Three-Quarters Of Indian Maternal Deaths Preventable, Study Finds

Main Category: Pregnancy / Obstetrics
Also Included In: Women's Health / Gynecology;  Abortion
Article Date: 12 Oct 2009 - 1:00 PDT

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Seventy-five percent of maternal deaths in India are preventable, according to a report released Wednesday by Human Rights Watch, the AP/Google News. The report also indicated that one in every 70 Indian women who reaches reproductive age will die from problems associated with pregnancy, childbirth or unsafe abortion. This maternal mortality rate is 16 times higher than Russia's and 10 times higher than China's, the report said. Lead researcher Aruna Kashyap said that in 2005, this translated into 117,000 deaths in India from maternal-related problems.

The study said that tens of thousands of Indian women die each year because of a weak medical system characterized by caste discrimination, poor planning, little accountability and limited access to emergency care. The report found that a large part of the problem is the lack of accountability for the high maternal mortality rate, with the government, hospitals and health workers all shifting blame. Factors contributing to maternal mortality range from poorly trained obstetrics staff to delivery charges that are out of reach for Indian villagers, many of whom live on less than $2 per day. Delivery, prenatal and postnatal care are supposed to be available at no cost, but clinics sometimes charge $10 for a delivery, plus $1 to cut the umbilical cord and $1 for cleaning the room.

Although India as a whole has seen a decline in maternal deaths in the past few years, some heavily populated areas "actually showed an increase in maternal mortality," the report stated, noting that even in areas where access to care seems to be improving, "significant disparities based on income, caste, place of residence and other arbitrary factors" continue to exist. In 2007, in six northern Indian states, 61% of maternal deaths were among Dalits -- or "untouchables" -- and indigenous people, the communities considered at the lowest rung of the Indian caste system, according to the report.

The report found that a large part of the problem is the lack of accountability for the high maternal mortality rate, with the government, hospitals and health wokers all shifting blame. Factors contributing to maternal mortality range from poorly trained obstetrics staff to delivery charges that are out of reach for Indian villagers, many of whom live on less than $2 per day. Delivery, prenatal and postnatal care are supposed to be avaiable at no cost, but clinics sometimes charge $10 for a delivery, plus $1 to cut the umbilical cord and $1 for cleaning the room.

The report's recommendations include requiring reporting of all pregnancy-related deaths to the government, investigation of those deaths and establishment of an obstetric emergency response system (Sullivan, AP/Google News, 10/7).

WSJ Examines Surrogacy in India

In related news, the Wall Street Journal on Thursday examined the proliferation of Indian surrogacy clinics, which serve both domestic and overseas couples. Since 2005, the number of surrogacy clinics has tripled to about 350 facilities throughout the country, according to Hrishikesh Pai, vice president of the Indian Society for Assisted Reproduction. Pai says that last year about 1,000 surrogate pregnancy attempts were made at the clinics and that this year, the figure is likely to increase to 1,500, with about one-third being made on behalf of international couples. According to the Journal, U.S. couples who use Indian surrogates often are motivated by the lower costs of overseas surrogacy.

The Indian Council of Medical Research, a government body, established surrogacy guidelines in 2005, and there are currently new laws under development that would increase standardization of contract terms, parental identification on birth certificates and compensation. The law also would require clinics to register surrogacy cases and report outcomes, the Journal reports. Critics of India's surrogacy say that new controls are necessary to avoid the exploitation of poor women (Cohen, Wall Street Journal, 10/8).

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