Maternal Mortality Rates in India, State Wise Data and Current Trends

Maternal mortality in India is the maternal death of a woman in India during pregnancy or after pregnancy, including post-abortion or post-birth periods. The Maternal Mortality Rate (MMR) quantifies the number of maternal deaths per 100,000 live births resulting from pregnancy or pregnancy termination, irrespective of the stage or location of pregnancy. It serves as a crucial indicator of the risks associated with pregnancy for women.

Maternal Mortality Rates in India

In India, the maternal mortality rate (MMR) has historically been notably high, yet recent trends indicate a decline. Accurately measuring maternal mortality is challenging, requiring comprehensive records of deaths and their causes, often obtained through surveys and census data.

Currently, Reproductive Age Mortality Studies (RAMOS) are considered the most effective method for calculating MMR. This approach involves analyzing various sources and records to gather data on reproductive-aged women’s deaths, supplemented by verbal autopsies to estimate mortality numbers. Globally and regionally, MMR is calculated every five years using regression models.

In India, the Sample Registration Survey (SRS) is utilized to estimate maternal mortality. The Office of the Registrar General’s Sample Registration System (SRS) issued a special bulletin on Maternal Mortality in India in March 2022, providing valuable insights into MMR trends.

Key Statistics and Trends

• India contributes substantially to global maternal deaths, with an estimated 4.7% annual decline in maternal mortality ratio (MMR) since 1990.
• Despite progress, India has faced challenges in achieving Millennium Development Goals (MDG) related to maternal mortality.
• However, there has been commendable progress, with MMR declining from 560 in 1990 to 97 per 100,000 live births in 2018-2020, showing a remarkable reduction.
• Different regions in India exhibit varying maternal mortality rates, influenced by factors like socioeconomic status, access to healthcare, and education levels.

Maternal Mortality in India State Wise

• Maternal mortality rates vary across states in India, with some states showing significantly higher rates compared to others.
• The Empowered Action Group (EAG) states and Assam exhibit higher MMRs compared to southern states and other states, highlighting regional disparities.
• Factors contributing to regional disparities include access to healthcare services, socioeconomic conditions, and educational levels.

Special Bulletin on Maternal Mortality

• Maternal mortality ratio (MMR) in India has declined by 10 points, from 113 in 2016-18 to 103 in 2017-19, marking an 8.8% decrease.
• India is on track to achieve the National Health Policy (NHP) target of 100/lakh live births by 2020 and the Sustainable Development Goal (SDG) target of 70/lakh live births by 2030.
• Seven states have achieved the SDG target: Kerala, Maharashtra, Telangana, Tamil Nadu, Andhra Pradesh, Jharkhand, and Gujarat.
• Nine states have achieved the MMR target set by the National Health Policy, including Karnataka and Haryana.
• Despite national improvement, Bihar, Odisha, Rajasthan, Chhattisgarh, Madhya Pradesh, Uttar Pradesh, and Assam still have very high MMRs (130 or more maternal deaths per 100,000 live births).
• Uttarakhand, West Bengal, and Punjab have high MMRs (100-130 maternal deaths per 100,000 live births).
• Karnataka and Haryana have low MMRs (71-100 maternal deaths per 100,000 live births).
• Uttar Pradesh, Rajasthan, and Bihar have seen significant drops in MMR, despite still having high levels of maternal mortality.
• Kerala has the lowest MMR, while Assam has the highest.
• West Bengal, Haryana, Uttarakhand, and Chhattisgarh have recorded an increase in MMR compared to the previous survey, contrary to the national trend.

Causes of Maternal Mortality in India

Maternal mortality in India can be attributed to various causes, including:

1. Severe Bleeding (Hemorrhage): Excessive bleeding during childbirth, often due to complications like placenta previa or uterine rupture, can lead to maternal death if not promptly managed.
2. Infections: Infections acquired during pregnancy, childbirth, or the postpartum period, such as sepsis or puerperal fever, can escalate rapidly and result in maternal mortality if not treated promptly with appropriate antibiotics.
3. High Blood Pressure Disorders: Conditions like pre-eclampsia and eclampsia, characterized by high blood pressure during pregnancy, can lead to life-threatening complications for both the mother and the fetus if left untreated.
4. Delivery-related Complications: Issues arising during delivery, such as obstructed labor, prolonged labor, or complications with anesthesia, can increase the risk of maternal mortality.
5. Unsafe Abortions: Maternal deaths can occur due to complications arising from unsafe abortion practices, including hemorrhage, infection, and organ damage.
6. Other Obstetric Causes: Maternal mortality may also result from complications such as ruptured uterus, hepatitis, anemia, or other obstetric emergencies.
7. Underlying Health Conditions: Pre-existing health conditions like diabetes, heart disease, or HIV/AIDS can exacerbate during pregnancy and increase the risk of maternal mortality if not adequately managed.
8. Social and Economic Factors: Factors such as poverty, limited access to healthcare, lack of education, and cultural practices may contribute to delays in seeking and receiving appropriate maternal healthcare, thus increasing the risk of maternal death.

Prevention and Interventions 

• Maternal mortality is largely preventable, necessitating effective healthcare interventions and strategies.
• Key prevention strategies include prioritizing maternal and child health services, improving access to quality healthcare during pregnancy and childbirth, and promoting community-based delivery huts.
• Government initiatives like the Pradhan Mantri Surakshit Matritva Abhiyan aim to provide free and comprehensive maternal care services to pregnant women.

Social Factors and Impacts 

• Social determinants like income inequality, access to prenatal and postpartum care, women’s education, sanitation levels, and caste dynamics significantly influence maternal mortality rates.
• Addressing social factors alongside healthcare interventions is crucial for reducing maternal mortality and improving overall maternal health outcomes.

Maternal Mortality Rate in India Government Initiatives

Maternal Mortality Rates in India UPSC

• Despite significant progress, maternal mortality remains a challenge in India, particularly in certain regions and among marginalized communities.
• Continued efforts focusing on healthcare infrastructure, access to quality services, education, and addressing social determinants are essential for achieving sustainable reductions in maternal mortality and ensuring safe motherhood for all women in India.

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