Maternal mortality rate (MMR) is the the number of deaths of pregnant women per one lakh live births in a given year, caused by complications during pregnancy or delivery. It is an important indicator of healthcare services in a particular area.
The state had fared second best in the country after Kerala on MMR during 2010 -12, with Maharashtra recording 68 maternal deaths per lakh.
“To bring down maternal mortality, Association of Maharashtra Obstetrics and Gynaecological Societies (AMOGS) has chalked out a two-year exercise of creating awareness and providing treatment facilities to women at all levels. This might help bring a real change in association with the public health sector from villages to the cities,” said Kanan Yelikar, GMCH Obstetrics and Gynaecology department head and newly elected AMOGS president.
“The maternal mortality ratio in Maharashtra has declined from 105 to 68 per one lakh live births since 2012, which was 200 per one lakh live births 10 years ago. Despite this, the pace of decline is insufficient to achieve the major development goals for maternal mortality. Hypertensive disorders, anaemia and post-partum haemorrhage (PPH) of pregnancy are a major cause,” said Yelikar.
Among the various reasons for the deaths, post-partum haemorrhage contributes 25%, high blood pressure 18%, anaemia 8%, and sepsis 12%. Meanwhile, lack of transport facility resulting in delayed treatment also is one of the factors, she said.
“Maternal deaths get automatically checked when pregnant women are encouraged to approach health care establishments for deliveries. Delivery complications are taken care of and effectively managed when a woman delivers a baby in a hospital. The rate of institutional deliveries – deliveries taking place at hospitals – has been consistently on the rise in the state due to various government sponsored schemes,” said Srinivas Gadappa, a gynaecologist at GMCH.
“However, the rate of maternal death is recorded at alarming 108 per one lakh live births at GMCH since women here are generally brought in urgent conditions, such that most of the mortalities are reported within 12 hours of admissions. Meanwhile, since this is the biggest referral hospital in the region patients not only from across Marathwada are brought here but critical patients from nearby regions like Khandesh, Vidarbha and Andhra Pradesh borders too are referred here,” she said.
AMOGS in association with state family welfare bureau which started implementation of the Janani Suraksha Yojana has chalked out a two-year plan which include training sessions for medical officers, ASHA workers and Auxiliary Nurse Midwife (ANM) in rural pockets, workshops at pockets reporting excess maternal mortality and community workshops across the state.
“We have also planned to conduct health check-up camps for girl students in schools. Around 5000 girl students would be targeted between the age group 14 and 18 years. Their height, weight, haemoglobin level and blood group would be checked and they would also be distributed health cards,” said Yelikar, adding that the students would also be briefed about the importance of maintaining haemoglobin level through proper diet plan
The objective to counsel girl students is that it has been observed that over 80% pregnant women suffer from anaemia of several degrees while 50% of the 80% suffer from severe anaemia reporting detected blood value below 5 grams per deciliter (g/dL), she said.