So you’re from the hospital; that explains a lot. In light of what has happened to Rashmi, the Neil/Pruno issue is petty and ludicrous, and I will not engage in any diversionary, tangential conversations about it.

  108. Hi,

    I read this just now and got very emotional because something like this happened to me in 2002, although not to this extent. Rashmi’s story is horrific and NO mother should ever go through something like this.

    I lost a baby at 6 months of pregnancy when she died inside and although the docs who took care of me did a good job, I hated the way I was handled at the hospital where I was taken for the ultrasound. At that time, we didn’t even know that the baby had died inside. The ultrasound doctor actually had the gall to call the others and juniors to take a look at the monitor to show what a 15 day dead baby looks inside its mother’s uterus. This was just after they told me that the baby had been dead inside. I was just 24! After that also, they were very insensitive towards me, treating me like an interesting case before sending me off to my gynec.

    I still seethe when I think of those doctors and I wish I had the presence of mind to tell them something at least. But who can say anything when their heart is breaking and their life is falling apart around them?

    I am so sorry about Rashmi, more so because I know from experience, how people feel uncomfortable with the grief of others and how they try to brush it off by saying that its negligible. I still ache inside for that baby daughter I lost. I have another healthy child now, but she can never be replaced. And that is the pain that only a mother who has lost a child she barely got to see or know, can know.

  109. rashmi is a brave mother, had read about her earlier and now i feel like i know her so well…i have gone through something like this ,though not up to this extent may be but the consequences are much more horrific…….my daughter is a special child , of 8 years ( her syndrome is genetic but the experience at the time of birth led to confusions at the time of diagnosis) and after that another round of doctors acting strange came to my life…….in all these years of interaction with doctors as a patients caretaker i have found that most of them are not sensitive at all and have joined medicine just because it gives them money……in truckloads…

    somehow it explains that an average Indian parents wants the child to become a doc or an engnr….which is just to earn lots of money….why the focus is money all the time? and the doctors are not even good professionals most of the times….why medicine is not pursued seriously here in our country?

  110. Satarupa and they ilk: (Bruno, Neil et al): You know what i like best? That in all this “Hai ram! why r u blaming the Doctor Latha VEnkatraman who just made the mistake of remaining away from the delivery of a VBAC and the hospital et al..” NOT ONE QUESTION RAISED BY SUMAN HAS ACTUALLY BEEN ANSWERED – NEITHER BY THE HOSPITAL NOR BY THE BRUNOS AND NEILS AND SATRUPAS OF THE WORLD.

    The problem is NOT VBAC. the problem is the handling of that VBAC.

    Wockhardt stands behind the doctor strong enough to do another post on her merits. Good for Wockhardt, and bad for the patients who choose Dr. Latha VEnkatraman.

  111. @ how do we: True. Something I noticed – and hadn’t until Wockhardt published Dr. Latha Venkataraman’s profile – brings to mind one more question to add to my growing list.

    I called the hospital front desk to make enquiries about Dr. Prabha Ramakrishna, who was actually present at the delivery, and who was cited as Dr. Latha’s co-consultant on Feb 28. They told me that Dr. Ramakrishna has approximately 8 years of experience… as compared to Dr. Latha, who has more than twice that experience under her belt.

    So my question: was it right for a doctor with the same qualifications but only HALF the clinical experience of the original consultant to attend Rashmi’s delivery? By her own admission, she did not recognize the signs of scar rupture until it was too late. Perhaps a more experienced doctor would have?

    Sure, I understand that doctors have to sometimes work as a team, and that doctors with less experience have to learn their craft somewhere. In this case, however, Rashmi had never met Dr. Prabha, and was told about her involvement only when it was too late to check on her credentials and experience level.

    At a meeting with hospital management, Rashmi and I were told that Rashmi “was very lucky” that Dr. Prabha attended the delivery because she has “a fine surgical hand” and was able to “save her uterus”, stitching it up beautifully. I then had to point out that if Dr. Latha Venkataraman had handled this case herself, maybe Dr. Prabha wouldn’t have HAD to stitch up a uterus that was ripped to shreds.

