This petition aims to ensure safer pregnancies and deliveries in Sri Lanka through three critical initiatives.

SAFE PREGNANCY IN SRI LANKA
A National Patient-Safety, Pregnancy-Education and Pre-Pregnancy Education Initiative
A Proposal for Safer Pregnancies and Deliveries in Sri Lanka

1. Our Vision
Every mother in Sri Lanka should have access to clear, evidence-based pregnancy information, understand the important decisions surrounding the timing of delivery, and receive care that prioritizes the safety of both mother and baby.

We believe that pregnancy safety is not only a medical responsibility. It is also a responsibility of education, communication, informed decision-making, and health-system quality.

With this vision, we propose Safe Pregnancy in Sri Lanka, a community and national-level initiative built around three approaches.

 

2. The Three Approaches
Approach 1 — A 39-Week Safety Hard Stop for Non-Medically Indicated Delivery
We propose consideration of a 39-week safety hard-stop system for planned deliveries that have no documented medical indication before 39+0 weeks.

The purpose is not to prevent medically necessary early delivery.

There are circumstances in which delivering before 39 weeks is medically appropriate and potentially lifesaving for the mother or baby. These situations must remain fully supported.

The proposed principle is:

• When there is no medical indication for early delivery, planned induction, cervical ripening, or delivery should not occur before 39+0 weeks.

Where an early delivery is medically necessary, the specific medical indication should be clearly documented.

Such a system could improve transparency, clinical governance, communication with parents, and patient safety.

We also propose strengthening monitoring and documentation of babies requiring NICU admission following early-term delivery, so that Sri Lanka can better understand patterns of neonatal respiratory complications, infection, morbidity and mortality.

Approach 2 — Simple Pregnancy Education in Local Languages
Every family deserves understandable pregnancy information from the beginning of pregnancy.

We propose that simple, evidence-based pregnancy education be made available to mothers and families within the first two months of pregnancy, preferably in the languages they understand best.

Education could include:

• Pregnancy development week by week
• The meaning of preterm, early-term and full-term pregnancy
• Why the timing of delivery matters
• Benefits and risks associated with different delivery timings
• When early delivery may be medically necessary
• Common pregnancy and newborn complications
• Warning signs requiring urgent medical attention
• Questions parents can ask before an induction or planned delivery
• The importance of antenatal care
• Newborn safety and when to seek urgent care
• The objective is not to replace medical advice.

Rather, it is to ensure that mothers and families can have informed conversations with their healthcare providers.

Approach 3 — Pre-Pregnancy Education for Future Mothers
Pregnancy education should begin before pregnancy.

We propose introducing age-appropriate health education for girls and young women as they complete school, helping them understand the foundations of a healthy future pregnancy.

Topics could include:

• Healthy nutrition
• Prevention and awareness of anaemia
• Folic acid and pregnancy preparation
• Maintaining a healthy weight
• Physical activity
• Avoiding harmful substances
• Understanding reproductive health
• The importance of medical care before and during pregnancy
• Understanding fertility and factors that may affect reproductive health
• Planning for a healthy future pregnancy
• The purpose is to build a generation that enters pregnancy with better knowledge and healthier foundations.

3. Why This Initiative Matters to Me

This initiative was born from a deeply personal experience.

I am a father who lost his newborn son  in two days following a delivery at 37+3 weeks of gestation.

Our pregnancy was uncomplicated Pregnancy. We had concerns about delivering before spontaneous labour when we were told for IOL at the last clinic.  Later, We specifically expressed our hesitation regarding delivery at 37 weeks by email conversation.

We were reassured that delivery at that gestational age was safe for both mother and baby.

 Our son was subsequently born at 37+3 weeks, following induction of labour. Labour had been initiated approximately 13 hours before birth.

Artificial rupture of membranes was performed approximately two hours before birth.

Approximately three hours after birth, my wife noticed that our baby's lips appeared blue, she thought it is reflection of her iron supplements.

Approximately another four hours later, grunting was observed, and the baby was transferred to the baby room in the private hospital.

Approximately 4 hours after that, our baby was admitted to the NICU in Jaffna Teaching Hospital.

Diagnosis was PDA + Moderate PPHN

Approximately another 30 hours later, on 2 October, our son died.

Later, we were informed that an infection had been identified in his blood on the day of NICU admission.

The postmortem examination reported a four-chambered heart with a large PDA, no ASD or VSD, and normal valves. The lungs were congested.

Histopathology reported:

Heart — no abnormalities identified
Brain — autolysed
Lungs — bilateral NRDS
Kidney — oedematous
The stated cause of death was:

“Sequelae of PDA with PPHN.”

The postmortem examination was conducted approximately 33 days after his death.

4. From Personal Tragedy to Public-Health Question
After our son's death, We were subsequently concerned that the timing of our son's delivery was influenced by the VOG's professional travel commitments, including attendance at a FIGO conference.

