Letters to the editor

Readers’ comments: Story on childbirth experience shows the need for women-centric healthcare

A selection of readers’ opinions.

Birth question

Krutika and Gautam should never have been subjected to the trauma of going from pillar to post seeking natural child birth (“To avoid a C-section at the end of my pregnancy, I went from hospital to hospital”). The goal posts for natural delivery seem to have changed considerably since my time. When my first child was born more than 40 years ago, my doctor went late to a family wedding because I was in labour. C-sections were the last resort, done only if the lives of mother and baby were endangered. We seem to be fast becoming an automated society lacking in empathy and going against all natural norms.

Kudos to Krutika and Gautam for sticking to their values, and I am glad Nature played her role in ensuring that they were rewarded for their patience. We need more youngsters like them. Krutika’s piece is straight from the heart. I hope it will tug at some doctor’s heart strings, enough to make a difference. All the best to Anaka and her parents. – Elizabeth Koshy


Congratulations to Krutika on becoming a mother. She has written about her experience lucidly and every point she raised resonated with me. I’m so proud of her for sticking to her guns, staying strong, making an informed choice and maintaining autonomy over her own body. The petition she refers to in her article was started by me, as a first step towards improving maternal health system of our country. We really need to ensure that the care being given is woman-centric, where neither our rights nor our health is compromised. We have a long way to go so we have to ensure conversations are not silenced and every woman’s experience is heard so that policy makers and caregivers can serve us better. The petition aims at transparency, accountability, information and I truly hope we can get this done. – Subarna Ghosh


I am glad Krutika and her husband persevered. We have three children all natural or semi-natural births. All the best to them and I thank them for sharing their experience. – Salim Ahmed


Thank you for this wonderful article. It is informative and useful. We are going through a similar situation and no doctor in Kolkata is willing to do a normal delivery.We have already changed four doctors. Even big hospitals are looting patients in this manner. We still hope that with god’s grace, we can have a natural delivery. I really appreciate the author’s endeavour to spread this information. – Gaurav Upadhyay


Don’t you think that for natural births and associated risks to the baby, parents should stand with doctors, and medical professionals should have the right and to work without fear of assault or lawsuits? Why do patients also insist that the doctor who has been treating them all along carry out the delivery? The doctor may have a personal emergency, or other patients to tend to at the same time. We often come across cases where there is a severe medical reason for which a C-section is necessary. But this leads to allegations that we are doing it for the money. Labour and childbirth are dynamic and unpredictable and one can trust that the doctor knows best. A few doctors may be greedy, unethical and manipulative but a majority believe in serving people. – Surupa Ranjan


The author mentions increase in C-section rates, but does not talk about the fact that maternal mortality and neonatal mortality rates have significantly fallen over the years. The doctors just wanted to ensure the author gives birth to a healthy baby.

In this field, anything can go wrong at anytime and when they do, two lives are at stakes. Believe in doctors and do not insult them. Such an article can also cause fear and panic among others. Leave treatment and diagnosis to those who have studied it. – Mallika Theogarajan


I faced a similar situation, when I was expecting my second child. My first delivery was an emergency C-section. For my second child, I had to change nearly five doctors and none supported the idea of option for a vaginal birth after a C-section. But I strongly felt my body could do it. I finally found a doctor who agreed but she said she can attempt a normal delivery only if I go into labour naturally. There were some minor complications, but after a 16-hour labour, I delivered my baby naturally. It was a proud moment and I recovered much faster than I did after my C-section. Through this letter, I want to pass on the message if you have had a healthy pregnancy with no complications, you can surely avoid a major surgery and opt for a natural birth if you prefer to. – Shabitha Clera DSouza


This was indeed a nice to piece to read. At the same time, I was left wondering about the thousands of women who opt for C-section in mostly urban India and another thousands of rural women who mostly go for natural birth. Childbirth in India mostly works on the fear factor. I have been looking at the the natural birth and rights-based perspective of childbirth.

On the one hand, the government and international donor agencies put pressure on women to go C-sections to ensure safe delivery and on another hand, we try to avoid talking about the rich heritage of midwifes who have been assisting countless deliveries in rural as well as urban India. I too had a natural childbirth at home with my family along with a Dai in a metropolitan city, but I still have to hear about how I took a risk. Many do not know the risks that they take when they opt for hospitals.