  112. well said ‘how do we know’!! just bragging about how many degrees one has, getting highest marks, holding offices, publishing papers does not make a doctor great. As you have rightly said the way the VBAC was handled is wrong, any hospital or doctor who do not put the WELLBEING of the mother & child as the highest priority, well above their personal agendas cannot be called the best. I pity the students who train in such institutes or under such doctors who will never learn from their mistakes. Sad that because of such people all doctors & hospitals get to be viewed suspiciously.

  113. Rashmi would also like me to let you know re the billing issue (why did you pay if there were extraneous charges?): The hospital refused to discharge her, or hand over Arnav’s body from the morgue until she cleared the bill.

    Me: OH GOOD LORD. well I hope everyone is satisfied with that answer now and doesnt want to know why she paid and is cribbing. God forbid we should ever know what that its like to have to pay to even take a loved one’s body home

  114. Goodness Lord ! I cannot even imagine the extent of trauma – physical, mental and emotional that this couple must have had to go thru.

    For the hospital to say that they would not hand over her baby’s body if the bills were not cleared – god – this hospital really is the PITS.

  115. Pingback: Remembering the Past « Sense and Sensitivity

  116. I just read the Hospital’s explanation. I think it is very feeble and stupid. That such a weak explanation is given. I am sorry for Rashmi BT. By the way a good lawyer will rip through the hospital’s explanation. I think a litigation is due here

  117. Even i think a litigration is due here. That they refused to discharge her i can understand, but that they refused to release the dead body of the child? NOW you have me REALLY angry. Guys, does anyone want to send Wockhardt GET WELL SOON MAMU flowers? I am going to. All the way from Delhi. To the MD of Wockhardt. in Mumbai. Who else wants to send this bouquet to Mumbai?

    And if anyone knows the new owners of the hospital business – Shivinder and Malvinder Singh, lets send them flowers too. What say? Lets tell them that killing a healthy baby and then taking 2.2 Lakhs to let go of the dead body of that baby is HEINOUS. As heinous as it gets.

  118. Hi,

    I am 37 weeks pregnant with my first child (after going through hell to concieve), obese , 30 yrs old, carrying a large baby , married to an IAF officer. I was trawling the net for something to help me make a decision about accepting a C Section in a (possibly) better equipped private hospital or being induced and possibly having an emergency C Section (in a Military Hospital)when I found this horrific account. I happen to know someone who was lucky enough to come out of a bad experience with this very same hospital in Bangalore, a few days after this happened. My heart goes out to Rashmi.

    Some people have commented on why she’s still not suing the hospital,so at this point of time,I just want to give them an idea of what most of us go through just to have children ,given the nature of an Air Force (or any other armed forces )officers’ job. Most of us are educated , highly aware individuals living in out of the way places (where our husbands our posted) with very little access to so called “big town ,good hospitals” . Most of us make the best of things by staying with our husbands as long as possible during the course of pregnancy, trusting our lot to the care of a small town gynae or whichever doctor of whatever level of expertise posted to the nearest military clinic/hospital, and then going “home” to our parents/in-laws to deliver the baby.

    Once at home, many of us make the ” choice” to changing our gynae , hoping that paying for medical care in a “good” hospital in a big city , will get us looked after better “outside” than inside a Military Hospital .

    If giving birth in a facility of choice is such an involved dance for Rashmi (and most women in our situation) , and given the nature of our legal system, as well as her husband’s line of work ,can you imagine how much of an uphill climb it would be for her to get legal redress from this hospital? Atleast this way, the hospital may still be forced into some degree of accountability to future patients.

    • i can truly understand what u said.I myself am an army officers wife and i had to change 5 doctors and 5 postings in the course of my first pregnancy …..its not easy to be married to d men in arms!!!!and rashmi….m sure she was undergoing something similar.
      i hope my prayers reach her

  119. Hei thats a really sad thing to happen, but just realised i lost a friend post the delivery at the same hospital on March 15th 2009 and the doctor was also the same(Latha). am so sorry and glad you published this as it really re-instates that somewhere the Doctor is a lot careless:((

  120. please read the hospital response carefully before making emotional outbursts.
    like patients.. doctors too have their rights and we should respect them. all doctors work with the HIPPOCRATIC oath and the motto of primum non nocere.. first do no harm! if you read the story objectively you can certainly see through to the facts.. the given doctor has indeed discharged her duty in a careful and responsible manner. SCIENCE should come before Emotions.

