The number of maternal deaths in Mumbai has seen a steady increase in the past few years, indicating the lack of adequate medical facilities for a vast section of the population in various parts of the city. According to the family welfare department of the BMC, maternal deaths (death of mother at the time of delivery) shot up from 222 in 2010-11 to 259 in 2011-12 – a rise of nearly 15 per cent. The figure went up further to 278 in 2012-13 and stood at 260 for 11 months of the previous financial year (April 2013 to February 2014). Data for March 2014 was not available, but the trend is expected to continue.
Dr Padmaja Keskar, BMC's deputy executive health officer, told dna that a whopping 50 per cent of the total maternal deaths are of women who come for treatment from outside the city. "The high incidence of maternal deaths is due to a large number of patients who come to civic hospitals from places like Kalyan, Thane, Navi Mumbai, etc, where medical facilities are relatively poor," she said.
The absence of timely referral in case of complications during pregnancy is a major reason for the increase in the number of maternal deaths, Dr Keskar said. In such cases, hospitals outside the city do not refer the cases immediately to Mumbai. Therefore, by the time the mother is brought to a hospital in Mumbai, her condition turns critical and her chances of survival are slim, she said.
A maternal death committee formed by the state government a year ago found that anaemia was among the main reasons for such deaths. Postpartum and antepartum haemorrhage, and infection are the other reasons. "Most mothers are anaemic which results in complications during pregnancy. We are training doctors for better investigation and also the supply of iron iron supplements has been strengthened," Dr Keskar said.
However, activists of NGO SNEHA (Society for Nutrition, Education and Health Action) think otherwise. "The lack of awareness among people and lack of facilities provided by public authorities in the state are to be blamed for the high number of maternal deaths. Even when a woman approaches a maternity centre in Mumbai and other places, there are not enough medicines available and the staff does not behave well. This demotivates women, who are then reluctant to go to hospitals," said Dr Armida Fernandes, founder of SNEHA, an NGO working for women and children's welfare.
Dr Fernandes also pointed out that a large number of women continue to deliver at home. "Women's health is still not a priority in lower-class families. They get married at an early age and soon get pregnant. Most of these women are anaemic," she said.
Officials admit that it is important to upgrade the health care system in areas outside the city so that complications during pregnancy can be tackled locally instead of patients being referred to hospitals in Mumbai.