A special bulletin on maternal mortality has revealed that Indian women in their 20s make up for the biggest chunk of maternal deaths. The report by the Sample Registration Survey (SRS) from 2015 to 2017 shows 68% of deaths were among women in the age group of 20-29. The three-year data also reveals a positive development of reduction in the maternal mortality ratio (MMR) as compared to 2014-2016.
“It is heartening that the MMR of India has declined from 130 in 2014-2016 to 122 in 2015-17. The drop has been most significant in empowered action group (EAG) States from 188 to 175,” the report said.
The SRS had categorised the States into three groups — the EAG States comprise Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh, Uttarakhand, and Assam; southern States consist of Andhra Pradesh, Telangana, Karnataka, Kerala, and Tamil Nadu; and Other States cover the remaining States and Union Territories. “Among the southern States, the decline has been from 77 to 72 and in the Other States from 93 to 90,” the report said.
What is maternal death?
Maternal death is 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.
Where do maternal deaths occur?
The high number of maternal deaths in some areas of the world reflects inequalities in access to quality health services and highlights the gap between rich and poor. The MMR in low income countries in 2017 is 462 per 100 000 live births versus 11 per 100 000 live births in high income countries.
Why do women die?
- -Women die as a result of complications during and following pregnancy and childbirth. -Most of these complications develop during pregnancy and most are preventable or treatable.
- -Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care.
- -The major complications that account for nearly 75% of all maternal deaths are: severe bleeding (mostly bleeding after childbirth), infections (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia), complications from delivery and unsafe abortion.
Factors that prevent women from receiving or seeking care during pregnancy and childbirth:
- poverty
- distance to facilities
- lack of information
- inadequate and poor quality services
- cultural beliefs and practicesAs per the World Health Organization (WHO), maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy. The WHO says the MMR dropped by 38% worldwide between 2000 and 2017. However, an estimated 810 women died every day in 2017 from preventable causes related to pregnancy and childbirth.
According to gynaecologist Dr. Ashok Anand, who is attached to State-run JJ Hospital in Mumbai, women have to prepare their bodies and be fit for pregnancy. “Unfortunately, the aspect of fitness is simply ignored.”
JJ Hospital carries out 8,500 deliveries annually. Dr. Anand said bleeding, hypertension, and infections are among the leading causes of maternal deaths. He said the highest number of deaths are seen in the age group of 20-29 because most women get married and get pregnant in this age group. “This is also the most fertile age group.”
Nearly 4% of deaths were in the age group of 15 to 19 which highlights the problem of early marriages and teenage pregnancies in the country. The sustainable development goals set by the United Nations target reducing the global MMR to less than 70 per one lakh live births by 2030.