    Me: everyone has read the response but i guess they have the right to disagree without it being dismissed as an emotional outburst no?

  121. I am really sorry to hear about your incident. You have shown immense courage & strength.

    I will pass on this message in hope that this is never repeated and that Wockhart would learn a good lesson. But I am not sure if that is justice enough.

    Thank you for sharing your experience. Thank you.

  122. Satarupa and they ilk: (Bruno, Neil et al): You know what i like best? That in all this “Hai ram! why r u blaming the Doctor Latha VEnkatraman who just made the mistake of remaining away from the delivery of a VBAC and the hospital et al..” NOT ONE QUESTION RAISED BY SUMAN HAS ACTUALLY BEEN ANSWERED – NEITHER BY THE HOSPITAL NOR BY THE BRUNOS AND NEILS AND SATRUPAS OF THE WORLD.

    Suman ,How do we know and et all.. By naking a patient records public and by debating that on public forums you have made rashmi a big scapegoat.. I wonder why instead to debating this on the blogs why dont everyone of you sue wockhardt and get your revenge..

    By some of the utterances in this blog.its very clear that there are two groups fighting against each other. And with Cradle being coming up so many times,, I am sure everyone has realised the reason of such much debate

    Me: everyone has read the response but i guess they have the right to disagree without it being dismissed as an emotional outburst no?
    Everyone has the
    right to disagree, but by email chain letters, blogging and by saying pass it along, it speaks of revenge,vendetta and lots of malice.. I am not sure why instead to litigation some people here is content in taking positions without any regard for the actual medical story

    Me: here’s a question shoib/satarupa/wockhardt hospital – why do all of you have the same IP address, same style of writing and email id – but different names each time?

    i’m sure you realise that there is no ‘revenge’ for a child lost. or do you? there is simply an endeavour to ensure that no hospital uses another as a guinea pig again.

  123. Yeah, I too got the feeling that this is some form of corporate warfare. Afterall, this sort of mudslinging is well known among marketing people.

    Me: very plausible – but then since some of the readers and commenters have met the poor mother who lost her child- there is that degree of confirmation that its not just corporate warfare. to say nothing of how hurtful that accusation might be to someone who is anyway dealing with the loss of their child

  124. funny, I run another blog for moms and pregnant women. and I have noticed that every time I say anything positive about any hospital other than wockhardt, they have someone write in and accuse me of being a marketing person from Cradle. I am just a ordinary woman working for no one, unlike the people whose IDs I regularly tag as coming in from Wockhardt who *are* PR people.

    What’s also strange is that anyone who read this story would be touched and upset… unless they had something personal to lose from it… like their own reputation or the reputation of their hospital.

  125. Me: here’s a question shoib/satarupa/wockhardt hospital – why do all of you have the same IP address, same style of writing and email id – but different names each time?

    wow thats another new line and a new story i guess ..Everyone in this blog who seems to talk in less emotive tone is categorised as the same IP from the hospital

    And also it seems that the owner of the blog also is an expert in investigating writing styles of people who commented on this blog.

    I would love to know if you could publicly mention all the IP adress of all the writers who has spoken at some times for the hospital and then do the same for the opposite side..

    Its sad that in this platform for debate people are using this to score personal points as insist of branding anyone who speaks about medical facts are shunned as being from the Hospital

    If blogs are used to take revenge and spread facts from one side.. All the best !! carry on the crusade..

    Me: and what exactly qualifies you to speak on behalf of the hospital? as for displaying IP addresses – i wouldnt do it unless you gave me reason to. Its got nothing to do with remote IPs. its got to do with the fact that you’ve used the same email id and left comments under different names. Unless its a HUGE coincidence that 3 different people miraculously have the same email id and feel the same way. although how gmail allotted the same id to 3 different people really beats me. please consider this a warning.

  126. i’m sure you realise that there is no ‘revenge’ for a child lost. or do you? there is simply an endeavour to ensure that no hospital uses another as a guinea pig again.

    yes for that we need legislation.. Would you take an initiative to stop clinical trials on humans and also maybe stop researching on Stem cells since that would entail some lives being lost.