I began researching the timing of delivery, early-term birth, neonatal respiratory complications, NICU admission and the physiological differences between 37, 38 and 39 weeks.

This research introduced us to the concept of early-term pregnancy, which refers to 37+0 through 38+6 weeks.

We also learned about international recommendations concerning non-medically indicated delivery before 39 weeks.

Guidance from organizations including ACOG and SMFM emphasizes avoiding non-medically indicated delivery before 39+0 weeks, while recognizing that medically indicated early delivery may be necessary.

We also examined WHO recommendations concerning induction of labour in uncomplicated pregnancies.

This research changed our understanding of an issue we had previously known very little about.

Most importantly, we realized that the distinction between medically necessary early delivery and non-medically indicated early delivery is extremely important for parents to understand.

5. What We Are Asking For
We are not asking doctors to delay medically necessary deliveries.

We are asking for a stronger system in which:

A. Medical indications are clearly documented
When a delivery is planned before 39 weeks, the medical reason should be clearly recorded.

B. Parents receive understandable information
Parents should understand:

• Why an early delivery is being recommended
• What medical condition makes it necessary
• What the alternatives are, where applicable
• What the potential benefits and risks are
• What may happen if delivery is delayed

C. Non-medically indicated early deliveries are prevented
Sri Lanka should consider a 39-week hard-stop mechanism for planned non-medically indicated deliveries.

D. Pregnancy information is available in local languages
Every mother should have access to understandable pregnancy education in Sinhala and Tamil, as well as appropriate English resources.

E. Neonatal outcomes are monitored
Hospitals should strengthen documentation and review of early-term deliveries, NICU admissions and relevant neonatal outcomes so that Sri Lanka can continuously improve its maternal and newborn healthcare system.

F. Pre-pregnancy education is strengthened
Young people should receive appropriate education that prepares them for healthier future pregnancies.

 

6. What We Are NOT Asking For
This initiative is not intended to:

• Interfere with doctors' clinical judgment
• Prevent medically necessary early deliveries
• Blame individual healthcare professionals
• Replace professional medical advice
• Tell parents to refuse medically recommended treatment
• Suggest that every early-term delivery is unsafe
• Claim that gestational age alone determines the outcome of a newborn

Our objective is much simpler:

To strengthen the system around pregnancy care so that medically necessary decisions are made transparently, parents are informed, and avoidable risks are reduced wherever possible.

7. How You Can Help
We are not asking every organization or individual to implement this initiative themselves.

We are asking you to help take this proposal to the highest level of authority that is accessible to you, through your professional, institutional, community or public networks.

If you believe that these proposals could contribute to safer pregnancies and newborn outcomes in Sri Lanka, we respectfully ask you to:

Review and consider this proposal.
Share it with the relevant medical, public-health, educational or policy authorities within your network.
Introduce or recommend this initiative to the people and institutions who have the authority to consider, develop or implement such policies.

Encourage relevant professional bodies and government authorities to examine the proposed 39-week safety hard-stop, pregnancy education in local languages, and pre-pregnancy education.
Provide your professional guidance on how these proposals could be practically and safely implemented within Sri Lanka's existing healthcare and education systems.
We are especially asking those who have greater access to decision-makers than an individual citizen may have to use that access to help move this proposal forward.

Our hope is that this initiative will not remain only a petition or a public discussion.

We hope it can reach the people and institutions with the authority to review the evidence, develop appropriate policy, establish practical safeguards, and ultimately implement meaningful improvements for families across Sri Lanka.

You do not need to personally carry the entire initiative.

If you can take this proposal one step closer to the appropriate authority, that itself would be meaningful support.

The level to which you can take this proposal is entirely dependent on your position, relationships and access. We simply ask that you take it as far as you reasonably can toward those who have the authority to create and implement change.

Even one introduction to the right person could help move Safe Pregnancy in Sri Lanka from a personal appeal toward a meaningful national conversation.

8. Our Appeal
Our son cannot be brought back.

But his life can become part of something meaningful.

We cannot change what happened to our family. We can, however, use our experience to ask an important question:

• Can Sri Lanka strengthen its pregnancy-care system so that every mother receives the knowledge, communication and safeguards she deserves?

We believe the answer should be yes.

We therefore invite medical professionals, public-health experts, community organizations, educators, policymakers, religious leaders, universities, NGOs and concerned citizens to work with us to explore practical, evidence-based improvements.

This is not about one hospital, one doctor, or one family.

It is about building a culture in which:

Every mother is informed.
Every medical indication is clear.
Every unnecessary risk is reduced.
Every newborn receives the best possible start.

SAFE PREGNANCY IN SRI LANKA

From one family's loss — toward a safer future for every family.

We respectfully request your support  in developing this initiative.