Motherhood is a choice you make every day, to put someone else’s happiness and well-being ahead of your own, to teach the hard lessons, to do the right thing even when you’re not sure what the right thing is… and to forgive yourself, over and over again, for doing everything wrong.
—Donna Ball

Becoming a mother is a beautiful and transformative experience that is filled with positive emotions and hope for the future. However, this journey can also pose significant risks and challenges, especially for those who lack access to proper medical care and support. Ensuring safe motherhood is crucial for the well-being of both the mother and child, and it is important to provide high-quality care throughout the entire process of pregnancy, delivery, and postpartum recovery.

Every year on April 11, National Safe Motherhood Day is celebrated to raise awareness about the importance of providing adequate care during pregnancy, childbirth, and postnatal services. This day was declared by the Government of India in 2003, in honour of the birth anniversary of Kasturba Gandhi. The declaration was made in collaboration with the White Ribbon Alliance India (WRAI), a coalition of 1800 organizations dedicated to improving maternal and child health.

Safe motherhood refers to the measures taken to ensure the well-being and health of women during pregnancy, childbirth, and the postpartum period. It is a significant global public health issue, particularly in low- and middle-income countries, where maternal mortality and morbidity rates are still alarmingly high. The World Health Organization defines safe motherhood as enabling women to have safe and satisfactory pregnancies and childbirths with access to high-quality healthcare and social support.

In 2007, the Safe Motherhood Initiative (SMI) marked its 20th anniversary. This international effort aimed to raise awareness about the extent and impact of maternal mortality and encourage governments, donors, UN agencies, and other stakeholders to take action to address this issue. The upcoming 20th anniversary of the SMI presents an opportunity to assess the progress of safe motherhood within the health and development agenda and evaluate the accomplishments and shortcomings of the initiative.

Significant progress has been made in certain key indicators related to maternal healthcare, such as an increase in the percentage of pregnant women receiving antenatal care and the percentage of births attended by a skilled birth attendant. For instance, in developing countries, antenatal care coverage has gone up by 20% since 1990, and over 50% of women now receive at least four recommended antenatal visits. During the same period, the proportion of skilled attendants present during deliveries rose from 41% to 57% in developing countries overall.

However, despite these advances, the Safe Motherhood Initiative has failed to achieve its target of reducing maternal mortality by 50% by the year 2000, which was set almost two decades ago. Although some countries have made notable progress in reducing maternal mortality rates, many countries with high levels of maternal mortality have made little or no progress, and in some cases, the situation has worsened. The fact that maternal mortality rates remain high even in countries where maternal healthcare utilization has improved highlights the importance of not just making healthcare available but also ensuring its quality.

Components of safe motherhood:

• Providing high-quality healthcare for mothers.
• Educating people about health and wellness.
• Giving women the tools and support they need to take care of themselves.
• Encouraging local communities to take an active role in promoting health.
• Improving healthcare systems to better serve the needs of women and children.

Safe Motherhood: In An Indian perspective

Safe motherhood is a significant concern in India due to the high maternal mortality rates. The World Health Organization reports that 15% of maternal deaths globally occur in India, with 35,000 women dying annually due to complications during pregnancy and childbirth. Although the government of India has implemented various initiatives to improve maternal and child health, more work is needed to ensure safe motherhood in the Indian context.

The lack of access to quality healthcare services, especially in rural areas, is a major contributor to maternal mortality in India. Women in remote areas face several obstacles in accessing healthcare services, including insufficient infrastructure, trained healthcare personnel, and transportation facilities. Additionally, cultural and traditional beliefs also hinder women from seeking medical care due to social stigma, lack of awareness, and affordability issues.

The Indian government has introduced various programs to address maternal health, including the National Rural Health Mission (NRHM), Janani Suraksha Yojana (JSY), and Pradhan Mantri Matru Vandana Yojana (PMMVY). NRHM aims to improve the availability, accessibility, and quality of healthcare services in rural areas through the creation of a network of community health workers called ASHAs. JSY provides financial assistance to economically weaker pregnant women to encourage institutional deliveries, while PMMVY offers financial assistance to pregnant and lactating women for their first live birth to compensate for wage loss and improve their nutrition.

The government has also implemented programs to improve the quality of maternal healthcare services, such as the Maternal Death Surveillance and Response (MDSR) system and the LaQshya program. MDSR aims to identify and address the causes of maternal deaths by conducting audits and using the findings to improve care quality. The LaQshya program focuses on improving the quality of care during childbirth through health worker training and ensuring the availability of essential equipment and supplies.

Despite these efforts, challenges remain in ensuring safe motherhood in India. The shortage of skilled health personnel, particularly in rural areas, affects the quality of care and hampers efforts to improve maternal and child health outcomes. Additionally, socio-cultural barriers, such as gender discrimination, lack of education, poverty, and traditional beliefs and practices, continue to prevent women from accessing healthcare services. Addressing these barriers requires a multi-sectoral approach involving education, women’s empowerment, social welfare, and the health sector.

The challenges to Safe Motherhood in India:

• Healthcare access: The lack of access to healthcare services is a major obstacle for safe motherhood. Numerous women residing in rural regions are unable to reach healthcare facilities or obtain skilled healthcare professionals, which results in inadequate antenatal and postnatal care.

• Undernutrition: Among pregnant women, malnutrition is a prevalent issue in India. It results in unfavorable health consequences for both the mother and the infant.

• Infrastructure inadequacy: The inadequate infrastructure, which includes roads, transportation, and communication, hinders the provision of health services in rural and remote areas.

• Cultural and social norms: Cultural and social norms related to pregnancy and childbirth can have negative effects on safe motherhood practices. For example, some societies do not allow women to obtain antenatal care or give birth in healthcare facilities, resulting in avoidable fatalities.

• Lack of awareness: Poor knowledge among women about the importance of antenatal and postnatal care and the significance of skilled birth attendance is a contributing factor to negative maternal health outcomes.

Prioritizing Safe Motherhood: A Crucial Step Towards Healthier Communities

In conclusion, safe motherhood is a critical issue that deserves attention from governments, healthcare providers, and communities around the world. It is essential to ensure that all pregnant women have access to comprehensive maternal health services that can help prevent and manage complications during pregnancy, childbirth, and postpartum periods. This includes access to skilled healthcare providers, emergency obstetric care, and family planning services.

Efforts to promote safe motherhood have made significant progress over the years, with improvements in maternal health outcomes seen in many countries. However, there is still a long way to go, particularly in low-income countries where maternal mortality rates remain high.

To continue making progress towards safe motherhood, it is important to prioritize investments in maternal health services and address the underlying social, economic, and cultural factors that contribute to maternal mortality and morbidity. This includes increasing access to education, reducing poverty, improving gender equality, and promoting women’s empowerment.

Overall, safe motherhood is not just a health issue, but also a human rights issue. Every woman has the right to safe and dignified maternal care, regardless of their socio-economic status or geographic location. By working together, we can ensure that all women have access to the resources they need to have safe and healthy pregnancies, births, and postpartum periods.
Lastly, it is important to understand that Safe Motherhood and women’s empowerment should function together to have a healthy society. Only when women are given the power and agency to make decisions about their lives, including their reproductive health can they access education, healthcare, and economic opportunities, which leads to improved health outcomes for themselves and their families, and strengthens their communities? By investing in safe motherhood and women’s empowerment, we can create a more equitable and just society where all individuals have the opportunity to thrive.