Maternal mortality remains a critical public health and governance challenge in India. Although the country has achieved one of the world’s largest declines in Maternal Mortality Ratio (MMR), progress has slowed in recent years. A study published in The Lancet highlights that India still faces major challenges in achieving the Sustainable Development Goal (SDG) target of reducing MMR below 70 by 2030.
MMR refers to the number of maternal deaths per one lakh live births due to pregnancy-related causes. India contributes nearly 10% of global maternal deaths, underlining the need for sustained policy intervention.
Status of Maternal Mortality in India
India’s MMR has declined significantly from 508 in 1990 to around 116 in 2023, reflecting improvements in maternal healthcare infrastructure, institutional deliveries, and public
health interventions.
According to the Sample Registration System (SRS), MMR reduced from 122 during 2015–17 to 88 during 2021–23. However, differences remain between national and UN estimates, with UN estimates placing India’s MMR at around 80. Such data gaps create challenges in accurate policy assessment and monitoring.
Despite overall progress, interstate disparities remain severe. States such as Kerala and Tamil Nadu have achieved relatively low MMR levels due to better healthcare systems and higher institutional deliveries. In contrast, states like Assam and Uttar Pradesh continue to report high maternal mortality, reflecting inequalities in healthcare access, nutrition, and infrastructure.
Further, the pace of reduction in maternal deaths has slowed, making the SDG target increasingly difficult to achieve within the remaining timeframe.
Causes of High Maternal Mortality
Haemorrhage
Severe bleeding during or after childbirth remains the leading cause of maternal deaths in India. Delayed emergency obstetric care significantly increases fatalities.
Sepsis and Infections
Poor hygiene during delivery and delayed treatment of infections contribute to maternal mortality, especially in rural and underserved regions.
Unsafe Abortions
Limited access to safe abortion services often forces women to undergo unsafe procedures, resulting in serious complications and deaths.
Anaemia and Malnutrition
Iron deficiency, undernutrition, and poor maternal health weaken women during pregnancy, increasing vulnerability to complications during childbirth.
Hypertensive Disorders
Conditions such as pre-eclampsia and eclampsia can cause seizures, organ failure, and maternal death if not diagnosed and treated on time.
Delays in Healthcare Access
The “three delays” model remains a major challenge:
- Delay in deciding to seek care
- Delay in reaching healthcare facilities
- Delay in receiving timely treatment
These delays are often linked to poverty, poor transport infrastructure, and weak healthcare systems.
Government Initiatives
India has launched several schemes to improve maternal healthcare:
- Janani Suraksha Yojana promotes institutional deliveries through conditional cash transfers.
- Janani Shishu Suraksha Karyakram provides free delivery, medicines, diagnostics, transport, and food for pregnant women.
- Pradhan Mantri Surakshit Matritva Abhiyan ensures free antenatal check-ups and early
detection of high-risk pregnancies.
- Surakshit Matritva Aashwasan guarantees respectful and quality maternal healthcare services.
- LaQshya Programme focuses on improving labour room and maternity care quality.
- Pradhan Mantri Matru Vandana Yojana provides maternity benefits to support nutrition and healthcare needs.
Way Forward
Improving maternal health requires strengthening primary healthcare systems, especially antenatal, institutional delivery, and postnatal services in rural and high-burden states.
Special attention must be given to states such as Assam and Uttar Pradesh through better infrastructure, trained medical staff, and continuous monitoring.
Preventing major causes of maternal deaths requires timely management of haemorrhage, hypertension, and infections through emergency obstetric care and skilled birth attendants.
Further, improving maternal nutrition, promoting family planning, and increasing awareness regarding reproductive health can significantly reduce maternal risks and early pregnancies.
Conclusion
Reducing maternal mortality is essential for achieving gender justice, public health, and sustainable development goals. While India has made substantial progress, regional disparities, healthcare gaps, and slowing improvements remain serious concerns. A comprehensive approach focused on quality healthcare, nutrition, awareness, and equitable access is crucial to ensure safe motherhood for every woman in India.