The article on high-risk pregnancies in The Hindu on February 17 astutely drew public attention to a matter of great concern to the obstetrics and gynaecology community, but often overlooked by the rest of the country. India has great strides in decreasing maternal mortality — from an MMR of 130/100,000 live births in 2016-2018 to a MMR of 97/100,000 in 2018-2020 — by ensuring an increase in institutionalised deliveries and antenatal care, and improving women’s access to reproductive healthcare services. However, India still has a long way to go. While we celebrate our achievements, we must confront the challenges that persist, ensuring that every pregnancy is safe, and every woman is assured of the best possible care.
Acknowledging that India is now the most populous country in the world, most States have begun to see an optimal total fertility rate to ensure a more stable population growth. But pregnancy is not always easy to go through and abound with risk factors. The study referenced in the mentioned piece, illustrates that on average across India 49.1% pregnancies are high-risk. Short birth spacing — less than 18 months between two pregnancies — tops the list making up for 31% of the contributing risk factors, followed by previous adverse outcomes at 19%. These risks are disproportionately higher among women with limited or no education. In a telling comment, the researchers noted in the article, “nearly half of Indian women were not using contraception to delay their next pregnancy”. This is a stark reminder of a critical gap in our healthcare and educational systems: the underutilisation of continuous, consistent, effective, modern contraception. Women and their partners need more information about and access to modern contraceptive products to help them choose what’s best for their bodies.