  127. another thing. Since you keep commenting about the IP thing

    just the fact that all bloggers who are so much enthused in spreading this story also seem to share mutual admiration society …

    http://threedrinksahead.wordpress.com/2008/01/16/search-strings-to-reach-three-drinks-ahead/

    the mad momma January 16, 2008 at 3:28 pm

    geez TDA – this is psyching me out. People hunting for you is never a good thing. And do give me the IP address of the person who wants my real name. I’ll be happy to help them out :)
    :) Sure – would give you the IP address, if I knew how to. Is there an option that lets you do that in WordPress?

    posted at http://threedrinksahead.wordpress.com/2008/01/16/search-strings-to-reach-three-drinks-ahead/

    all blog same post in all 8 blogs… In case you want i can even tell you all the IP address that can tell you all blogs that have actually been hosted specifically to share this story

    And just for your information,.. I think some people do have the brains to use a remote IP ( Just for your knowledge )… So even if your stats at wordpress show that that IP’s are different, let not that fool you into thinking that the IPs are really different

    having
    Thats the problem about INTERNET . what is see is necessarily not always real

    Me: I’m sorry – but you’ve been absolutely incoherent. Please dont bother to elucidate further. I doubt you’ll be very successful. Really. As for explaining why a shoib and a satarupa share the same email id… i dont think i want to know at all!

  128. Shoib,

    In response to your “yes for that we need legislation.. Would you take an initiative to stop clinical trials on humans and also maybe stop researching on Stem cells since that would entail some lives being lost.”

    1. In LEGAL clinical trials, the humans used are very well made aware of the side effects of the trials, and still, they volunteer to take part in the trials. It is a choice they are allowed to make. What choice did Rashmi have when her gynec did not stay with her for the duration of her labor – which is exactly what the procedure requires?

    2. Stem cell research uses discarded or non viable embryos to further research. Any method used to manufacture embryos are illegal. Even then, if you are so concerned about the non-viable embryos, I don’t see you offering to adopt and gestate them and raise them as your kids.

    3. Just because there are illegal practices in the medical research field does not mean it is ok for a mother to be treated the way she was and then lose her child. Two wrongs never make a right.

    Me: thanks CC. I needed some time to reply to her/him on the research issue and I see you’ve done a great job of it.

  129. I am totally devastated after reading this.

    Wockhardt Bangalore, has some very poor medical practices and isn’t even aware of a lot of critical and trauma-care protocols.I personally faced this when my mother suffered a cerebral stroke last December and we took her to the Wockhardt emergency.As per standard stroke management protocol, a stroke patient needs to be treated with the highest priority given that the effects of a stroke are reversible if treated within a time limit after which the clot would have caused irrevesrible damage.And our so-called “state-of-the-art” Wockhardt hospital did not even have a stroke management protocol in place, which resulted in my mother spending close to 4 vital hours in an emergency bed till they could even shift her to an ICU bed.And all they had was a pulse monitor in that emergency bed.Her clot had already caused irreparable damage and left her complete left side of the body paralysed.She has recovered to some extent through a huge amount of physiotherapy.

    Wockhardt Hospitals,Bannerghatta road, Bangalore is only good for cardiac related problems with Sr. Vivek Jawali and others being very competent. All the other departments there work on “Ram bharose” and “Japa and Tapa”.So better watch out before stepping in there.

    Me: I’m so sorry to hear about your mom and I’m so glad to know she is recovering. this sounds awful…

  130. So one more question for Wockhardthospitals/satarupa/shoib: If you are ISO certified – and I know this from my work with the IT industry – you have a process chart for every possible thing you can imagine. yet there seem to be no processes/protocols for basics – stroke management, VBACs, informed consent, redressal. What gives???

  131. Devastating!!!! I could not get myself to read the painful incident in several attempts ….. I dont care to read hospitals comment at all…I assume the nuances of VBAC or C-Section etc is best known to the docs else we would choose to deliver at home .. by self!!!! There were multiple point of negligence for sure…

    God give you strength Reshmi / Vivek!

