WRITE UPS - MATERNAL MORTALITY - High Maternal Mortality: A Social Problem, Not A Medical Problem

MATERNAL MORTALITY  - High Maternal Mortality: A Social Problem, Not A Medical Problem


India has one of the highest maternal moralities in the world. The medical names of these conditions that kill these mothers are 1) Anemia (2) Hemorrhage 3) Eclampsia 4) Sepsis. Childbirth is a physiological process. There are hundreds of physiological processes going on in the body and humans don’t die of a physiology. Childbirth is probably the only physiology that can kill. Besides, the dying mother is all very young and in the most productive years of her life. This makes any one take a note of the problem.


As written in the previous paragraph, there are many medical names to which one can attribute the death of a mother, just as anemia is called as blood replaced by water. The doctor is in-fact the last person in this entire chain. He receives the patient when the problem is either very serious or irreparably damaged. 90% of the current causes of maternal mortality in India are preventable. But prevention is at the level of the society. Eclampsia – a state of convulsions is due to high B.P. in pregnancy. Once eclampsia occurs both, the mother as well as the fetus are at an instant risk of death. But this eclampsia can be prevented if B.P. as not allowed to go out of control. Another cause or medical name for death of a mother is hemorrhage. Doctors get these mothers in a state of shock with profuse bleeding and many a times the mother can’t be saved.


In the previous section I have written about different names of condition that kill the mother. I am specifically using the word medical “names”. But if we closely look at these conditions, the killers are actually different. Anemia would not have occurred if she would have taken just two tablets of iron every day when she was pregnant. The eclamptic patient would have not died had she taken regular antenatal care leading to early diagnosis and treatment of the hypertension in time. Post partum hemorrhage patients would not have died if the mother could have reached the medical help in time. Sepsis would not have killed the mother if she had resorted to legal abortion (MTP) services and healthy and readily available hospital services for delivery.

Now who is responsible for this? Obviously the society! Making a women and her family conscious of her health is a social problem. Doctors can’t do it. Improving a women’s status in the society is a social problem-doctors can’t do it. The Government on recommendations of doctors have started free supply of iron to treat and prevent anemia in pregnant women. But the society and the pregnant mothers think that because these tablets are free they are useless and so they throw them away. Inaccessible roads and inhospitable terrains prevent the woman of hemorrhage from reaching medical help in time. A doctor can’t improve the roads and establish effective communication systems. The Government has to do it. Blood donation is still a huge problem. At most places the demand is more than the supply. Relatives refuse to donate blood when they accompany women in labour or with complications for which blood is required. What can the doctor do in this? At the most he can go and donate blood. I have seen countless doctors (obstetricians) who themselves donate blood for these patients and then come and operate the patient abandoned by relatives. Clean delivery environment and safe abortion services are easily available in this country. But women still prefer to deliver at home or get aborted through unsafe means. Doctors can’t reach out to every home for delivery. The population is so large that it is impossible for a doctor to reach out to every home delivery. Instead the society can convince the mother to avail of safe delivery and abortion services.


Having conclusively accepted that mothers die due to society and not due to doctors –what is the solution? The solution is in literacy and improvement of economic conditions both, together. They are the most powerful ways to solve this problem. Individually they can’t solve the problem. Punjab is financially rich and so is Gujarat but maternal mortality is high. Tamilnadu and Andhra are literate but financially poor- maternal mortality is high. Kerala, flush with petrodollars and excellent literacy has the lowest maternal mortality in the country. Reasons are not for far fetched. Financial prosperity coupled with education will automatically save 90% mothers in our country. Doctors can’t do this. It is not a medical problem. This only society can do it as it is a social problem.


Improving financial prosperity of the society by employment generation agriculture and industrial growth coupled with spread of literacy can easily help India achieve figures of maternal health comparable with the developed world.



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