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One of the most important but neglected health issues in India is maternal health. In such a scenario, is motherhood a boon or curse?
Women face life-threatening challenges during pregnancy and childbirth. This is especially true of women from a marginalised socio-economic background – they have to confront various challenges while getting medical treatment and basic maternal care, both in their own homes and from hospitals.
In our country, one of the most important but neglected health issues is maternal health, particularly in rural and low socio-economic areas. Maternal health refers to the health of women during pregnancy, childbirth and the postnatal period. According to the World Health Organization (WHO), out of 536,000 maternal deaths globally each year, 136,000 take place in India.
Women that belong to lower socio-economic backgrounds and rural areas do not even get a full meal in the whole day. Bounded on traditions, they are supposed to feed the male members and children first and the leftovers become their meal. These types of situations lead them to eat only to survive and none of them thinks of having a balanced diet. The patriarchal society prioritizes men in every aspect of daily life and the traditional system in the family supposes men and boys to get better nutrition, health facilities, education etc., in comparison to women and girls. Therefore, the system does not allow women to get proper nutrition or even regular health check-ups. These irregularities in their health check-ups and poor health conditions of women lead to an unhealthy life. There are numerous women’s health concerns that are influenced by various factors such as gender disparities, early marriage, domestic violence, sexual abuse, malnutrition, poverty, illiteracy, access to quality healthcare, etc.
Due to a patriarchal perspective, women’s health and education have constantly been ignored in our country. This ignorance has not only deteriorated their health but is also a contributing factor to their children’s poor health. The lack of information about a balanced diet is mainly due to the low education levels of women. Malnutrition among children in urban India is characterized by considerably poor levels of breastfeeding, and a higher prevalence of iron and vitamin D deficiency. However, in rural areas of the country, a higher percentage of children suffer from stunting, are underweight, and consume fewer milk products. Rural children also have low zinc intake which leads to diarrhoea, growth retardation, loss of appetite, and impaired immune function.
The most common and direct causes of maternal risk and death are excessive blood loss, infection, high blood pressure, unsafe abortion, and obstructed labour, as well as indirect causes such as anaemia, malaria, and heart disease. India’s anaemia burden among women is widespread, with 53.1 per cent of non-pregnant women and 50.3 per cent of pregnant women being anaemic as per the National Family Health Survey ( NFHS-4). Despite suffering from a deadly disease, anaemia, most women don’t have many options for getting some rest and taking a nutritional and iron-rich proper diet to overcome the illness. They are even expected to look after the entire family and manage all the domestic tasks. This hypocritical action of patriarchal Indian families and in-laws is very inhumane and puts the maternal health of a woman at greater risk.
Even in the 21st century, millions of women and adolescent girls around the world are facing challenges in the accessibility and affordability of health care services because of their socio-economic status and illiteracy. Gender-based discrimination (preference for a son) along with other social pathologies like the dowry system and early marriage often results in mistreatment and abuse of women which eventually leaves a negative impact on their overall health.
Maternal delivery at home without skilled care at birth is another major public health issue. The socio-cultural and familial reasons cause some women to choose to give birth at home as they hesitate to seek professional emergency care for delivery complications. The reasons for not seeking professional care include the stereotypical belief that some check-ups are unnecessary, women’s inability to meet the costs associated with visiting a health care facility, and even some women are forbidden by their families from having these check-ups. Another reason for not seeking care during pregnancy is the lack of knowledge about antenatal care as well as the long distances to healthcare centres and lack of transportation.
Most women in our country are constantly fighting silent wars for their basic and peaceful survival. India has the largest youth population in the world however it is ironic that India also has the highest suicide rates in the world. According to the National Crimes Record Bureau data (2019), 800,000 people die because of suicide worldwide every year, 17% of them were Indian residents and it was recorded that personal or social factors such as family problems, marriage-related issues and romantic affairs were the primary reasons for 45% of total deaths amongst the youth population. Moreover, India has also witnessed an emerging pattern of maternal suicides. Adolescent pregnancy or ‘motherhood in childhood’ is one of the most serious mental and physical health threats to young women in India as young girls are, physically and psychologically, unprepared to experience pregnancy and its implication on their physical and mental health. Apart from physical implications, it can also lead to serious mental disorders (depression), between 46 to 48 per cent of new Indian mothers experience depression. In India, perinatal depression (during pregnancy and childbirth) is linked to suicide which is driven by factors like socio-economic concerns, pressure to have a male child and domestic violence. Women who were forced into early marriage may have had their education interrupted, mobility restricted, financial dependence, and thus, a lack of decision-making power over their sexual and reproductive health and rights. Such lack of agency also causes severe distress, feelings of helplessness, hopelessness, and despair.
Giving birth to a newborn or planning a family is one of the greatest blessings to a couple but a woman has to go through a lot of hardships during this journey. Improving healthcare services, in conjunction with education, maybe the most important intervention for raising women’s awareness of their rights and preventing them from becoming easy prey to severe emotional and mental disturbances. In addition to taking the necessary steps to improve health indicators and provide universal healthcare, the government must also prioritize implementation and execution at all levels.
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