Some still don’t see docs due to taboos, shyness
The percentage of women who made at least four antenatal visits to maternity clinics has risen by 0.8 per cent over four years as per the State Fact sheet of the National Family Health Survey, 2019).
According to the NFHS, the percentage of women who made at least four visits to maternity clinics during pregnancy was 68 in 2005, 70.1 in 2015, and 70.9 in 2019. However, social stigma and lack of resources have kept prenatal services out of reach for many.
Abhadevi, a mother of three who lives in Devagere village, informed The Observer that for all her pregnancies she regularly visited maternity clinics but during her first delivery, she was left with no other option but to give birth at home as she experienced labour pain at around 2 in the night. Asked why she never availed of the services of government hospitals, she said: “There are long queues in these hospitals and one has to wait long for one’s turn.” Most private hospitals are too far from her village and there are no transport facilities.
Gudiya, a 30-year-old mother of three, said her visits to maternity clinics increased during the last trimester as she had suffered from anemia. Many pregnant women in villages don’t visit maternity clinics unless they suffer from health issues such as vomiting, dizziness and low hemoglobin.
Gudiya was many times helped by anganwadi workers in getting an appointment in private clinics.
Padmini (name changed), who had a baby in 1999, said: “Stigma still exists in society. Being an urban woman, I was supported by my husband’s family, who used to encourage me to visit maternity clinics; but at times they used to advise me to not be too regular with these visits as the doctors might try to convince me for a C-section.”
According to a research paper titled ‘Enablers and Barriers to the Utilization of Antenatal Care Services in India’, published by the National Center for Biotechnology Information, antenatal care depends on certain factors which include the economic status of the mother, her autonomy to make decisions, and her exposure to media. Most doctors prescribe a minimum of three antenatal visits to ensure a safe pregnancy.
Dr Parineeta Bansal, a practising gynecologist, said antenatal visits have increased due to exposure to media, intervention by NGOs and government schemes like the PradaMantra Surakshit Matritva Abhiyan and Janani Shishu Suraksha Karakaram. Pregnant women have become more aware than they were before.
The infant mortality rate is higher in rural India than in cities due to a lack of pregnancy care, improper deliveries, suffocation, and low oxygen saturation in newborns. Many times, mothers are forced into labour when C-section is needed in complicated cases, Dr Bansal added.
Many women miss out on essential supplements like iron and calcium tablets. Sometimes serious health conditions of either the child or the mother go unnoticed due to a lack of monitoring.
Dr Chethana Mohan, the owner of Janani Maternity Home, said: “There has been a significant rise in the number of mothers who regularly make visits to maternity clinics. A sedentary lifestyle, now common among women has led to more complicated pregnancies that need medical intervention. Also, the percentage of midwives has seen a significant drop as more women are now particular about hygiene.
“Stigma is still prevalent among older women who feel shy of exposing their private parts to the doctor and are hesitant in sharing intimacy issues.”
According to Unicef, maternal mortality is a key health indicator. Maternal deaths occur due to excessive bleeding, infections, high blood pressure and unsafe abortions. For girls between 15 and 19 years of age, pregnancy-related complications are the number one cause of death among young mothers.