April 15, 2006 Released by IANS
When India celebrated Safe Motherhood Day on Tuesday, the lacuna in proper care for women during pregnancy and childbirth made it less of a celebration this year in the villages of Madhya Pradesh.Poverty and pregnancy form a lethal cocktail that strikes down rural women in the state, denying them basic and antenatal care, nutrition or medical support.
Prema Bai from Hardhot village, over 70 km from Raisen district headquarter in Madhya Pradesh, is four months into her pregnancy. Wife of a daily wager, she and her husband earn a paltry Rs.40 each daily to feed their five-member family. Medical supplies and prescriptions remain a distant dream as Prema struggles to manage one square meal a day.With every meal at stake, visiting a doctor for an antenatal check up is out of the question. Consequently, she is left with no choice but to trudge in her neighbour's bullock cart to the only government clinic in the village for free medical treatment."For an expectant mother in the remote areas of Madhya Pradesh, it is common to travel in bullock carts or cycles over pot-holed roads to distant rural health centres in the hope of getting proper healthcare," health experts say. However, these centres hardly have any bed to offer to the patients, and painkillers are the only medicines available. Of course, they do offer advice to Prema and other pregnant women to visit a gynaecologist.
But no gynaecologists are available in a village like Hardhot.
"The situation is worse in rural areas," says a new Population Council study.The study adds that less than half of the pregnant women, mostly illiterate and socio-economically disadvantaged, don't even seek any care."The women think that check-ups were not necessary (60 percent) or not customary (four percent)," the report reveals.
Lack of knowledge regarding the importance of antenatal care, the long trek to health centres and a lack of cheap transportation are other bottlenecks that pregnant women face."An inability to meet costs related to visiting a health facility prevents 15 percent of the women from undergoing such check-ups."Still, some of the poor women reach the nearest available medical facilities in the hope of getting better care but are mostly left to fend for themselves.Compelled by myriad disadvantages, the women in rural areas opt for home delivery often in dangerously unhygienic conditions, increasing the chances of fatal complications both for the mother and child.A majority of maternal deaths take place after delivery, most of them within 24 hours after childbirth, for want of postpartum care, which allows health workers to detect and manage problems and to make sure that the mother and child are doing well.The state government had came out with a new Reproductive and Child Health Programme in 1990, but its success can be gauged by Prema's trauma.In a state where women on an average have three children, the maternal mortality ratio is one of the highest in the country, said the study.
Madhya Pradesh Health Minister Ajay Vishnoi, however, seems satisfied with the government schemes promoted by the state under the Rural Health Mission.Though he admitted that fighting traditional gaps would take time, he said: "We will soon be appointing lady officers in rural areas to assist pregnant women and ensure safe delivery with post-pregnancy childcare."
The truth is that despite several improved maternal child health services and postpartum programmes aimed at safe motherhood, the lives of many women in the reproductive age group here are still at risk.
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