In a country, where health is already a neglected sector in many ways, maternal mortality rates continue to go up each year. Many people love to generalize and blame everything on the rising population statistics. However, the real causes of maternal mortality are deeper and more complex than that.
First, it is the rising cost of healthcare in general and maternal care in particular. It is quite common for every hospital to charge an exorbitant fee from their pregnant female patients. Even those located in the rural areas charge female patients for every visit and check-up. In such conditions, families whose budget is already very tight, feel compelled to go to the quacks or untrained midwives, whose charges are lesser. Unfortunately, they ignore the risks of going to these unqualified individuals, who cannot deal with unforeseen eventualities. There are welfare hospitals in slum areas, but unfortunately, even they also suffer from a lack of funds.
Then, there is the attitude problem. Families, even the most educated ones, often have a primitive attitude towards pregnancy. The general feeling is that if one family member had a problem-free pregnancy, then all the women of the same family, are supposed to have a pregnancies free of complications. There is a general lack of acceptance that all pregnant women face the risk of obstetrical complications, regardless of genetics. Hence, any untowardly symptom reported by the pregnant woman is often ignored.
Coupled with this attitude is the general lack of trust in doctors, especially gynaecologists. People tend to think that if extra medicines are being prescribed or the doctor is suggesting a C-section, the ulterior motive is to increase the hospital's earnings. There are, of course, hospitals which do indulge in unethical practices, but there is no reason why one cannot take precautions, especially when it comes to something as risky as a complicated pregnancy.
There is also a primitive attitude towards C-sections. And here, families from both urban and rural areas stand should-to-shoulder. The belief that rules in this regard is "no C-section, no matter what." It is mistakenly believed that if children, especially first-borns, are delivered via a C-section, the couple will be unable to have more children in the future. For this reason, families are willing to risk everything in order to ensure a normal birth, even if there is obstructed labour.
In most cases, a pregnant woman is taken to the hospital, only when it is too late to help her in any way. Some hospitals refuse to take on unregistered patients, or refer her to another hospital, which further delays matters. In the urban areas, there is also a tendency for the nurses to call the patient's doctor at the very last stage and they make the patient to keep pushing even if the labour is obstructed.
All the above factors collectively endanger the life of the pregnant woman, and ultimately, if she is not attended to in a timely manner by a qualified doctor, ends up contributing to the ever-rising maternal mortality rate.
What can be done in such circumstances? Basically, everything comes down to education, awareness and a change in attitude.
If the female patient is registered in the very first trimester of pregnancy at a proper hospital and goes for pre-natal checkups, it is likely that a complication will be diagnosed and treated in a timely manner. But this ideal situation can only be brought about when those around the pregnant woman understand and realize that she does need extra care and medical attention (even if it costs more), and they are willing to rush to the hospital at the first alarm signal.
At the governmental level, funds need to be injected into awareness programmes, either through the mass media or through trained health personnel who can provide door-to-door information and health facilities.
It is said that a change in attitude is extremely difficult to bring about. Difficult as it may be, the task is not completely impossible. If nothing can be done about the attitude of those in the rural areas, then at least they can start with their own families and take extra care of the women who are due to give birth soon. It is all very well to hold seminars and lectures on the topic, but how active is one on an individual level, within one's own family? One can make a difference at the rate of one family at a time. Will someone take the initiative?
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