Motherhood: Who is Deciding?

Aleya Akhtara reports on a critical lack of access to maternal healthcare and family planning options amongst women in Meghalaya. Young women often must begin having families at very early ages. Many do not have access to professional care during their pregnancy or during delivery. While the government and other organizations have stepped up efforts to increase public awareness about family planning choices and expand access to institutionalized care, women are not often able to access these resources. Furthermore, many say the government has not followed through on the services it has promised to deliver.

Mothers in India face one of the most severe broad-scale public health challenges in the world. According to the World Health Organization, India contributes 25.7 percent of maternal health deaths globally per year. Nearly half of these deaths result from anemia and hemorrhage—two very avoidable causes of death. Dangerous and high-risk abortions are the third leading cause of maternal mortality. While not a comprehensive answer, open access to adequate family planning could help curb this last threat.

Beyond the most severe case of maternal mortality, mothers face ongoing, chronic health challenges. Due to the high demands on their time and labor, they often do not have resources to commit to their own health (including time, food, rest and other factors). More than one-third of Indian married women have a chronic energy deficiency. Further still, a considerable proportion suffer from untreated gynecological problems, such as reproductive tract infections (RTIs), menstrual problems, cervical erosion, infertility, uterine prolapse and others. Many endure these hardships silently. Lack of empowerment and information often bars these women from being able to seek out productive care, even when free clinical programs are available.

The government and nongovernmental organizations have put forward several efforts to aid women across the country in the struggle for competent and comprehensive maternal care. While these programs are at various stages of implementation and many are controversial, women’s health remains a critical national challenge.

The source of many of these challenges lies in key cultural, social and economic issues. Maternal health has as much—if not more—to do with women’s and community empowerment as it does with clinical appointments. Individual community needs and challenges must be part of any plan to tackle this significant issue.

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