I hope in future we get to read more articles where women could exercise their rights over their bodies, especially when they are most vulnerable. – Shalini Arvindan


I would like to congratulate the author on the birth of her daughter. I found this story very heartening. I salute the author and her husband’s courage to have a natural delivery despite all the odds. – Manish Lalwani


I am deeply moved by the author’s experience and empathise with the struggle they had to undergo to bring their child into this world. My wife and I are also late parents and went through many fears and apprehensions before the delivery.

However, because of my wife’s age at the time, we had reconciled to the fact that we would have to opt for a caesarian. But she went into early labour and she also started crowning early. We had to have a natural delivery but it was perfectly safe! We were overjoyed and the guy was absolutely fine. Thank you for inspiring other mothers who want a natural delivery. –Sanjay Anthony


I have been married for two years and have a beautiful baby daughter. I was compelled to undergo a C-section at the last minute. I am very healthy and had the right weight during pregnancy. Through the nine months, by gynaecologist was sure I would have a natural pregnancy. But when I had contractions and visited her clinic, she asked me to wait for a few hours because the baby was not yet in the pelvis. I was having frequent contractions and was in a lot of pain, but she said we could not begin the delivery process yet. She then asked my husband to sign some papers and arranged a team to perform the C-section. I was firm on my decision to carry on with a natural birth, but the doctor scared us and said that our baby’s life will be in danger if we do not opt for surgery. I had to agree eventually. Please choose a wise doctor who will love the patient and not their pocket. – Ekta G


I fully respect the writer’s experience, but not her interpretation. The reason for higher C-section sates is because of extremely has nothing to do with profiteering intentions. This was the writer’s first experience with child birth but doctors have dealt with numerous such cases and is in a position to know what is a safer option. Also, there is a lot of pressure on the doctors who are shamed and threatened by families if things go wrong. There are cases of attacks too. So, doctors have become defensive and choose to err on the side of caution. – Bharat


The story accurately describes the situation today. As a 67 year old, I urge all young mothers to opt for natural deliveries as far as possible. The healing process is much faster than a C-section. – Anjali Mayaskar

Tipu Sultan’s legacy

While most of the narrative gets lost these days on Right-Wing versus secular, let me try to present the version of a modern- day logical Hindu (“Tipu Jayanti: BJP wants to correct history’s wrongs. It should start with caste oppression”). I think Ajaz Ashraf is not being completely objective as he just mentions Tipu Sultan as having fought against the Britishers. I don’t think a man like him is ignorant about Tipu’s brutal exploits in Coorg and the surrounding region. I think this is selective ignorance. He very cleverly diverted the attention to a different social issue. But this is like convincing this younger Jewish generation that Hitler fought the tyranny of British and hiding the Holocaust. The point is simple and clear. Aurangzeb and Tipu were oppressors. You can’t expect us to sympathise with you if you glorify them. For a change, glorify people like Khan Abdul Gaffar Khan and APJ Abdul Kalam. – Srijan Singh

Cleaning up India

The NDA will not follow the advice here (“In a post-Panama-and-Paradise world, what can India do to bring back illicit money stashed abroad?”). The people who the Panama and Paradise Papers implicate are those who have stashed black money abroad. The NDA is more concerned in implicating the Gandhis. – Arun Sharma

Abortion rights

This is a most laudable scheme (“Government doctors are being trained to help women in India get safe and legal abortions”). Openly disseminating medical and legal information on abortion removes the stigma and improves access to facilities to women. Particularly praiseworthy is the recommendation to train non-allopathic doctors and mid-level healthcare professionals also in performing abortions.

However, being a doctor and member of the Reproductive Rights Advocacy Alliance Malaysia, I’m puzzled at the adoption of the laminaria tent to dilate the cervix before suction currettage when misoprostol is cheaper and faster and the dilated cervix offers virtually no resistance to dilatation before the suction canula is applied. It has also been approved by the WHO and Ipas. – SP Choong

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

Putting the patient first - insights for hospitals to meet customer service expectations

These emerging solutions are a fine balance between technology and the human touch.

As customers become more vocal and assertive of their needs, their expectations are changing across industries. Consequently, customer service has gone from being a hygiene factor to actively influencing the customer’s choice of product or service. This trend is also being seen in the healthcare segment. Today good healthcare service is no longer defined by just qualified doctors and the quality of medical treatment offered. The overall ambience, convenience, hospitality and the warmth and friendliness of staff is becoming a crucial way for hospitals to differentiate themselves.

