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Maternal Health in India progressing, but a lot needs to be done: Dr Raka Guleria, Fortis La Femme
Dr Guleria, a Senior Obstetrician and Gynecologist at Fortis La Femme in New Delhi talks about the issues of maternal health in India, the important of nutrition and dietary habits during pregnancy and how men folk’s contribution is equally important when it comes to a healthy and happy mother and child.
- By Pooja Chaturvedi Sah
- New Delhi
- Jun 26, 2023
Maternal health is a significant factor when it comes to development and advancement of any nation, both economically and socially. In fact, Maternal health is one of the important indicators of the quality of health services in the country.
Maternal health refers to women’s health and wellness at the time of pregnancy, the birth of the child, and during the postnatal period. Factors like access to quality health service and its utilization, antenatal care (ANC), care at delivery, and postnatal care play a major role when it comes to the health of a mother and her child.
India has made remarkable progress in reducing maternal deaths in the last two decades. According to a government report on maternal mortality for 2018-2020, the national maternal mortality ratio (MMR) is 97 per 100,000 live births. According to a WHO report, India reduced the MMR by 77%, from 556 per 100 000 live births in 1990 to 130 per 100 000 live births in 2016.
However, the current state of maternal and child health in India is a multifaceted issue with both challenges and progress. While there are numerous programs and schemes being continuously launched by the Government to improve the ecosystem for the mothers and children in India; lack of proper facilities in rural areas, and unawareness amongst the mothers and families are the detrimental factors when it comes to maternal and child well-being.
We spoke with Dr Raka Guleria, a Senior Obstetrician and Gynecologist at Fortis La Femme in New Delhi, with over 25 years of work experience, about the issues of maternal health in India, the important of nutrition and dietary habits during pregnancy and how men folk’s contribution is equally important when it comes to a healthy and happy mother and child.
What are the most important parameters to measure and improve maternal health in the country, especially in our rural hinterlands?
I think the most important factor is the education of both women and men. When it comes to maternal health, the men play a very crucial role. So I think more education and enlightenment of people, especially the men folk in the family, is very important. Second important factor is women empowerment and women literacy.
But all these things come down to family dynamics as a deciding factor. Family really needs to care and nurture the expecting mothers, and help them access the healthcare facilities that are available. This includes routine check-ups, proper medications and diet, providing a happy environment for the woman who is expecting, and being present for the mother and child. These, to me, are the most important factors for improving the maternal health of a nation.
In present times, the pregnancy age in India averages between 30-35 years, as opposed to 20-25 years in earlier times. Are there any challenges of late pregnancy?
The pregnancy age is changing because more and more women are working now and focusing on their careers, which is very important. Having a child is a full-time job. However, the number one challenge of late pregnancies is that the fertility rate starts decreasing a little as you grow older. Plus, you come up with other problems such as high blood pressure, diabetes etc after 30. It is balancing between work and the female’s choice for a family. One needs to be aware about these factors.
One such issue is gestational diabetes during pregnancy. How can one prevent this?
Gestational diabetes, or diabetes in general, is like an epidemic now and one has to be really careful about it. According to me, this is happening because we are leaning towards a western lifestyle, in terms of our work-timings, our sleeping patterns, and our food and dietary choices. Maybe we should stick to what we have been doing since the past so many years, especially when it comes to our diet, as it plays a major role in causing gestational diabetes. For instance, as opposed to the common myth, an expecting mother doesn’t have to eat for two. She should just have her normal food and the baby will still grow. Other things that are important are exercise and mental well-being.
So what are three important things that you would advise to an expecting mother when it comes to nutrition and diet?
The first thing is to increase the protein in her diet. Protein is her daal, paneer, eggs, chicken. Second is to increase the fluid intake which includes water, juice, buttermilk and so on. Protein is what the mother and baby need to grow; Fluids is necessary for the mother’s well-being. Third important thing for an expecting mother is to get micronutrients, that are vitamins and minerals needed by the body in very small amounts, from her diet.
With numerous schemes and programs related to maternal and child health being active and implemented, what according to you, is the apt picture of maternal health in India?
Things are progressing in the right direction. I commend the ASHA workers who go house to house and push for maternal health and vaccinations. Another such example is Janani-Shishu Suraksha Karyakram which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. So according to me the maternal health situation is improving in India and education is playing a major role in it.
However, having said that, I think Government still needs to improve their hospitals, as issues like over-crowding, lack of equipment and basic amenities like gloves and water supply needs to be assessed. I believe the government needs to really work hard, and get these things in order.
Lastly, how did the pandemic change the way we look at maternal care today?
During the pandemic, as we were all isolated, we went to tele-medicine and managed to help a lot of women regarding their diet, medications, and general check-ups. We could connect with people even from the rural areas and make them access and talk to a specialist. The pandemic showcased the need for tele-medicines, especially when it comes to women who could not travel to the hospitals during pregnancy and post-delivery. However, tele-medicine is a two-edged sword and needs to be properly regulated.