Although safer motherhood has remained high on the political agenda, still safe child birth is an atrocious circumstance in rural & tribal regions of Madhya Pradesh. Latest state report of NFHS-3 Madhya Pradesh presents a shocking picture of maternal health care in the state. State government is asserting to ensure 79% institutional deliveries but still only 8% of tribal women delivered their babies in a health facility.

Safe motherhood means that no woman or baby should die or be harmed by pregnancy or child birth or within 42 days of termination of pregnancy & it aims at reducing maternal and new born mortality and morbidity. But unfortunately Madhya Pradesh holds third position with regards to the all India mortality ratio with maternal deaths of 379 per lakh live births.

The dangers of childbearing can be greatly reduced if a woman is healthy and well nourished before becoming pregnant, if she has a health check-up by a trained health worker at least three times during every pregnancy, and if the birth is assisted by a skilled birth attendant such as a doctor, nurse or midwife. The woman should also be checked during the 12 hours after delivery. However rural & tribal women in Madhya Pradesh are not very lucky to break these periling signs of unsafe deliveries.

The health indicators of NFHS-3 Madhya Pradesh report shed light that safe child bearing is the only right secured for urban & elite class women. In the urban areas of the state 59.9% delivered their child in health institution. Against this only 20.2% women in rural region got the opportunity for institutional delivery.

Around 56 percent women in Madhya Pradesh are anaemic & must need special care during pregnancy especially tribal women with 74 percent women living with anaemia & out of them 1.2% women are severe anaemic.Still only 32.5 in rural setting got  minimum three ante-natal check-up for early detection of any pregnancy related complications by doctors or any other health provider. The proportion of urban pregnant ladies who are given ANC is almost double comparing rural women. Less than 10 percent rural women took IFA tablets for at least 90 days to pick-up their hemoglobin level during pregnancy. They are either not supplied with it or not given awareness regarding the need of special nutritional needs during pregnancy.

Rural women are at disadvantage for maternal care but if she is also tribal women than motherhood becomes a gamble to her life. She do not have right to get care during pregnancy. It is evident as just 25.9% women are receiving minimum three ante-natal check-ups & less than 8 percent getting IFA tablets for 90 days. An around 92% delivery of tribal women takes place either at home or on the road side with the support of any skilled birth attendant but not in a health facility.

One of most basic facility for institutional delivery is to have sufficient number of beds in health institutions. But most distressing feature is that at present only 26000 beds are their in government hospitals in Madhya Pradesh and out of them only 9300 beds are their in rural areas, which further means that only one bed is available per 5.95 villages in Madhya Pradesh with total 55,392 villages. In such a radical situation, is it possible to ensure safe motherhood?

It results in either maternal death, termination of pregnancy or into still birth of fetus. Consequently 18.5% pregnancy in schedule tribes got terminated & 6.6% pregnancy results into still birth, ultimately into degraded health of tribal women. Even in such a dreadful situation they do not have access to proper post-natal check-up much needed to prevent the death of women while living birth to a life.

- Seema Jain