Every day, 52 women in India die from pregnancy-related complications. Behind this number are stories of delayed care, missed chances and lives that could have been saved. A recent UN report puts India’s maternal death toll at 19,000 for 2023. Despite ongoing efforts, pregnancy continues to be unsafe for many, particularly in rural areas of the country.
Though UNICEF’s guidelines clearly highlight the basics, including timely antenatal care, skilled assistance during childbirth, and proper postnatal support, access to these services remains uneven. Where a woman lives and her financial status often determines the quality of care she receives and gaps in awareness, policy, and infrastructure continue to limit the reach of life-saving interventions.
This was evident in Ujagaon Village in Assam’s Bodoland Territorial Region. During a Village Health, Nutrition, and Sanitation Day, Olivia Narzari, a BTR Block Fellow, met Namrata Boro, a woman in her third trimester who had only recently discovered she was pregnant. Namrata had missed essential supplements like iron, calcium, and vitamins in the early stages.
Olivia, part of the BTR Development Fellowship Programme run by Transform Rural India (TRI), a solution designer for regenerative development, with the Bodoland Territorial Council, recommended urgent sonography. The test confirmed a high-risk pregnancy. Namrata had low haemoglobin and high blood pressure, raising serious concerns.
But complications were not just medical. Namrata, already a mother of two, was unsure about continuing the pregnancy. This is where local health workers stepped in. Olivia contacted the community health officer, ANM, and ASHA workers. Together, they engaged in repeated counselling, helping Namrata understand that terminating the pregnancy at this stage could endanger her life.
Eventually, Namrata agreed. She was taken to Guwahati Medical College, where doctors performed a successful caesarean. Her son was born healthy, weighing 3.4 kg.
This case is a strong example of how community-level action and trust-building can fill the gaps in maternal care. Many rural women are unaware of their health rights and available support systems – very few register for antenatal care early, which is crucial for monitoring the pregnancy and identifying risks.
There are also schemes like the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), launched by the Ministry of Health and Family Welfare, which offers free, quality antenatal care on the ninth of every month. But such programmes can only work in rural areas only when women are informed and encouraged to access them.
Stories like Namrata’s highlight the need to expand initiatives like the BTR Fellowship to more underserved areas to ensure that state-run schemes reach the intended beneficiaries. With trained fellows working at the grassroots, India can narrow the maternal care gap and move closer to safer outcomes for every mother and child.
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