Why in news?
India’s latest maternal mortality ratio (MMR) for 2019–21 was reported at 93 deaths per 100,000 live births. While progress has been made, wide disparities remain across states, prompting renewed debates on women’s health and sustainable development goals.
What is maternal mortality?
- Definition: A maternal death is the death of a woman during pregnancy or within 42 days of its termination, from any cause related to or aggravated by the pregnancy.
- MMR calculation: The ratio measures maternal deaths per 100,000 live births. It reflects the safety of pregnancy and childbirth services.
- Indicator of development: High maternal mortality indicates gaps in healthcare, nutrition and women’s status. Reducing it is part of the UN Sustainable Development Goal 3.1.
Current status and disparities
- National trend: India’s MMR has fallen steadily from over 200 in 2010 to 93 in 2019‑21. The decline reflects better institutional deliveries and improved access to health services.
- State variations: Kerala and Maharashtra report the lowest ratios (around 20–30), while states in the East and Northeast still record high figures. Assam has an MMR above 160, showing persistent gaps.
Challenges behind maternal deaths
- Three delays: Maternal deaths often occur because families delay seeking care, because transport to health facilities is poor, or because hospitals lack skilled staff and emergency supplies.
- Medical complications: Severe bleeding, high blood pressure (pre‑eclampsia), infections and obstructed labour remain leading causes. Underlying anaemia, malnutrition and early marriages increase risk.
- Infrastructure gaps: Many primary health centres lack obstetricians, blood banks or ambulance services. Rural women struggle to access referral hospitals in time.
Government initiatives
- Janani Suraksha Yojana: Cash incentives encourage pregnant women to deliver in health facilities and use antenatal care services.
- Janani Shishu Suraksha Karyakram: Provides free delivery, C‑sections and neonatal care in public hospitals, including free transport and medicines.
- Comprehensive Emergency Obstetric Care: Upgrading community health centres to handle complicated deliveries through skilled staff and surgical facilities.
- Maternal death review: States conduct confidential reviews to identify systemic failures and propose corrective actions.
- Kerala model: Kerala uses a confidential enquiry system to study each maternal death, guiding targeted interventions that have kept its MMR low.
Way forward
- Focus on high‑burden states through targeted investments in health workers, referral systems and blood banks.
- Empower community health workers to provide prenatal care, nutrition counselling and early risk detection.
- Educate families on recognising danger signs and seeking timely care. Encourage spacing of births and delay of early marriages.
- Strengthen postnatal care for mothers and newborns, including iron supplementation and monitoring of blood pressure.