  132. This story had been so heartening… Couldnt read through.. mind was so hurt … could feel the pain of rashmi and of aranav… oh how he must have struggled inside … sad that docs could be so negligent .. I too had my baby at Wockhardt and under the same doc. In my case too even though my gynaec was Dr. Latha, she informed me that she would not be there to attend my delivery as she was on vacation and suggested that Dr, Prabha would take care of… Surprisingly they missed having my blood test done during my pregnancy. It was until I pointed out that they said “Oh how come we missed it” and did my blood test around my 7th month.
    I had delivery through C Section and precisely the samy manner my baby’s heart beat started dropping as I incurred contractions. Sadly the nurses at the station werent capable enough to identify the featal heart beat drop. When I pointed that out they said the machine is faulty and they changed the machine. In the labour room as first they said they will make me deliver normal, the attendant nurse dint even know to make out the reading of the heart beat . It was god send, that the gynaec registrar came by at the moment and identified that babys heart beat was falling around 75/80 beats and informed Dr. Prabha … Dr. Prabha then instructed for C section. As pointed out my Rashmi, the OT didnt have strecth for transferring the patient to the OT table. They expect us to move when we are in so much of labour pain. In my case all of them picked and transferred me. Another part I was given epidural twice. The Initial one didnt work out as I could still feel the pain and the doc said that we are extrmemly sorry but this happens and so we will give you one more. Somehow I wasnt very happy the way they handled the situation. In my case by God’s blessing and to the timely registrar that I have my baby safe in my hands.

    Me: good Lord that sounds awful. I’m so so glad you and your baby are safe.

    • OMG.. this is such a lucky coincidence.. how can a nurse not know how to read the damn heart rate monitor? Even a lay patient can read it!! Am sooo glad that you and your baby are fine!

  133. This is truly horrible!
    I guess these ‘big’ hospitals are just money making centers with scant regard for the patients.
    Their explanation is pathetic to say the least.
    My prayers are with Rashmi and I sure do hope something good will come out of this

  134. And I just cannot believe that such a hospital which bills 2.2 lakhs for a delivery does not have a basic thing like a stretcher in the labour room!!
    Not to mention the faulty BP apparatus and the falling stirrup!

  135. hi,

    There’s nothing one can say that can undo or even lessen the enormity of pain that Rashmi is going through. I read so many comments regarding the insensitivity, incompetence and negligence of doctors in the above.

    I have to admit that the assumptions of negligence and incompetence seem justified, but one needs to look beneath the surface. Maybe my view is different because I am a doctor and I have seen situations where such gross life-altering outcomes could have been avoided if the doctor had taken out enough time to explain the actuality of the procedure and the risks involved more thoroughly to the patient.
    I also recollect my not-very-reassuring experiences with an ob/gyn during my pregnancy which made me avoid any further consults until after 28 weeks of my pregnancy. I made sure that the doctor I eventually consulted would be available and around when I was due to deliver and I appreciate the fact that she actually checked her schedule for 3-4 months later to check that she wouldn’t be away even for a couple of days. Such personalised care is rare and I was lucky to have it.

    My point here is just this:
    All would-be moms, please make sure your doctor can assure you of being available to personally conduct your labour. Avoid any doctor who refuses to discuss your situation and symptoms completely. Spend at least 20 min with your doctor on each visit so that you can have a good idea how considerate he/she is and how willing and committed they are to devoting the required amount of time to each patient.

    Second, there is a consent form that needs to be signed before any hospital/doctor takes up a patient for any medical/surgical procedure. Ensure that the procedure is completely explained to you before you sign the form. The MCI sets out a code of ethics and updates it every couple of years. One of the points that is stressed is for the doctor to avoid paternalism – where the doctor assumes control of the patient’s situation and decides for the patient. Not sure if this happened with Rashmi being advised to opt for a VBAC, but I believe that the doctor should have helped her decide on a caesarean section if she suspected the birth would be difficult. And experienced doctors can identify patients who would have a difficult time during labour, which is why we spend over 10 years learning the requisites thoroughly before we practise independently.

    Third, we need to stop such blatant commercialising of medical practice. Stop to think whether opting for soft options when it comes to diet, exercise, etc., can further fuel such entities which quote statistics to cover up something so unforgivable. For example, just improve your diet to include foods rich in folic acid, iron and vitamins instead of popping iron and folic acid tablets. You are not even aware of the side effects of the tablets you take blindly which can affect you and, most importantly, your baby.
    Its difficult to be critical when one is so happy at having a baby, but analysing things rationally can ensure that you stay happy.

