An emergency: maternal mortality rate up

We have to keep up appearances given that we are on the verge of superpowerdom. We have to put our best foot forward even if it means that anyone who gets in the way may come off worse for the wear. So as we were digging, retiling, retrofitting and beautifying the capital’s already torny Connaught Place, a woman died amid the rubble in full public view after giving birth to a sickly baby girl.

Did this send a frisson of shock down the collective spines of the ministries concerned? Or, for that matter, shock many of us? No, because we have more pressing tasks like sweeping beggars into tents so that the Commonwealth Games visitors won’t see these eyesores. To make all this possible, day after day, malnourished mothers dig away at construction sites leaving their wasted babies exposed to the elements and to wandering animals. Yes, these are productive women, they will be instrumental in helping us hold up our heads high when the Commonwealth aerostat goes up.

To die in order to give life is the ultimate cruel irony to be visited on any human being. But this is what is happening to millions of unfortunate women in India. It is as though an uncaring health system has abandoned them even as the government quibbles about how best to ‘control’ the population. For many rural women in India, the birth of a child, normally an occasion for joy and celebration, often means the difference between life and death. For both the mother and the child.

At last count, at least 78,000 women die from pregnancy-related complications each year. This is among the highest maternal mortality rates in the world. The solutions to saving both mother and child are quite simple, and cheap. Just deliver what has been promised in all government programmes. Care and supplements for the expectant mother, health checks through the public health system and professional care for both mother and infant after delivery. In India we are hobbled on many counts. Women are simply not a priority in the health system such as it is. So accustomed have women become to being marginal in the scheme of things that even a pregnant woman does not think herself important enough to deserve special care. The others in the family come first.

So we have the prospect of the malnourished and often underage mother giving birth in unhygienic conditions to a baby whom she does not know how to care for. For most rural women, a clinic is a trek away and often they are denied entry in these places. We have often read reports of women having to give birth outside clinics after being turned away by doctors. It is all very fine to talk of keeping population numbers down, always with the underlying assumption that it is poor who breed like rabbits. But how about caring for the babies on the way and their mothers before planning to stop future infants from being born?

It is appalling that while the government, and indeed many of us, keep worrying about the rising population, we pay no heed to one vital fact that could keep the numbers down. The assurance to a mother that both she and her child would be born into good health. Has any health worker gone around to the many thousands of women who are working day and night on the Commonwealth Games to enquire whether either they or their infants have any access to healthcare? In village after village, the story of our dismal healthcare is the same. The public health clinics, such as they are, are usually locked for the better part of the year. There are no health workers worth the name. Those few that do function give out the ubiquitous pink pills that are meant to treat a variety of illnesses from iron deficiency during pregnancy to fevers.

As the ebullient Jill Sheffield, president of Women Deliver, put it to me recently, women’s health is never top of the agenda for anyone. She spoke of how she made an impassioned plea to the World Bank on the issue of maternal health complete with facts and figures. At the end of her presentation, where she felt she had literally slain them in the aisles with her emphasis on women’s health and its direct correlation to economic worth, the officials asked her if she could provide them with all the data on a format which could fit into a pocket. For a professional of so many years, this was disconcerting. But she did just that and the World Bank, in a sort of epiphany, understood what she had been saying for so many, many painful hours.

Maybe this would be good idea in India. Let us not have lengthy policies on maternal health. Let us just have some back of the envelope calculations. It shouldn’t be too tough for Health Minister Ghulam Nabi Azad to figure out that no woman should be allowed to die producing a child, which will add to the demographic dividend that we are so proud of. That a woman’s health is pivotal to the economic productivity that has catapulted us near-great nation status. But it does not do us proud to tell the world that while we are zooming down our exclusive Commonwealth lanes, a woman gave birth to a child who will never know who her mother was and how painful it was for her to bring her little daughter into this world.

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