Maternal and pregnancy-related premature deaths in India

Maternal and pregnancy-related premature deaths in India

India loses 5 mothers every hour, accounting for the maximum number of maternal deaths in the world.

New Delhi, Jan 13, 2017: Each year, 45,000 women die due to preventable pregnancy-related causes across India. These alarming statistics reflect the importance of strengthened comprehensive health care systems and promoting institutionalized deliveries.

There are several factors that account for maternal mortality in India. Hemorrhage (25.6 percent) is the topmost cause of maternal death, followed by sepsis (13 percent), toxemia of pregnancy (11.9 percent), abortions (8 percent) and obstructed labor (6.2 percent) while other causes together account for the remaining 35.3 percent.

Padma Shri Awardee Dr. K.K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement said that, “The WHO defines maternal death as ‘the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes’. Various governmental schemes like the Janani Suraksha Yojana (JSY) and Rashtriya Swasthya Bima Yojana (RSBY) have contributed to a significant rise in institutional deliveries, which account for more than 80 percent at present. However, increasing deliveries at healthcare facilities are not reflected in a decline in maternal mortality. The missing link in this regard is the quality of healthcare that these mothers are getting, especially in rural remote areas. Moreover, literacy and social issues also correlate directly to maternal deaths. Other determinants include nutrition, poverty, and socioeconomic marginalisation. There is a need to work on these issues beforehand.”

The current challenge in this context would be to identify and duly outline the role of governments, health organisations, communities, and households to improve access, delivery, and utilisation of existing health care services and optimising them on a real-time basis.

“It is clear that the current system is unable to meet the needs of pregnant women. Most importantly, complications of pregnancy and obstetrical emergencies need to be addressed in a holistic manner. Apart from addressing the medical aspects, there is also a strong need too look at these issues from a social perspective. Awareness campaigns aimed at educating women about antenatal care and hygiene, the importance of institutional deliveries and utilizing current resources of maternal healthcare are needed. Shortage of equipment and trained staff at referral facilities and lack of emergency transport also need a closer look”, added Dr. Aggarwal.

Some ways that organisations can help improve maternal health outcomes are as follows:
Early registration of antenatal cases.
Health education of expecting couples.
Availability and awareness regarding Iron–Folicacidtablets and fortified food, even to the most remote ares.
Prevention and early treatment of infection, antepartum and postpartum haemorrhage.
Treatment of diabetes, hypertension, tuberculosis and malaria that are common concommitant ilnesses.
Awareness about asceptic measures during delivery.
Close monitoring of high risk cases like those with diabetes, heart diseases etc.
All IMA doctors have been encouraged to support the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) and offer free antenatal check-ups to pregnant woman at government premises on the 9th of every month.

Sources:
5 women in India die every hour during childbirth: WHO
http://medind.nic.in/maa/t05/i3/maat05i3p214.pdf
http://www.iegindia.org/upload/publication/Workpap/wp353.pdf
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About IMA: Indian Medical Association is the only representative, national voluntary organization of Doctors of Modern Scientific System of Medicine, which looks after the interest of doctors as well as the well being of the community at large. It has its Headquarter in Delhi and State / Terr. Branches in 29 States and Union Territories. It has over 2, 53,000 doctors as its members through more than 1650 active local branches spread across the country.