• Maternal Mortality Ratio (MMR): India’s MMR is 93 per 1,00,000 live births (SRS 2019–21), down from 103 (2017–19).
• State-wise Disparities:
  • High MMR: Madhya Pradesh (175), Assam (167)
  • Low MMR: Kerala (20), Maharashtra (38), Karnataka (63)
  • Moderate: Punjab (98)
• Three Delays Model:
  • Delay in decision-making at home – Ignorance, culture
  • Delay in reaching facility – Geographic barriers; 108 ambulances help
  • Delay in receiving care – 66% specialist vacancies, non-functional FRUs
• Top Medical Causes:
  • Post-Partum Hemorrhage (PPH) – Needs urgent blood transfusion
  • Obstructed Labour – Due to malnutrition; needs C-sections
  • Hypertensive Disorders – Pre-eclampsia, eclampsia go undetected
• Other Factors: Unsafe abortions, infections, co-morbidities (malaria, TB), mental health issues
• Policy Focus:
  • Strengthen FRUs, blood banks, skilled staff
  • Promote institutional delivery, maternal death audits
  • Kerala’s model (confidential reviews, mental health care) is a best practice
• Goal: Achieve MMR < 70 by 2030 (SDG Target)

Mains Questions

1. Discuss the trends and state-wise disparities in Maternal Mortality Ratio (MMR) in India, highlighting the need for targeted interventions.
2. Analyze the ‘Three Delays’ model of maternal mortality, explaining the causes and consequences of delays in decision-making, reaching healthcare facilities, and receiving care.

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