Under Safe motherhood there are two divisions

• MDNMSR Committee
• Preventing the Preventable Maternal Deaths training (PPMD)

The MDNMSR - Maternal Death Near-miss Surveillance and Response functions under the Safe Motherhood Committee with the primary objective of ensuring the safety of every antenatal woman. Its ultimate mission is to eliminate all preventable maternal deaths through systematic review and learning.

Maternal Near Miss (MNM) audits focus on women who have survived life-threatening complications during pregnancy, childbirth, or the postpartum period, based on WHO near miss criteria. Each survivor represents a valuable learning opportunity in obstetrics.

The committee aims to systematically document these near miss cases and facilitate discussions on selected cases through interactive platforms involving practicing obstetricians and subject experts. This approach promotes shared learning and improvement in clinical practice.

This initiative is currently being advanced under the Safe Motherhood Chairperson, Dr. B. Prasannakumari, with the support of experienced obstetricians and gynecologists. The program is coordinated at the state level by the State co- ordinator . The present state co ordinator is Dr Kala. At the district level it is co ordinated by the district captains, vice-captains, with the continued support of the Government of Kerala. Organization State Level

The state team comprises:

• KFOG President
• KFOG Secretary
• Safe Motherhood Chairperson
• MDNMSR Coordinator
• All District Captains and Vice-Captains
• RCH Officers

District Level

Every practicing obstetrician is a member of the district team.Each district team is led by:One Captain and Three Vice-Captains.The District Collector heads the district review meetings.Meetings are convened by the RCH Officer.In the absence of the District Collector, the District Medical Officer (DMO) presides.KFOG is represented through district captains.

Roles of Vice-Captains

• Reporting all maternal deaths to the state and CRMD coordinator
• Reporting all maternal near miss cases
• Preparing and submitting meeting minutes to the state coordinator

Achievements and Ongoing Activities

Under the previous State Coordinator, Dr. Lekshmiammal, maternal near miss reviews were transformed into a powerful educational tool for practicing obstetricians. Dr Lekshmiammal did a great job in organising MDNMSR meetings regularly and set a benchmark.

Post-COVID, the committee revitalized regular district meetings across all districts, where selected near miss cases are presented and discussed.

Since 2024, MDNMSR Case Connect Webinars have been introduced, further strengthening knowledge sharing. These efforts have been complemented by Safe Motherhood webinars by the chairperson.

These platforms have evolved into valuable forums for: Expert guidance, Dissemination of updated guidelines and protocols and Experience sharing among clinicians.

Future Directions

While significant progress has been made, there remains considerable scope for strengthening the program. As Chairperson, the focus will be on:

• Ensuring monthly, well-structured district meetings across all regions
• Encouraging consistent reporting of all near miss cases through active engagement of captains and vice-captains
• Promoting full participation of practicing obstetricians in meetings and webinars
• Developing a comprehensive database with analytical insights from near miss cases
• Extracting and documenting key clinical lessons (“pearls of wisdom”) from each case

In PPMD i.e Prevent the Preventable Maternal Deaths, training sessions and classes are taken at every district with the aim to train and teach and update all the practising gynecologists and nursing personnel in the Dept of OBG. The PPMD training under the chairperson Prof Dr Pressanakumari and present state Co-ordinator Dr Agnes Mathew has come up innovative ideas to execute the same. In the year 2025 the training was more of a simulating case scenarios based management involving most common obstetric emergencies.The preparedness of the staff was assessed to tackle the same. Similarly new plans and agenda and training modules are in the queue for the upcoming year.

We have plans to develop an Application for including all pregnant women so that they can communicate to the Obstetrician when needed.

So tackling from multiple aspects, the committee is with the agenda that every motherhood begins and ends as a safe journey .