Post‑natal Care Gaps in India: Need for Structured Maternal Follow‑up After Delivery
India has reduced the Maternal Mortality Ratio (MMR) from 254 (2004‑06) to 87 (2022‑24). Institutional births now exceed 90 %. Yet the health system largely ignores the mother’s recovery once she leaves the hospital.
Key Developments
- Only 82.8 % of mothers receive any post‑natal check within two days, a figure that mostly reflects a discharge check rather than continued care.
- The World Health Organization (WHO) recommends a minimum of four post‑natal contacts for mother and baby, but India’s national data capture only the first contact.
- Post‑partum deaths account for about one‑quarter of maternal mortality between days 8‑42, the period when most women are at home.
- Caesarean section (C‑section) deliveries rose from 21.5 % (NFHS‑5) to 27.2 % (NFHS‑6), increasing the number of women recovering from major surgery at home.
- The Home‑Based Newborn Care programme schedules ASHA visits on days 3, 7, 14, 21, 28 and 42, but only three of these include the mother.
Important Facts
The NFHS‑6 records 90.6 % institutional births and a C‑section rate of 27.2 %. The ASHA checklist looks for danger signs such as excessive bleeding, fever, or breast problems, but omits blood‑pressure measurement, mental‑health screening, and glucose testing for women with prior gestational diabetes.
Traditional postpartum practices in many Indian communities prescribe rest, special foods, and help with the baby for up to 42 days. While culturally valuable, these customs rarely include clinical examinations that could detect hypertension, anaemia, or depression.
Exam Relevance
Understanding post‑natal care gaps links to several UPSC topics: health‑system performance (GS3), gender and women’s empowerment (GS1 & GS4), and the role of community health workers like ASHA. The rise in C‑section rates raises questions about surgical safety, health‑care financing, and equity—core issues for GS3.
Way Forward
To protect maternal health after discharge, three steps are needed:
- Expand scope of post‑natal visits: Include blood‑pressure checks, haemoglobin testing, mental‑health screening, and glucose testing in the ASHA checklist.
- Assign clear ownership: A designated primary‑care physician or obstetrician should document and follow‑up on the mother’s recovery beyond the delivery record.
- Introduce measurement: Add a national indicator that tracks completion of all four WHO‑recommended post‑natal contacts for the mother, not just the baby.
Integrating these measures into existing programmes will ensure that the mother’s health is counted, not left to be described as “normal” by family members. Only then can India claim comprehensive maternal health beyond the point of delivery.