Maternal mortality and the tragic death of Rachel N. Guite

John Phaltual *

Rachel Ngailunmawi Guite

There was fiddling and dancing, on the day the babe was born
But poor Queen Jane, beloved, lay cold as the stone.".
"The Death of Queen Jane", an English ballad that describes the events surrounding the death of a Queen Jane.

The exciting moments of pregnancy and birth of baby twins have turned to sorrow and heartfelt loss with the death of the mother, Rachel Ngailunmawi Guite on December 17th, 2017.

Rachel Ngailunmawi Guite (38) @ Rachel N. Guite, MCS, Joint Secretary (Finance & DP) Govt. of Manipur and wife of Paukhanmung Guite, MPS passed away on that fateful night of 17th December at Raj Medicity Hospital, Imphal, due to Pulmonary Embolism was one year away from being certified as an IAS rank. She leaves behind her loving family and friends who will always love her.

In lieu of gifts or flowers on the to-be happy occasion, the bereaved family encountered a flower of mourning in her honor at her final mortal abode with the epithet "Rest in Peace". To these family, the pain and the disappointment is great and their loss will be carried heavily in their hearts for all their days. In the weeks and months ahead, they will miss her terribly and will be in need of love, compassion, time and understanding from all of them.

Each life comes into this world with a mission. Sometimes the mission or purpose is clear; sometimes it is vague and shrouded in misunderstandings. In time, we will see what this mother's mission was on earth. Could it have been just to add a little flicker of love that otherwise may never have been lit? Was it to soften our hearts so that we may in turn comfort others? Could it have been to bring us closer together? This mother's life was short, yet the death has left a huge void in all of our hearts and lives. Let us remember today and for always the mother who will never see childhood or adulthood of their babies, but will remain in their memory forever.

Incidentally, dying in childbirth is not pretty at all. Many such stories have a beautiful death that just results in the mother kissing her husband and baby goodbye. It should be noted that some deaths in childbirth are pretty fast - a woman with uterine atony can hemorrhage to death in minutes without emergency medical intervention, but that's a lot of blood.

Sadly, the case of Rachel Guite is all too familiar in Manipur State, where, in spite of access to the best medical care in the city of Imphal, the rate of maternal death related to pregnancy or birth cannot be control or halted. The death of a woman during pregnancy, at delivery, or soon after delivery is a tragedy for her family and for society as a whole. Sadly, few women die each year in Manipur as a result of pregnancy or delivery complications.

Maternal mortality is a global concern. The world maternal mortality rate has declined 44% since 2016, but still every day 830 women die from pregnancy or childbirth related causes. According to the United Nations Population Fund (UNFPA) this is equivalent to "about one woman every two minutes and for every woman who dies, 20 or 30 encounter complications with serious or long-lasting consequences. Most of these deaths and injuries are entirely preventable."

The most common causes of maternal mortality are postpartum bleeding , pulmonary embolism, complications from unsafe abortion, and obstructed labor. Other causes include blood clots and pre-existing conditions. Indirect causes are malaria, anemia, HIV/AIDS and cardiovascular disease, all of which may complicate pregnancy or be aggravated by it.

Nearly five women die every hour in India from complications developed during childbirth, with heavy blood loss caused byhemorrhage being a major factor, WHO has said. Nearly 45,000 mothers die due to causes related to childbirth every year in India which accounts for 17 per cent of such deaths globally, according to the global health body. The World Health Organization (WHO) said the major cause of maternal deaths is Post-Partum Hemorrhage (PPH), which is often defined as the loss of more than 500-1,000 ml of blood within the first 24 hours following childbirth.

India's economy may be booming, but when it comes to providing adequate health care to pregnant women, the country is falling behind even its poorer neighbors. A few Indian states are leading the way. Kerala, Tamil Nadu and Maharashtra have already reached the U.N. Millennium Development Goal of bringing their maternal mortality rates down to 109 women per every 100,000 live births, while several other states — Andhra Pradesh, West Bengal, Gujarat and Haryana — are close to achieving it.

What can women do to prevent a pregnancy-related death?

Many factors influence pregnancy-related health outcomes. It is important for all women of reproductive age to adopt healthy lifestyles (e.g., maintain a healthy diet and weight, be physically active, quit all substance use, prevent injuries) and address any health problems before getting pregnant. Visit your health care provider at recommended and scheduled time periods to discuss if or when you are thinking about getting pregnant. This is important to make sure you receive appropriate medical advice and care, and have healthy pregnancies.

A healthy pregnancy begins before conception and continues with prenatal care, along with early recognition and management of complications if they arise. Health care providers can help women prepare for pregnancy and for any potential problems during pregnancy. Early initiation of prenatal care by pregnant women, and continuous monitoring of pregnancy by health providers, are key to helping to prevent and treat severe pregnancy-related complications.

Rachel Guite lost her life few days after her baby twins were born. She dies giving birth like the Matriarch Rachel in the Bible. In the Bible (Genesis 35:16-20) we can see that Rachel wife of the Patriarch Jacob died while giving birth to the son. Before dying, she named the boy Ben-oni. But Jacob called him Benjamin.

Possibly whatever biological issues that made Rachel (of the bible) difficult for her to have children to begin with also led to her death in childbirth, though such death in childbirth was unfortunately common back then. But the narrative connection may also show us how important having children was to Rachel; she preferred death to not having children, and she ultimately did give her life in the process. Like the Matriarch Rachel who continue her existence through her progeny which retroactively qualified her to be as matriarch of Israel, so too, mother Rachel Guite continue her existence through her baby twins, a boy and a girl.

Rachel N. Guite was such a valuable asset to the state of Manipur, and we all feel the loss deeply. As Alan Sacks said "Death is more universal than life, everyone dies but not everyone lives". May the Almighty God give comfort and strength to the bereaved family.