In a trend pointing to increasing awareness of antenatal care, the number of non-institutional deliveries in Mumbai has seen a steady decline over the past several years. From 1,701 in 2011, the number of home births came down to 415 in 2018. In 2019, a total of 260 home births were recorded till July.
However, the high number of non-institutional births in areas with dense slum pockets and migrant population remains a cause of concern.
Civic officials attribute the improvement to increased awareness and better access to health facilities and antenatal care. “Our health workers on the ground are constantly talking to women and couples to motivate them,” said Dr. Padmaja Keskar, the executive health officer of the Brihanmumbai Municipal Corporation (BMC).
She said the BMC also implements the Janani Suraksha Yojana, under which poor women who give birth in medical institutions get ₹600.
Institutional births play a crucial role in reducing maternal and infant mortality and allow the mother and baby to have access to trained health care staff in case of an emergency. The BMC records an average 1.7 lakh deliveries every year. While the non-institutional deliveries are less than 1%, their concentration is seen in slum pockets and areas with a high migrant population. For example, the L and M East wards, which cover Kurla and Govandi, have recorded the highest number of home births for several years.
Of the 1,465 home births recorded in 2015, L ward accounted for 237 and M East for 188 births. In 2016, the two wards recorded 57 and 336 home births respectively. While the number has seen a decline in recent years, the two wards continue to top the chart.
According to the BMC’s assistant health officer, Dr. Chandrashekhar Chiplunkar, both wards have a large population and also poor access to health facilities due to ignorance among residents. “There is also a huge migrant population, and people are from a poor socio-economic background,” he said.
The BMC runs Bhabha Hospital in Kurla and Shatabdi Hospital in Govandi, but they are often criticised for lacking facilities.
Dr. Chiplunkar said home births are uncommon now. “At times, women don’t reach the hospital on time and deliver at home or midway. There are some cases wherein women get false labour pain many times and they land up at the hospital and when they go into labour, they ignore it and deliver at home,” he said.
A 2010 study of determinants and costs of home births in Mumbai slums lists customs and traditions, absence of the husband or a relative to accompany the woman to the hospital, fear of institutional staff, convenience, the hospital being far from home, financial barriers, lack of transport, and poor perception of institutional care as some of the reasons for the practice.
“Women who have poor antenatal care may have high-risk pregnancies, and dealing with complications becomes difficult during home births. The poor also don’t have access to trained midwives and sterilised environment to carry out the birth,” gynaecologist Dr. Kiran Coelho said.
