Definition:

Maternal mortality refers to the death of a woman during pregnancy or within 42 days of termination of pregnancy, from causes related to or aggravated by pregnancy or its management — not from accidental or incidental causes.

 India’s MMR Trend (per 1,00,000 live births):

• 2017–19: 103

• 2018–20: 97

• 2019–21: 93 (Latest)

State-wise Classification:

Empowered Action Group (EAG) States + Assam:

• High MMR

  • Assam: Highest – 167

  • Jharkhand: Lowest in group – 51

Southern States:

• Relatively low MMR

  • Kerala: Lowest in India – 20

  • Karnataka: Highest in South – 63

Other States:

• Mixed performance

  • Maharashtra: 38

  • West Bengal: 109

Key Causes (Based on the “Three Delay Model” by Deborah Maine):

1. Delay in Recognizing Danger & Seeking Care:

   • Due to lack of awareness, cultural beliefs, or finances.

2. Delay in Reaching the Facility:

   • Remote villages, poor transport, difficult terrain.

3. Delay in Receiving Care at the Facility:

   • Shortage of specialists: 66% vacancy in CHCs

   • Lack of blood banks/storage units

   • Poor readiness of First Referral Units (FRUs)

Medical Causes of Maternal Deaths:

• Post-Partum Hemorrhage (PPH)

• Obstructed Labour

• Hypertensive Disorders (e.g., Eclampsia)

• Unsafe Abortions, Sepsis, Co-morbidities (e.g., TB, Malaria)

Way Forward:

• Early registration & routine antenatal care

• Promote institutional deliveries

• Ensure skilled birth attendants & emergency care

• EAG States: Focus on basic healthcare & blood banks

• Southern/Other States: Improve quality & specialty care

• Adopt Kerala Model (Dr. V.P. Paily): maternal death audits, mental health focus

Conclusion:

Maternal deaths are preventable. With political will, infrastructure, and regional strategies, India can achieve SDG goal of MMR < 70 by 2030.