A study by the Deloitte Centre for Health Solutions in fact indicates that good patient experience is also excellent from a profitability point of view. The study, conducted in the US, analyzed the impact of hospital ratings by patients on overall margins and return on assets. It revealed that hospitals with high patient-reported experience scores have higher profitability. For instance, hospitals with ‘excellent’ consumer assessment scores between 2008 and 2014 had a net margin of 4.7 percent, on average, as compared to just 1.8 percent for hospitals with ‘low’ scores.

This clearly indicates that good customer service in hospitals boosts loyalty and goodwill as well as financial performance. Many healthcare service providers are thus putting their efforts behind: understanding constantly evolving customer expectations, solving long-standing problems in hospital management (such as long check-out times) and proactively offering a better experience by leveraging technology and human interface.

The evolving patient

Healthcare service customers, who comprise both the patient and his or her family and friends, are more exposed today to high standards of service across industries. As a result, hospitals are putting patient care right on top of their priorities. An example of this in action can be seen in the Sir Ganga Ram Hospital. In July 2015, the hospital launched a ‘Smart OPD’ system — an integrated mobile health system under which the entire medical ecosystem of the hospital was brought together on a digital app. Patients could use the app to book/reschedule doctor’s appointments and doctors could use it to access a patient’s medical history, write prescriptions and schedule appointments. To further aid the process, IT assistants were provided to help those uncomfortable with technology.

The need for such initiatives and the evolving nature of patient care were among the central themes of the recently concluded Abbott Hospital Leadership Summit. The speakers included pundits from marketing and customer relations along with leaders in the healthcare space.

Among them was the illustrious speaker Larry Hochman, a globally recognised name in customer service. According to Mr. Hochman, who has worked with British Airways and Air Miles, patients are rapidly evolving from passive recipients of treatment to active consumers who are evaluating their overall experience with a hospital on social media and creating a ‘word-of-mouth’ economy. He talks about this in the video below.


As the video says, with social media and other public platforms being available today to share experiences, hospitals need to ensure that every customer walks away with a good experience.

The promise gap

In his address, Mr. Hochman also spoke at length about the ‘promise gap’ — the difference between what a company promises to deliver and what it actually delivers. In the video given below, he explains the concept in detail. As the gap grows wider, the potential for customer dissatisfaction increases.


So how do hospitals differentiate themselves with this evolved set of customers? How do they ensure that the promise gap remains small? “You can create a unique value only through relationships, because that is something that is not manufactured. It is about people, it’s a human thing,” says Mr. Hochman in the video below.


As Mr. Hochman and others in the discussion panel point out, the key to delivering a good customer experience is to instil a culture of empathy and hospitality across the organisation. Whether it is small things like smiling at patients, educating them at every step about their illness or listening to them to understand their fears, every action needs to be geared towards making the customer feel that they made the correct decision by getting treated at that hospital. This is also why, Dr. Nandkumar Jairam, Chairman and Group Medical Director, Columbia Asia, talked about the need for hospitals to train and hire people with soft skills and qualities such as empathy and the ability to listen.

Striking the balance

Bridging the promise gap also involves a balance between technology and the human touch. Dr. Robert Pearl, Executive Director and CEO of The Permanente Medical Group, who also spoke at the event, wrote about the example of Dr. Devi Shetty’s Narayana Health Hospitals. He writes that their team of surgeons typically performs about 900 procedures a month which is equivalent to what most U.S. university hospitals do in a year. The hospitals employ cutting edge technology and other simple innovations to improve efficiency and patient care.

The insights gained from Narayana’s model show that while technology increases efficiency of processes, what really makes a difference to customers are the human touch-points. As Mr. Hochman says, “Human touch points matter more because there are less and less of them today and are therefore crucial to the whole customer experience.”


By putting customers at the core of their thinking, many hospitals have been able to apply innovative solutions to solve age old problems. For example, Max Healthcare, introduced paramedics on motorcycles to circumvent heavy traffic and respond faster to critical emergencies. While ambulances reach 30 minutes after a call, the motorcycles reach in just 17 minutes. In the first three months, two lives were saved because of this customer-centric innovation.

Hospitals are also looking at data and consumer research to identify consumer pain points. Rajit Mehta, the MD and CEO of Max Healthcare Institute, who was a panelist at the summit, spoke of the importance of data to understand patient needs. His organisation used consumer research to identify three critical areas that needed work - discharge and admission processes for IPD patients and wait-time for OPD patients. To improve wait-time, they incentivised people to book appointments online. They also installed digital kiosks where customers could punch in their details to get an appointment quickly.

These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.