The birthday of Kasturba Gandhi is celebrated as National Safe Motherhood day to draw the attention to draw attention to issue of safe pregnancy and motherhood. Safe motherhood means to have a safe and healthy pregnancy, delivery and post-delivery. It is insisted that women should get proper attention & care during pregnancy as healthy mother can give birth to a healthy baby. All focus is mainly on the pregnancy and child birth. However once the baby is born women have no option but to face major changes in their lives. During the post natal period, the women are mostly left unattended. The postnatal period begins from birth and ends when the baby is six weeks of age.

The postnatal period is a very special time where women undergo the transition into motherhood. For during pregnancy it can be very difficult to comprehend just what being mother will be like. The changes women undergo do not just include the physical changes that occur from the birth, but social and psychological changes as well. Women can feel quite uncomfortable initially & needs utmost care in the post natal period.

The government of Madhya Pradesh made umpteen promises to promote safe motherhood all mothers & thereby insisted on encouraging institutional deliveries. It claims to achieve its target by raising the percentage of institutional deliveries from 22% in 1998-99 to 79% in 2008-09. However as per the NFHS-3 report the state stands at third position in maternal mortality in India. Against the national average of 301 maternal deaths per lakh child birth, Madhya Pradesh witness 379/100000 live births. This further means that among 18, 24,962 deliveries in 2007-08, 6916.60 mothers have lost their life during child birth.

Highest priority is given on ante-natal check-ups (ANC) & deliveries .But most of the maternal deaths occur in the post natal period in lack of proper medical care & attention. There are three serious complications that can develop in the period after delivery: eclampsia (within the first two days or 48 hours after delivery), infection and hemorrhage (heavy bleeding).According the DLHS-3 report only 37.7% mothers who received post-natal care within two weeks of delivery. The first two weeks are the most important period to decide the well-being of mother.

Ideally a new mother should visit a health facility for her first postpartum visit, or be visited by a health worker at home, within seven days of delivery. This is especially true if she delivered at home to make it sure that the woman is recovering from the labour and delivery. But situation is worst in rural part of Madhya Pradesh because in our state 58.3% deliveries takes place at home. And merely 32.5% mothers in rural areas receive post-partum check-up. The women delivering at home do not receive any medical check-ups & are at greater risk.

Analysis of the causes for women not getting the post natal check-ups reveals that one of the important reasons is the lack of medical staff in the health institutions especially in rural & tribal areas. In Madhya Pradesh only 15% Obstetricians & Gynecologists are in place CHCs, the referral unit for PHCs & SHCs. For the 278 CHCs operational in Madhya Pradesh only 41 gynecologists has been posted so far.The situation is more terrifying at PHCs level running in lack of specialist &  medical officers.

Another shocking feature is the discharge of mother within a day of delivery from the hospitals due to lack of bed facilities in existing health institution. The total number of beds covering number of bed in district hospital, civil hospital, CHCs, PHCs & even SHCs is just 23000 including 9000 beds in health institution of rural areas.

Every minute, another woman dies in childbirth. Every minute, the loss of a mother shatters a family and threatens the well-being of surviving children.

Without a proper post natal check-up, the dream of safe motherhood is a distance dream for about 60% of women giving child birth. It’s high time to make efforts sincerely to chalk out plans & policies at ground level to prevent the death of the mother while giving a birth to new life.

Seema Jain