Articles

Overview:

The blog discusses the many challenges women face while accessing maternal health services. The ways to overcome these challenges are also discussed.

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Maternal health refers to the health of a mother in the antenatal period, during delivery and in the postpartum period. It is necessary to ensure quality care during these periods so that maternal and child wellness is optimum. The maternal mortality ratio (MMR) is an indicator of a country’s ability to ensure a safe motherhood journey. According to the WHO, it is “The number of maternal deaths during a given time period per 1,00,000 live births during the same time period.” While the MMR in India has seen a significant decline and is currently said to be at 93 deaths per 1,00,000 live births, to achieve the sustainable development goal (SDG) set by the UN for MMR (lower than 70 deaths per lakh of live births), a lot of work still needs to be done.

Challenges Faced

The obstacles faced by women while accessing maternal health services are manifold. The WHO has identified the following as the main barriers faced.

• Financial Constraints

  The cost of maternal health services plays heavily on women’s minds and they end up foregoing prenatal visits and postpartum care. Women in rural areas may find it difficult to pay for transportation to cities and end up losing out on advanced imaging facilities that are typically only available in cities.

• Geographic Constraints

  Women living in remote areas may have trouble finding transportation to hospitals. Lack of access to ambulance services might delay emergency care.

• Socio-Cultural Constraints

  These constraints play a huge role in women accessing maternal health services. Issues include:
  • Gender Discrimination: This can affect women’s education and awareness, thus depriving them of knowledge regarding skilled birth attendance and the importance of antenatal and postpartum care. Women’s decision-making ability too can be severely restricted.
  • Traditional Beliefs: Long-standing practices deter professional medical services’ usage and coerce women to choose home births and traditional healers instead.

• Healthcare Constraints

  • Lack of Trained Healthcare Workforce: Not having enough medical personnel or a lack of skilled personnel can result in substandard care.
  • Lack of Resources: Not having the necessary equipment, medication, etc. can severely affect the quality of care rendered.
  • Disrespectful Behaviour: Not treating women with the respect they deserve may result in women foregoing essential services.
  • Miscommunication: Doctors not communicating properly with patients leads to patients not trusting doctors. Further, miscommunication among doctors can lead to missed diagnoses and poor treatments.

Possible Solutions

A comprehensive, multi-sectoral effort is essential to address maternal health concerns. An outline of what can be done is given below:

• Role of States and Communities:

  • Focus on improving overall health by paying attention to clean water, unpolluted air, adequate housing, nutritious food, safe communities, affordable transportation and community fitness centres.
  • Spread awareness on the importance of maternal health and frame policies in support of it.
  • Implement telehealth and emergency obstetric services for rural areas/outskirts.
  • Identify areas where discrimination (based on religion, caste, language, etc.) affects healthcare delivery and implement plans to overcome the same.
  • Ensure co-ordination between academic centres and hospitals to provide staff training and ensure continuity of care.

• Role of Healthcare Systems:

  • Healthcare leaders should make sure trained workforce, equipment and services are available across health centres.
  • Have standardized maternal care guidelines and check their implementation.
  • Engage with health insurers to bridge the gap in access to health facilities and other barriers.
  • Provide additional training in obstetric emergencies to family physicians serving in rural/distant areas.
  • Make sure that women feel comfortable in healthcare settings.
  • Tailor care according to cultural preferences.

• Role of Healthcare Professionals:

  • Identify inconsistencies in care and work to remove disparities.
  • Listen to women’s concerns without any preconceived notions.
  • Talk to families about providing a supportive environment for pregnant women.
  • Educate women on signs to watch out for so that they can get timely care.
  • Train non-obstetric healthcare providers who will be involved in the postpartum period (like pediatricians) to identify postpartum conditions.

• Role of Families:

  • Encourage women to practice good lifestyle habits and not ignore health checks.
  • Involve the father in the pregnancy journey.
  • Be aware of warning signs and risk factors to identify when women need help.
  • Support women through the breastfeeding period.

Equipping Women with Knowledge

Given below are some crucial steps women themselves can take to enjoy a safe and happy motherhood journey.

• Pre-Conception Planning

  • The steps to take to ensure a healthy pregnancy start even before conception. If the body is in a good condition before pregnancy, it is better prepared to handle pregnancy.
  • A nutritious diet is a must. Prenatal supplements can be taken after consultation with a gynecologist.
  • Achieving/maintaining a healthy weight before becoming pregnant can drastically reduce the risk of complications during pregnancy.
  • Lifestyle modifications like quitting smoking, alcohol and drugs are essential to protect both the mother’s and the baby’s health.

• Gestational Period

  • This is the period between conception and birth.
  • During this period too nutrition is extremely important as the mother’s body is now nourishing a child as well. Along with a well-balanced diet, nutrient intake (calcium, iron, etc.) should also be monitored.
  • Staying physically active by doing supervised, low-impact activities is advised.
  • Pregnancy can be emotionally draining for some – prenatal yoga, breathing techniques and other relaxation methods will help in handling this emotionally demanding period.
  • Adequate hydration should be ensured. While 6-8 glasses a day is what is advised, it is best to consult a gynaecologist as individual requirements will vary.
  • If there are pre-existing health conditions, it is imperative to avail professional help and have them strictly monitored.

• Labour and Delivery

  • The apprehension as the D-day approaches is a normal feeling but one that can be managed if we know what to expect.
  • Discuss how to prepare for delivery with the gynaecologist.
  • Antenatal classes can help prepare expectant parents for the parenting journey and the challenges that lays ahead.

Maternal health care is a human right. The responsibility in ensuring this fundamental right falls on all of us – the government, the healthcare system, the society and the family.

Smart Motherhood Starts Here: Common Questions on Maternal Care

What is maternal health and why is it important?

Maternal health refers to the well-being of women during pregnancy, childbirth, and the postpartum period. Ensuring quality maternal healthcare reduces risks for both mother and baby, promotes safe deliveries, and supports long-term family health.

What causes high maternal mortality rates in some regions?

High maternal mortality rates are often due to limited access to skilled healthcare, poor nutrition, lack of transportation, cultural barriers, and insufficient emergency obstetric care, especially in rural or underdeveloped areas.

What can women do before pregnancy to improve maternal health outcomes?

Pre-conception care is crucial. Eating a balanced diet, maintaining a healthy weight, avoiding alcohol and tobacco, taking prenatal vitamins, and managing pre-existing conditions can significantly reduce complications during pregnancy.

How can families support a healthy pregnancy?

Families play a vital role by encouraging regular check-ups, promoting healthy lifestyle habits, being emotionally supportive, recognizing warning signs early, and involving fathers in the pregnancy and parenting journey.

How can healthcare systems improve maternal care in India?

Healthcare systems can improve maternal health by training more professionals, ensuring availability of equipment and medication, offering respectful care, and making culturally sensitive services accessible even in remote areas.

Why is postpartum care as important as prenatal care?

The postpartum period is when women are most vulnerable to health issues like infections, depression, or complications from delivery. Regular follow-ups, emotional support, and health checks help ensure full recovery and maternal wellness.