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Indian social media is increasingly filled with desperate calls for help and heartbreaking obituaries from pregnant women due to complications related to Covid. The rising number of these deaths is setting India back after decades of strides in reducing maternal mortality.
In 1946, a year before India’s independence, India reported that about 2,000 mothers died for every 100,000 births. Poorly equipped and under-trained midwives, home births and poor transport over long distances in emergencies contributed to the high number. Sustained efforts over the decades to expand maternal health services, deliveries in hospitals instead of homes, and improved prenatal and postnatal care have helped India bring the maternal mortality rate down to 130 per 100,000 live births in 2016.
Covid-19 threatens to drive back these hard-won gains. A study in the International Journal of Gynecology and Obstetrics found that medical treatment for pregnant women decreased 45.1 percent for institutional deliveries from October 2019 to February 2020 and April to August 2020. High-risk pregnancy increased 7.2 percent and ICU admissions two and a half times. Fear of contracting the virus also reduced postnatal visits by women to hospitals.
I spoke to over 50 nursing homes across the country, and each one turned down to accept pregnant women who had tested positive for the virus. Some were afraid of contracting the virus, while others did not have the resources to treat both positive and negative Covid-19 patients. Some felt unable to adequately treat high-risk patients. Most nursing homes do not have intensive care beds or specialist doctors.
During my travels through Maharashtra – one of the hardest hit Indian states – I stopped at dozens of rural health centers. Most reported a shortage of government-appointed doctors and specialists, including surgeons, doctors, gynecologists and pediatricians. Most lacked any form of prenatal care, even though there was a government program that offered free checkups.
The virus does not spare expectant mothers either, even among the upper and middle classes in India’s cities, who always had the financial means and better access to health care than people in impoverished villages.
In early April, when the second wave of the pandemic hit Delhi, several members of the Chauhan family were infected in Delhi’s Saket neighborhood. Anshuma Chauhan, her daughter-in-law, who was eight months pregnant, was isolated in her bedroom. On the night of April 29th, Ms. Chauhan could not breathe. “After all, the virus found her,” her sister-in-law told me.