Fostering a commitment to prevent maternal deaths

Maternal Mortality in India: A Comparative Analysis

Maternal Mortality Ratio (MMR):

• Estimated at 93 maternal deaths per 1,000 live births in 2019-21.

• Declined from 103 in 2017-19 to 93 in 2019-21.

States Categorized into Maternal Mortality:

• “Empowered Action Group” States: Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh, Uttarakhand, Assam.

• “Southern” States: Andhra Pradesh, Telangana, Karnataka, Kerala, Tamil Nadu.

• “Other” States: Maharashtra, Gujarat, Punjab, Haryana, and West Bengal.

Three Delays Leading to Maternal Deaths:

• Recognizing impending danger and seeking expert care.

• Transportation delays: Long journeys from remote rural hamlets to health facilities.

• Initiating specialized care at the health facility.

• Lack of specialists and blood banks: Many mothers not receiving adequate blood transfusion within two hours of massive bleeding after delivery.

Strategies to Reduce Maternal Deaths:

• Address these three “three delays.”

Maternal Deaths and Their Causes:

• Bleeding Post-Delivery: Major cause of maternal deaths due to inadequate contraction of an overstretched uterus.

• Obstructed Labour: Prolonged labour can lead to foetal distress and a lethal rupture of the uterus.

• Hypertensive Disorders of Pregnancy: Unrecognized and untreated hypertensive disorders can result in severe emergencies.

Focus Areas for States:

• Early registration, routine antenatal care, and institutional delivery.

• Kerala model of a Confidential Review of Maternal deaths.