Doctors say the advice is preposterous, and even dangerous, considering India’s already-poor record with maternal health. Women are often the last to eat or receive healthcare in traditionally patriarchal Indian households.
Malnutrition and anaemia, or iron deficiency, are key factors behind India having one of the world’s highest rates of maternal mortality, with 174 of every 100,000 pregnancies resulting in the mother’s death in 2015. That’s better than five years earlier, when the maternal mortality rate was 205 maternal deaths per 100,000 live births, but still far worse than China’s 27 per 100,000 or the United States’s 14 per 100,000, according to UNICEF.
“The government is doling out unscientific and irrational advice, instead of ensuring that poor pregnant women get to eat a nutritious, high-protein diet," said gynecologist Arun Gadre, who is based in Pune, but works in rural areas.
The government booklet, titled Mother and Child Care, smacks of religious dogma and ignores widely accepted medical evidence that pregnant women benefit from eating protein-rich meats and can safely engage in sex, doctors said.
It says pregnant women should also shun “impure thoughts" and look at pictures of beautiful babies to benefit the foetus.
“Pregnant women should detach themselves from desire, anger, attachment, hatred and lust," reads the booklet, released last week by the Central Council for Research in Yoga and Naturopathy, a part of the government’s ministry that promotes traditional and alternative medicine.
The traditional medicine minister defended the booklet as containing “wisdom accumulated over many centuries," and said it did not advise specifically against sex, only against all thoughts of desire or lust. “The booklet puts together relevant facts culled out from clinical practice in the fields of yoga and naturopathy," minister Shripad Naik said.
It is the latest push for vegetarianism by Prime Minister Narendra Modi’s Hindu-nationalist government, which already advocates avoiding beef and strictly limits the transportation and slaughter of cows, which are considered sacred by Hindus.
But the latest homily to pregnant women has outraged the medical community.
“This is a national shame. If the calories of expectant mothers are further reduced by asking them to shun meat and eggs, this situation will only worsen," Gadre said. “This is absurd advice to be giving to pregnant women in a country like India."
About a third of India’s 1.3 billion people struggle to live on less than $2 a day. Many are lucky to eat more than one full meal a day, and women often give their portions up to their hungry children or husbands.
Malnourished women are more likely to give birth to underweight babies, who then are in danger of being “stunted" or not growing to their full height and weight. A full 48% of all Indian children under the age of 5 are considered stunted, according to a 2015 report by UNICEF.
“Undernourished girls grow into undernourished women. Married by their families while still in their teens, these girls become pregnant by the time they are 17 or 18, when their bodies have not matured enough to safely deliver a child," said Amit Sengupta, a physician and healthcare activist with the Delhi Science Forum, a public advocacy organization.
He said the government’s advice to pregnant women betrayed “backward thinking" and hostility toward evidence-based science.
“This kind of advice is detrimental to women’s health," he said.