Maternal Health Care In India: A Crisis Beyond Control
By Anwesha Bose:
Maternal health care is a rather wide term. Often, the term is confused with only the period of time, when the women gives birth to the child. However maternal health care is a concept that encompasses family planning, preconception, prenatal, and postnatal care.
In the Indian scenario, all the above mentioned phases are not very well defined. This stems from the lack of education and awareness among women, traditional nature of families and plain indifference. Now, the crisis varies with location like urban or rural, with income of the family and even with castes like scheduled tribes.
Family planning in India has been a matter of debate since time immemorial, considering the exploding number of people. Government has come up with various nationwide programmes to curtail the increasing number. Despite having one of the oldest family planning programs in the world, India has a fertility rate of 2.9 and a crude birth rate of 23/1,000 persons. Thus statistically, the number of births per female is a rather high number. Such high rates of birth and fertility indicates that on an average woman give birth to at least two children during their reproductive age. While that may sound perfectly normal, however in the rural scenario women may give birth to as many as ten children irrespective of the fact whether they can sustain them or not.
Thus often they do not get enough time to recover from childbirth. Factors like haemorrhage (both ante and post partum), toxaemia (Hypertension during pregnancy), anaemia, obstructed labour, puerperal sepsis (infections after delivery) and unsafe abortion cause a high maternal mortality rate.
Maternal death is defined as death of women while pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by pregnancy or its management. The maternal mortality ratio is maternal death per 100,000 live births in one year. WHO estimates show that out of the 529,000 maternal deaths globally each year, 136,000(25.7%) are contributed by India. This is the highest burden for any single country.
In urban areas, services offered for maternal health care sees patterns of inequality. Urban marginalisation takes place in which only the poor are excluded. Private health care services are beyond the budget of marginalised women. While the go may go for birth and check -ups in government run hospitals; however they never measure the survival rate of these women. The Indian government stated that maternal health in the country had considerably improved because 10 million women had given birth in health facilities in 2009 and into 2010. Under its flagship National Rural Health Mission and Janani Suraksha Yojana (JSY), or Safe Motherhood Scheme, the Indian government uses cash incentives to encourage women to give birth in health facilities. The government does not, however, measure the numbers of women who survive the delivery and the post delivery period, a much more accurate measure of success.
As a natural process, females do gain considerable amount of weight during pregnancy and this carries on even after child birth. But many of them ignore this change and remain unaware of the complications which arise due to them. The condition however becomes, so worse that women become obese which leads to hormonal imbalances and increasing hypertension. Further, many now face the crisis of not been able to conceive on time after marriage. Many of such women lie in the above 30 age group, who have devoted much of their time in career building.
Our society is caught in the crossroads; emerging from the traditional methods of child birth, government schemes and women’s rights. Caught in this confusion, many families know what is the right thing to do, but they are blinded by superstitions and lack of information.
We as the youth should volunteer to provide information for maternal care whether it is through Social work, or through people around us. Many aspiring doctors are blinded by ‘money’ rather than the work they ought to do. For them, it is important to remember the oath they took- to work selflessly for the life of another.
Blaming the government is easy, but to become the change you wish to see is difficult.
A mother is all compassionate and ever sacrificing, and whenever she dies, one child is left orphaned. So it is time that we wake up to this terrible reality about maternal health care. To end I quote Helen Rice;
“A mother’s love is patient and forgiving when all others are forsaking, it never fails or falters, even though the heart is breaking”
Image courtesy: http://www.pluggd.in/infant-maternal-care-in-india-gets-the-attention-of-the-gates-foundation-297/