    Smitha

  136. Shocking… but not surprised- given my personal experience with Wockardt & Apollo. I stay very close to these so called advanced medical hospitals, was very happy seeing them coming up, but completely shocked at their treatments and now do NOT go to them at all!!

    To be specific, I know some journalist friends. In case it is not yet there in print media and is required, I can help out.

  137. Hi,

    Does anyone have any idea on whats happening on this front?

    Since this issue hasnt been exposed to the media, there’s no other place I can look for updates.

    Pointers anyone? Suman…?

  138. A very heart wrenching incident. It’s a shame that anyone is a noble profession as medicine can be so callous and insensitve to seeing someone withering in pain.

    It’s inexcusable for the hospital to give such a careless response.

    Utter shame on the doctor who was too busy with personal calls at work.

    It’s the actions of a few people that tarnish the iamge of the entire hospital .

    I think the hospital owes atleast an apology to Rashmi and work on corrective measures to ensure no patient is treated badly.

    We all go to hospitals with so much hope and trust. This is really very sad .

    I have personally had several experience of incorrect judgement by doctors but perhaps that is something that cannot be overruled.

    The least hospitals can do is treat patients with a little concern for the wellbeing of the patient.

  139. I wanted to write many weeks ago, but held off, wanting passions from both sides to cool off a little. The loss of her baby will forever be a sad memory for Rashmi, as she tries to get on with her life ahead. And she must, if not for anything else, but to respect the memory of her baby by informing, educating, and advocating for mother and baby-friendly practices in maternity care and childbirth in todays hospitals.

    VBACs are not for everyone… Having said that, it is a myth perpetuated by the medical community and “Once a c-section, always a c-section”. I am living proof – My first born was an emergency c-section while my second was a normal birth. At our birthing center that I and my husband recently started in Hyderabad, we had a mom who had a VBAC. In my view, It is an unpardonable crime for a doctor to suggest a VBAC if he or she is not willing to constantly be at the mother’s side throughout her labor.

    Most doctors have never assisted a VBAC. In fact very few of the current crop of OBs have much experience in even normal birth. Their teachings and training in medical colleges talk predominantly of interventions – i.e., Epidural, Induction, Episiotomy, Forceps and C-Sections.

    One must do their own due diligence – ask your OB well ahead if she is going to be present during your delivery. How much of experience she has in VBAC? If she hedges her answer, do not hesitate to look for other options. For her you may be the thousandth delivery, but for you, it is your first or second – so you have to look out for your own interests.

    At the very least, a VBAC attempt requires CONSTANT MONITORING. Most doctors cannot and will not sit with you for more than 5 mins in your delivery room – leave alone, be with you for your entire labor. Most nursing staff dont know what to monitor and how to monitor. Fetal Monitors strapped to mothers restrict her ability to move – further hampering progress of labor. The trick for a successful VBAC is constant support by competent medical care giver, constant monitoring, uninhibited movement and providing comfort measures to mother, and no labor augmentation and induction in addition to minimizing vaginal exams. Mother should be able to labor on her own and be well hydrated (no routine IVs). She should be able to eat and drink lightly during labor.

    It is mandatory that you ask hard, specific questions of your hospital and doctor if they support all of the above. Before deciding, take a look at their premises, see how the staff go about their business… do they show empathy and care for mothers (mothers are not patients), or is it “just another day in the office” for them. If it is the latter, it should raise an immediate red flag.

    Remember, the birth of your child is a cherished moment in your life. Do not be taken in by fancy interiors and piped music and five-star ambiance. It is your caregivers heart and passion to support you throughout your labor, birth and postpartum that is most essential.

    My sincere hope is that Rashmi and her family finds the strength and hope to move on from this sad event and is able to turn it into a positive energy to help other women. God knows, there are thousands of women who have no clue about how to select a competent, caring place to give birth, where doctors do not rely on the knife to “deliver babies” rather support mothers who give birth with love, compassion and empathy.

    Dr. Vijaya Krishnan

  140. What ever Wockhardt has written regarding Rashmi is defensive. Wockhardt is boasting and eager to get the case analysed by competent authority. Wockhardt may buy some highly paid lawyers but at the end if this case is prosecuted properly in courts, with transprent media vigilance, then Wockhardt will loose the case 100%.

