Maternal mortality: Karnataka disappoints

There is reason for India to draw some satisfaction from the fall in maternal mortality in the country. Maternal Mortality Ratio (MMR) -- the number of maternal deaths per 100,000 live births -- has dropped from 122 in 2015-17 to 113 in 2016-18, according to the special bulletin on Maternal Mortality in India 2016-18, released by the Office of the Registrar General’s Sample Registration System. Five states — Kerala, Maharashtra, Tamil Nadu, Telangana, Andhra Pradesh — deserve applause.

They have achieved the World Health Organisation’s Sustainable Development Goal of bringing down the MMR below 70. While Karnataka’s record has improved -- its MMR dropped from 97 in 2016-17 to 92 in 2016-18 – its performance is disappointing. It lags all the other southern states when it comes to protecting women at the time of childbirth. Consider this: Kerala and Tamil Nadu have MMR of 43 and 60 and stand first and third respectively in the country. Why is Karnataka falling behind its neighbours?

While India’s performance on the MMR has improved, it is disappointing that it has failed to achieve the 2017 National Health Policy’s target of reducing the MMR to 100. States like Assam (215), Uttar Pradesh (197) and Madhya Pradesh (173) need to do more to protect women at the time of childbirth.

An important reason for high maternal mortality is poor nutrition. The health and wellbeing of an expectant mother is not given the priority it deserves. Gender discrimination underlies this problem as women and girls are the last to eat and get to eat the least in a family.

This is true even when they are pregnant. Consequently, many pregnant women are severely anaemic and do not survive childbirth. Child-marriage is still widely practised in India. An adolescent’s body is not ready for the rigour of childbirth and many young mothers die during delivery. Another important reason for high maternal mortality is lack of access to trained healthcare professionals.

The Covid-19 pandemic and the devastating impact it has wrought on public health and livelihoods will impact India’s MMR adversely in the coming months and years. Already, fear of contracting the disease has kept many pregnant women from going to health centres and hospitals for their check-ups and delivery.

Some have contracted Covid-19 during their pregnancy. Heavy medication for Covid-19 can be expected to affect the health, even survival of the mother and child. Amid a myriad of problems of health, economy and joblessness, government must avoid the temptation to treat MMR as a lower priority.