Dharmpur, Rajasthan: Guddi Vishambhar emerges from her mud home, cradling a baby son delivered safely thanks to a new hotline that is slashing maternal mortality rates in a corner of India where they had remained stubbornly high.
Three months ago, the 25-year-old from Dharmpur village in Rajasthan state went into labour in a country where a woman dies from pregnancy complications every seven minutes.
But fearful of giving birth at home far from medical help, she called the “Janani Suraksha” or “Safe Motherhood” helpline. A taxi arrived and ferried her to the nearest clinic an hour away, where Sachin was born after a difficult delivery.
“If it wasn’t for the helpline, I don’t know what would have happened,” said Guddi. “I was bleeding a lot and don’t think I or Sachin would be healthy if I had given birth at home.”
Rajasthan shoulders a less impressive distinction—one of the highest maternal death rates in India. According to Unicef, India accounts for almost 20% of the world’s maternal mortality cases: 301 for every one lakh live births in 2006.
But across the deserts of Rajasthan, low literacy, poor infrastructure and poverty drive that ratio up to 445 per one lakh births, according to a government survey conducted between 2001 and 2003.
“Most of the deaths are avoidable and are caused by poor nutrition, no antenatal care, home births where complications arise and poor access to health clinics,” said Pavitra Mohan, health project officer for Unicef in Rajasthan.
An hour away from the Taj Mahal, scores of women in Guddi’s Dholpur district continue to die needlessly every month.
An economic boom that is transforming India’s cities is largely invisible here. In Revai village, about 100km southwest of the marble mausoleum built by Mughal emperor Shah Jahan in 1648 in memory of his wife Mumtaz, another family laments the death of a mother in childbirth.
Thirty-three-year-old Muni died in August 2005 when eight months pregnant, leaving behind her husband and four children. “She was bleeding and had severe pains in her abdomen, but we didn’t know what to do,” said her brother-in-law, Murari Harijan.Poverty and poor transport and health infrastructure force 70% of the district’s women to deliver at home, where maternal deaths are common due to haemorrhage, eclampsia, infections and related conditions such as anaemia.
“People here think that if a pregnant woman has pain or bleeding, it is normal, and that it will go away,” said S.D. Mangal, a local gynaecologist. “But they are wrong.”
The Janani Suraksha initiative, set up by local charity Manglam Seva Samiti and backed by Unicef, is making a difference in Dholpur, but there’s a long way to go.
Forty cars are now on call across 170 villages in the district’s Badi area, which used to report 30-40 maternal deaths a year. In the last 12 months there have been just eight.
“We can’t build clinics in all the villages, but the helpline ensures we get expectant mothers to the nearest one as quickly as possible,” says the charity’s Ashok Tiwari, adding government officials hope to extend it to other parts of the state.