  141. just wondering, how stupid they are. After such a case, again the doctor says, they are correct on their side, and again will attempt to do the same. That means they are not ready to lose the money that comes in to the hospital, its really really pathetic. I suggest Rashmi to go for some other good doctor,and pray for her.

  142. At the outset, my sincere hope that Rashmi will recover completely from this traumatic incident.

    I read almost all the posts. My reading of the doctor’s view is different from the one held by most here. Could that view be based on data that is not available with us? I believe that only proper access to data can help understand whether the hospital and the doctor are at fault/continue to be at fault. If as Wockhardt says, that the procedure has a risk factor of 0.5% of going wrong, can they tell us how many patients have gone through VBAC since this incident? What is the data from various Bangalore hospitals? This is not to clear them in any way, but I feel it is important to understand why a senior doctor is saying what she is saying?

  143. Hi.. I came across this blog sometime in September last year. At the time I was in the third trimester of my first pregnancy. And I was consulting the same doctor in question. I used to firmly believe that I had to trust the doctor completely and have faith in her. So I did not read the complete blog, lest I start having doubts.
    But after a traumatic experience that I had during my delivery, I came back to this and wished I had read it earlier. I also realized that there were other similar cases of negligences being reported about the same doctor.
    I am in the process of writing a letter to the concerned hospital authorities regarding my experience and after I despatch the same, I will write a detailed account of my experience.
    But at this time all I would like to say is I agree with Ms Rashmi’s point that after all that we have gone through, the only thing we expect from the doctors is an acknowledgement of their “error in judgement”. But I’m afraid that’s one folly we all Indians carry. We never admit that we can make a mistake. We think we are above everyone else and can do no wrong.
    I wish these and other such cases come to the notice of as many women as possible. If nothing, I think as women responsible carrying another life with us, we have the right to information and the right to make an informed decision, rather than let Doctors take their own decisions.

  144. Pingback: For Rashmi, Wockhardt and others « Ramesh Tendulkar’s Musings

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  146. Okay…this came up on ur popular posts list…so read the post n ALL the comments! The post is so disturbing. I feel so bad for Rashmi. Do you know how she is doing now? do u know if the hospital actually admitted to their mistake finally? Please let us know.

    • yes pavi i am in touch with her. mailed her recently but am not at liberty to talk about her case
      i deleted the second part of your comment as you requested. God bless and all the best.

      • Thanks for your response. I u’stand u not being able to talk abt it. I just hope she is fine. She will be in my prayers.

        n thanks for the wishes.

        God…this is crazzzy..i cant stop the tears now. When i read the post..i was just shocked n disturbed but now this comment…it brought it all out. I cant stop crying. silly me!

  147. wow.. so sad…. after reading this when I have my second baby in January I will for sure have another c-section.. NO VBAC FOR ME!!! So sorry for your loss..

  148. I was deeply saddened by this story and pray for Rashmi and her family. I live in the US and had a uterine rupture with my second delivery. What saved my baby was the excellent medical staff at the hospital: an emergency C-section was performed in under 10 min and my baby’s life was saved. Reading Rashmi’s story, I keep wishing someone competent had intervened during her delivery and helped save her baby’s life. A uterine rupture is a risk for any woman with a C-section history, and is something any doctor/hospital should stand prepared for.

    For a doctor to say “you can have another baby” or “do japa-tapa” is so, so heartless. Unfortunately, education does not help grow a conscience, as is the case with this doctor. I am very sorry for Rashmi’s loss.

  149. Hi MM,

    I’d read your post about rashmi almost a year ago and at that point in time, it was just a sad story and nothing more than that. Eventually i even forgot about the whole thing.

    Today, just a few days away from my own delivery, I don’t know what made me come back to this story. And I see it in very different light… my own experience and the mindset of a mother-to-be.

    The surprising fact is that i am married into a family that swears by Dr Latha and when i got pregnant in Jan this year, I was pushed into consulting her. Here are a few of my experiences and am glad I put my foot down.

    1. My first request for an appointment with Dr LV was a desperate one… I was given an appointment 8 days after my first phone call. On the day of the appointment, which was at 11 am, I was called in only around 4pm and met some other junior doctor.

