Every gynecologist and obstetrician′s worst nightmare is an unexpected problem during delivery at the end of what might have been a normal gestation.

Today′s obstetrics practice is so fraught with uncertainty and discouragement that many young physicians are turning to safe havens like infertility medicine, laparoscopy, fetal medicine, or gynec-oncology instead.

Hence, to reduce and manage obstetric difficulties, the Kerala Federation of Obstetrics and Gynecology is collaborating with the government to train medical professionals working in mid-level institutions.

Obstetric physicians have experienced a lot of discouragement due to the recent spate of events in Kerala, where unexpected maternal deaths sparked rioting, and the doctors were charged with medical negligence. A 9-minute Malayalam video was posted on the KFOG YouTube channel and featured medical professionals discussing their real-life experiences with challenging births and how they handled the close calls.

During unanticipated obstetric crises such as amniotic fluid embolism, HELLP or cardiac emergencies, quick situation evaluation, decision-making, and the time required to carry out the necessary intervention become essential.

The ability of the doctor at the mid-level center to make the difficult decision to send the patient to a larger hospital and contribute to the saving of lives in difficult circumstances depends on strong relationships, teamwork, and networking between hospitals.