Maternal health services in India need to be wholistic
Maternity is joy. However, there are risks in pregnancy. Physical, mental and emotional setbacks take a toll on expectant mothers. And the journey of pregnancy until childbirth is often beset with barriers. A weak health system being at the foremost in low resource countries.
There have been improvements in the last two decades with better diagnosis and treatment facilities, but there is a long way to go.
Some maternal health in India related facts (source: NHM, GoI)
1 in 2 pregnant women have an antenatal check up in the first trimester.
Only 50% of women have four antenatal check ups during pregnancy.
Only 20% pregnant women have had full antenatal care as recommended by the department of health.
38.7% to 78.9%, a significant increase in institutional births in the last 10 years.
Medical attention for maternal health is necessary, even essential but its not enough or wholesome.
Studies show that 74% of mothers have experienced pregnancy specific anxiety (British Medical Journal) and 25% of pregnant women suffer from prenatal depression, mostly between 18-32 weeks of pregnancy (The Lancet). Women can be unaware of what to expect, and usually are not told about danger signs to look out for or precautions to take.
There are many mental health problems that a woman can experience in pregnancy. Mental health problems can happen at any time during the pregnancy. Also, mental health issues may appear for the first time in subsequent pregnancies.
Feeling sad all the time, remembering past experiences that were associated with distress, attacks of panic and fear, obsessive rumination and intense fear around birthing are complaints one often hears.
A woman's health and wellbeing affects her unborn baby too. In fact, most of the issues that newborns are affected by can be prevented by adopting often simple measures during pregnancy. Furthermore, there is significant disparity in maternal health care utilisation. Rural women and those who are challenged with literacy are disproportionately affected. In rural India, self care, awareness of changes in pregnancy and the need to attend to one's mental health and wellbeing during pregnancy remains an enigma. A study published in World Health and Population demonstrates how raising awareness and supporting women to take measures for their health and wellbeing during pregnancy, neonatal morbidity and mortality can be reduced.
"Pregnant women or mothers with mental health problems are less likely to care adequately for their personal needs, to seek and receive antenatal or postnatal care, or adhere to prescribed health regimens."
"If you want to reduce maternal mortality, you must focus on the mental health of mothers"- Sriram Haridass, India representative of the United Nations Population Fund.
The COVID-19 pandemic has caused difficulty and stressful time for many pregnant women and has taken a toll on women's health and wellbeing during pregnancy.
"The mental health issues and problems faced by women in rural India are even more serious. Owing to the lockdown and enforcement of social distancing norms, it was not possible for local health workers to reach every woman. In rural areas, most of the time, antenatal care services are provided in groups (usually 10 to 20 pregnant women at a facility). Many pregnant and lactating mothers are left without medical care." (S.Jungari)
It is important that you take care of yourself and use support services if you have any concerns about your health or your baby’s health (Learn how Kushal has responded to the COVID -19 epidemic). There is a lot of guidance and information resources to help you cope with the epidemic when pregnant. Take a look at the Maternal Mental Health Alliance site.
We offer pregnancy mental health and wellbeing services in rural and urban India. Mental health and wellbeing workshops are carried out in remote communities. Our online pregnancy health and wellbeing guide is widely used by women in these communities to get wholistic information on how to stay physically and mentally healthy during pregnancy.