    2. I never met or spoke to either Dr Latha or Prabha, both of who are senior most docs at the Gynec dept in the hospital I was visiting till I was 7 months pregnant though all my appointments at the hospital were with Dr LV. My file still says Dr Latha Venkatram / Prabha Ramakrishna.

    3. Being a first time mom, a lot of things were new to me. During my 5th month anomaly scan, i read the doctor’s report which said: “Everything is normal. However this scan doesnt rule out the possibility of any chromosomal disorders and the patient has been informed about the same.the procedures have been discussed in detail with the patient.” Nothing was ever mentioned about even a possibility of any chromosomal disorders and when i went back to the hospitals and the said doctor saying nothing has been discussed, she causally mentioned that its just a formality and that theres nothing to discuss!!!

    I was terribly angered by this and didnt want to see a doctor who doesnt have time for her patients.. Even my husband, who accompanied on several visits to the doctor felt irritated that we never got to meet the ‘one’ and at the particular sonography incident which gave us sleepless nights for several months. Sadly though, my husband’s family insisted several times that they’d use their personal influence to make sure that Dr LV sees me at least once. Its just ridiculous that you now need to resort to using influence to basic things as seeing a good doctor! I figured that she was only about money and didnt really care. Rashmi’s story adn the doctors callous statement about japa tapa and that she can conceive again has further reaffirmed my belief.

    I am so glad I decided not to continue waiting for Dr LV to give me her ‘expert advice’ and instead opted for a comparitively junior doctor who has been one of the most caring gynecs ever. I truly love her!! She didnt dismiss any of my concerns, however silly they were, gave me practical advice, like a mother would and at the same time also told me to keep myself informed about various procedures in general. Most importantly, she had time for me and remembered my case everytime I met her.

    I had to shift to Bombay recently for my confinement and am thankful that I have found a good doctor here.

    Am due to deliver in less than 2 weeks. I have an inkling that it might be a C-section so am trying my best to prepare myself mentally to handle it. Whatever it is, I hope it goes off well and I come back home with a healthy little baby!

    BTW, I’ve also read your section on ‘our cesarean stories’. Thank you for posting such useful and informative stories.

  150. They wont change things because its not hitting them where it hurts. YOU HAVE ONE HELL OF A LAWSUIT!!!!! I am a labor nurse. Do this daily. STOMACH PAIN, POST DATES, INDUCTION AGENTS??????? NOT WITH A VBAC, Im so sorry for your loss…HIT THEM WHERE IT HURTS…then you will see stuff be different.

  151. You know, when I was in hospital after my C-section, nurses and other random support staff would just come in and let my door BANG shut, not caring that a baby, hardly a day old was in the room. Am sure my baby mustve been scared out of its wits atleast 20 times a day. And there was nothing I could do. Just recollecting this makes my blood boil and my heart ram in anger even today, even now.

    I just CANNOT even BEGIN to imagine what Rashmi would’ve gone through, must be going through. I read this post a few days back and cant stop thinking about it. My heart goes out to her and to anyone who suffered even remotely like this.

  152. i just delivered a baby a few months back.he turns 5 months today.I had a c section and I plan to have another baby after sum time.I wanted it to be a VBAC,cause i suffered a lot after my c section.but the suffering came coz i developed infection.42 injections in 5 days……it was a nightmare.but today i m fit.except for some loose abdominal muscles,i have no regret.
    but reading about Rashmi has completely changed my mind.I wont mind undergoing another c section.some more flabby belly muscle….i think I or nybody else can live with it….but loosing ur child!!!i cant even imagine what rashmi must have gone through…and to see that little one on a ventilator….i cant!!!!
    yes c-section may take a longer tym to heal….but then u hav ur baby to make u forget all the pain….you can recover your fitness,your health,your body….trust me when i say this.I have seen it all…the worst.
    may you get justice rashmi….and may you have the strength to forget the pain you got.And i thank you for changing my mind…..

  153. sorry for these words but..
    tht b**ch had no rights to take arnav’s life away..

    i am a doctor too..though junior..
    in my 18th week..n after reading this ..i am really really scared
    a doctor performing VBAC doesnt recognize warning signs of rupture cannot be accepted in any court of law..definitely nt in GOD’s…and tht she would do the same in next similar situation..huh..her license shud b cancelled

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