Every year on April 11, India marks National Safe Motherhood Day, a reminder that bringing a child into the world should not come at the cost of a woman’s life. Yet, for many women across the country, pregnancy and childbirth remain fraught with risk, shaped as much by systemic gaps as by social realities.
India has made notable progress in reducing its maternal mortality ratio (MMR), with recent data showing a steady decline over the past decade. Institutional deliveries have increased, and schemes such as Janani Suraksha Yojana and LaQshya have pushed for safer childbirth practices. But behind these numbers lies a more uneven story, one where access, awareness, and quality of care vary sharply across geographies and communities.
In urban centres, access to tertiary care and skilled professionals has improved outcomes, but even here, challenges persist.
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Overburdened public hospitals, rising costs in private facilities, and gaps in respectful maternity care continue to affect women’s experiences. In rural and remote areas, the situation is often more precarious, with delayed referrals, lack of transport, and shortages of trained staff compounding risks during labour.
A key concern remains the “three delays” that public health experts often cite, the delay in recognising complications, the delay in reaching a healthcare facility, and the delay in receiving appropriate care. Each of these can turn a manageable complication into a life-threatening emergency.
Nutrition and anaemia continue to be silent contributors to maternal deaths. Despite multiple government programmes, a significant proportion of pregnant women in India remain anaemic, increasing the risk of complications such as haemorrhage, the leading cause of maternal mortality.
Equally critical is the question of antenatal care. While more women are registering their pregnancies, the quality and continuity of care remain inconsistent. Regular check-ups, timely screenings, and counselling are essential, but often fall through the cracks due to workforce shortages and overburdened systems.
"Antenatal care is important for ensuring the health of both mother and baby. However, there is still a lack of awareness regarding this. So, huge gaps still exist across the country and is alarming for experts. Many women tend to delay their first visit, miss regular check-ups and follow-ups, or even don't have access to essential screenings due due to the myths, lack of awareness, affordability, or accessibility issues," says Dr Mansi Sharma, Consultant obstetrician and Gynaecologist, Motherhood Hospitals, Kharadi, Pune.
"So, understand that concerning conditions like anaemia, gestational diabetes, and hypertension often go undetected in many women and can impact the overall well-being," she adds.
Experts say consistent monitoring by the expert, prompt nutrition support by including fresh fruits and vegetables in the diet, and patient education is crucial for women to be able to seek timely help. Remember that bridging these gaps through community outreach and accessible healthcare services for all will help to prevent complications in women like pre-term birth, gestational diabetes and even improve maternal and neonatal outcomes.
Beyond infrastructure, social determinants play a decisive role. Early marriages, closely spaced pregnancies, and limited decision-making power continue to shape maternal health outcomes, particularly in vulnerable communities. For many women, seeking care is not just a medical decision but a negotiation within the household.
Mental health, too, is emerging as an overlooked dimension of safe motherhood. Postpartum depression, anxiety during pregnancy, and the psychological toll of high-risk pregnancies often go unaddressed in a system still focused primarily on physical outcomes.
Technology is beginning to offer new pathways. Telemedicine, mobile health applications, and AI-enabled risk assessments are helping bridge some gaps, particularly in underserved areas. However, digital solutions are only as effective as the systems they are embedded in and must be accompanied by robust on-ground support.
As India works towards its Sustainable Development Goal targets, the focus is increasingly shifting from mere survival to ensuring a dignified and positive childbirth experience. Respectful maternity care, informed consent, and patient-centred approaches are slowly entering the conversation.
Safe Motherhood Day, then, is not just about celebrating progress, it is a call to confront the inequities that persist. Because safe motherhood is not merely a health indicator; it is a measure of how a society values its women.