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Maternal Mortality: Making Women’s Lives Matter

Maternal Mortality: Making Women’s Lives Matter

As told by Human Rights Watch researcher Aruna Kashyap.

On the Ground in India

It was scorching hot as we parked the car outside this small village in the Indian province of Uttar Pradesh, something we’d done a dozen times in the past few days. As we walked through the village entrance, I hoped that, this time, we’d find a professional health care worker here.

More women in India die from pregnancy than anywhere in the world, in part because of its large population. Uttar Pradesh has the country’s most dismal figures related to maternal mortality, or death from childbirth.

The Indian government recognizes the problem and spends millions trying to eradicate it.  But women continue to die here in record numbers.

I was investigating why.  I had sat with families, listening to husbands who lost wives and parents who lost daughters.

Watch a Webby Award-winning video that tells one mother’s story “In Silence” now.

Why the Gap between Funding and Care?

But I hadn’t yet heard these stories from health care professionals.  Most health workers are difficult to locate, either in the field vaccinating children against polio and filarial, or visiting patients.  I was getting anxious.  Interviewing medical professionals was the key – their information could help explain the gap between funding and care.  I began chasing them from village to village, hoping someone would take a break.

We walked through the village to the home of a local matriarch, and she promised to introduce me to the town’s ASHA, a health care worker appointed by the village head.  I had waited in the courtyard for 40 minutes when the ASHA finally arrived.  Her name is Trishna, and she wore her off-white sari draped around her head.  At first, she was hesitant to open up.  Eventually she told me her concerns.  I would later learn that some of her problems were shared by many Indian health care workers – the power struggles between nurses, the workers who charged impoverished people for services that were supposed to be free. She spoke of nurses taking bribes in exchange for treatment. 

We talked for two hours.

I soon met with other health workers, and the picture of maternal mortality in Uttar Pradesh became clearer. 

•Rural clinics, although a positive innovation, were overcrowded.
• Sometimes, two pregnant women shared a bed, or women would sit on the floor.
•Some rural clinics frequently went without electricity.
•In emergencies, clinics generally had no means to transport women to hospitals, and blood transfusions couldn’t be given on site. 
•Rarely were any of the health workers trained in obstetrics and gynecology.

I learned that official figures on death due to pregnancy couldn’t be trusted.  Most women who gave birth in clinics were sent home within a few hours or the next day, with no follow-up care.  Some of the women died days later.  I met village health care workers who had never learned that when a woman dies within a week of giving birth, it’s still considered maternal mortality.

Click here for more information on maternal mortality.

Falling Short of the Mark

It became clear that, while the Indian government had the best intentions in establishing clinics and guidelines for maternal health, its efforts fell short of the mark.  Yes, the program succeeded in having more women give birth in clinics, but the hoped-for impact – lives saved – wasn’t there.

Money wasn’t the only problem.  Millions of dollars in government funds for health care in Uttar Pradesh go unspent each year, according to one study by the Indian Planning Commission.
The real issue is accountability.

Rural villagers need someone to complain to if they feel they’ve been mistreated at a rural clinic, or if their family members die as a result of childbirth.  Their complaints need to be investigated, and those responsible need to be held accountable. 

Also, every death from pregnancy should be accurately recorded.

Backed by the right policies, both Sri Lanka and Malaysia have managed to halve their maternal mortality numbers in five or six years.  By putting in place the right measures, India may be able to do the same.

Find out how Human Rights Watch is fighting  to help mothers survive pregnancy and childbirth now.

Read more:

Photographer Susan Meiselas and reporter Dumeetha Luthra traveled with Human Rights Watch to India to retrace the steps of one woman who died after giving birth to a son. This Webby Award-winning story was produced by Magnum in Motion with Human Rights Watch.

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202 comments

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8:17PM PST on Mar 8, 2014

Thank you.

1:57PM PST on Jan 11, 2013

Thank you Alicia, for Sharing this!

2:56PM PST on Dec 29, 2010

How terribly sad.

8:22AM PST on Dec 22, 2010

Thanks

8:22AM PST on Dec 22, 2010

Thanks

7:20PM PST on Dec 21, 2010

It's been my life time so far fighting for women's rights.
Men fail themselves and humanity when they are violent in any form to women. Violence is not the path to liberation. Will I live to see the day of no more eviolence agains women and children?

10:06PM PST on Dec 6, 2010

Corruption & Greedy Bureaucra ts - will India, My country ever be freed ever???????????

8:01PM PST on Dec 5, 2010

I thank-you for yet another informative, interesting article. The video, "In Silence Now" was very touching. I worked in the medical field as a RN for over thirty-one years. I saw many changes in health care during those years. Some changes were for the better, some were not. Eventually it all came down to the almighty dollar. The hospital I obtained my Nursing education from & then worked at was drained financially daily until it joined the long list of hospitals that were forced to close their doors due to lack of money. I would like to know where the money goes &/or where it is to begin with. Hospitals shouldn't be forced to close their doors due to lack of money. And the circumstances in India & other areas of the world who's plight is as is in India just cannot be. We have developed new technologies to help people live longer, healthier lives. Yet there are mothers dying needlessly during or after childbirth. A severe contradiction of terms in my opinion I thank-you for reading this.

7:24PM PST on Dec 5, 2010

I thank-you for yet another informative, interesting article. The video, "In Silence Now" was very touching. I worked in the medical field as a RN for over thirty-one years. I saw many changes in health care during those years. Some changes were for the better, some were not. Eventually it all came down to the almighty dollar. The hospital I obtained my Nursing education from & then worked at was drained financially daily until it joined the long list of hospitals that were forced to close their doors due to lack of money. I would like to know where the money goes &/or where it is to begin with. Hospitals shouldn't be forced to close their doors due to lack of money. And the circumstances in India & other areas of the world who's plight is as is in India just cannot be. We have developed new technologies to help people live longer, healthier lives. Yet there are mothers dying needlessly during or after childbirth. A severe contradiction of terms in my opinion I thank-you for reading this.

12:13PM PST on Dec 5, 2010

Noted.

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