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Informed approach towards pregnancy for effective maternal and childcare

Aditi Hazra-Ganju
Wednesday, April 18, 2018, 08:00 Hrs  [IST]

When you share with others that you are pregnant, the first thing you hear is that it is the most natural thing to happen to a woman and you will instinctively know what is right for you and your baby - nothing could be further from the truth! While we bask in the exhilaration of nurturing a new life and enjoy the attention showered, we tend to forget that we now carry the responsibility of another individual’s health, and it is not enough to rely on your instincts alone. It is our responsibility to access correct, credible information and take care of ourselves in the right manner. There is sometimes too much information that you get bombarded with and most of it may not be relevant. To make the most of the information you gather, ensure the source (especially if it is online) is a credible source, culturally relevant and recent. It is always good to contextualize your information with the help of your doctor and take their help in understanding what is relevant to your pregnancy.

I never realized how rare it was for women to be completely aware of and prepared for their pregnancy and delivery experience. As we explored this field more and immersed ourselves in challenges in maternal health over the past year, some realizations have really shaken me up. During one of our field visits for a research project on digital literacy amongst pregnant women and new mothers in Mumbai slums, we learnt just how unprepared and uninformed some of these women were. I remember my chat with a lady from Bihar, the wife of a security guard and a mother of three, she had delivered each of her three children in three different cities, without any help or support from family or trained medical staff. I was not sure whether to be horrified or happy for her that she and all her children were happy and well.

While the World Health Organization (WHO) has been committed to it’s vision of ensuring “Every pregnant woman and newborn receives high-quality care throughout pregnancy, childbirth and the postnatal period”, India committed to halving preventable deaths of pregnant women and newborns in five years. The Janani Suraksha Yojana, launched as a part of the National Rural Health Mission was launched with the sole purpose of improving maternal mortality by encouraging more institutional deliveries.

You may wonder why this is such a big deal as for most of us “urbanites” the decision to deliver our baby in a hospital is a given, however, this may not be the case in peri-urban areas, small towns and villages. The prevalence of institutional deliveries in several big cities in India was found to be shockingly low and we can safely assume that the numbers in peri-urban and rural areas will be lower. The challenge is not just to increase the number of deliveries in the hospital but also to tackle the issue of early registration at a medical facility. This is important as it gives pregnant women the right start to care, starting with taking the right supplements, early detection of and addressing any underlying conditions, getting regular check-ups and familiarity with hospital and staff.

Today, there’s a lot of apprehension amongst doctors in handling deliveries for women who are not already registered in their facility. Understandably so, as they’re ill-prepared with no idea about the medical history and pre-existing conditions which could lead to complications during child-birth.  They fear medico-legal issues that could arise in these situations and have little or no support from the regulatory authorities on tackling this.

A colleague recently narrated a story about her aunt, an established Obstetrician who runs a maternity hospital, turning away a family who brought a woman in labor. Disturbing as it was to see someone in pain being sent away by someone who is supposed to heal, there are layers to every story. In this case, her aunt was concerned that the family was “shopping” for the facility that would ensure there was a normal delivery and not a C-section. She was being cautious as in the past, families have blamed the doctor for any complications, even though the woman is brought in at the last minute and background information is not provided or even hidden from the doctor to avoid a C-section delivery. It’s not about who’s to blame in cases like this, the core concern is a breakdown of trust between us and our care providers and rebuilding this trust requires effort from both sides.

During pregnancy, just the fact that you are partnering in the journey with your care provider, keeping up with regular check-ups and engaging in a dialogue with your doctors will help maintain the transparency in the process, give doctors confidence in dealing with complications that may arise and most importantly, make this journey hassle-free and enjoyable.

I’m practical enough to realize that not all women have the luxury of being able to afford and access the facilities they would like during their pregnancy, not many have the luxury of being in control of these decisions, but I can certainly hope that those who can will make the right, informed decision and partner with us in our vision of “Shared motherhood”- driving change for the benefit of future mothers to take a small step towards reducing maternal mortality.

(Author is with Avegen Pvt Ltd)


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