Once J R D Tata wrote to Jawahar Lal Nehru that uncontrolled population growth would become a burden on our natural resources and infrastructure. Nehru shot back to Tata that the population was the strength of India. Whatever be the logic, institutional support to maternity care is imperative to safe child birth and a healthy population.
India’s poor infrastructural support for women at the time of delivery has come in for sharp criticism by the UNICEF in its State of the World’s Children Report 2009. According to the report, around 78,000 women die each year in the country from pregnancy and childbirth-related causes. This means that on an average one woman dies every seven minutes of complications related to childbirth. Two-thirds of all maternal deaths in the country come from nine states: Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Orissa, Madhya Pradesh, Chhattisgarh, Rajasthan and Assam.
The high maternal mortality rate in the country is the result of multiple problems and all these need to be tackled to reduce maternal deaths. For one, there is a shortage of health care centres in most parts of rural India. Accessing institutional support becomes a problem as pregnant women find the trek to the nearest hospital often involving a walk of several kilometres extremely difficult. In some places, hospitals are accessible but these are poorly equipped or understaffed.
Inspite of limitations, Indian states are making sincere efforts to improve the maternal care infrastructure. To cite some examples, Orissa has initiated a plan of 24-hour free transport facilities to all expecting mothers for institutional delivery. This initiative has been named as ‘Janani Express’.
The maternal mortality rate (MMR) in Bihar has fallen by about 15 percent, as more and more women are opting for institutional deliveries. Women have also been demanding improvement in health services and
infrastructure. Unicef is helping the state government bring down MMR through increasing awareness about health during pregnancy and training of mid-wives. Institutional deliveries in 2006 were 136,000 and now they are over 1.1 million.
However, I was shocked to read a news recently about what is happening in a developed country like UK. As per reports, a shortage of midwives and hospital beds is forcing thousands of British women to give birth outside maternity wards, putting the lives of babies and mothers at risk. Babies are born in offices, lifts, toilets, ambulances, corridors, postnatal and antenatal wards and hospital reception areas. It is said that there has been drastic cut in the number of midwives as well as the number of maternity beds whereas birth rates have been rising sharply, upto 20% in some areas.
The rise in the number of births outside labour rooms in UK is matter of serious concern. What the Govt there is doing?
Dr P R Prasad
Tags: child birth, health care, maternity care, MMR