The Vital Importance of Prenatal and Postnatal Care in India

For most women, becoming a mother and holding their newborn baby is one of the happiest moments of their lives. It is a joy and happiness that every woman wishing to become a mother is entitled to. However, for many pregnant women in India, this dream often turns into a nightmare because of complications arising from pregnancy and childbirth.

According to UNICEF, every day, as many as 800 women die due to pregnancy-related complications, and countless more lose their babies (Source: Unicef.org, 2019). This tragic reality is a stark reminder of the urgent need to address the issue of inadequate prenatal and postnatal care in the country. Read along as we do exactly that!

Understanding Prenatal & Postnatal Care

Prenatal care—medical care during pregnancy—helps moms have healthy pregnancies and deliveries. On the other hand, postnatal care focuses on the well-being of moms and babies after childbirth, giving them a strong foundation for life.

By providing good prenatal and postnatal care, we can greatly improve health outcomes for mothers and children in India. This leads to fewer complications during pregnancy and childbirth, healthier development for newborns, and better overall health for both mothers and babies.

The Current State of Maternal Health Care in India

India has made significant strides in addressing maternal health challenges, with the Maternal Mortality Ratio (MMR) declining from 130 per 100,000 live births in 2014-16 to 97 per 100,000 live births in 2018-20 (Source: unicef.org, 2020).

However, significant challenges persist, particularly in addressing maternal health disparities across socio-economic groups and geographic regions. Pregnancy-related complications remain the leading cause of death among adolescent girls aged 15-19 years, highlighting the increased risks faced by this vulnerable group.

Importance of Prenatal Care

Prenatal care is crucial to ensuring a healthy pregnancy and promoting the well-being of the mother and the developing baby. Here are five key reasons that drive the importance of prenatal care:

1) Early Detection of Complications

Regular prenatal check-ups and screenings enable healthcare providers to identify and address potential complications early on.

2) Optimal Foetal Development

Prenatal care ensures that the developing foetus receives the necessary nutrients and support for optimal growth and development. This includes monitoring the mother's nutrition, administering essential supplements like folic acid, and conducting regular ultrasounds to track the foetus's growth milestones throughout the pregnancy. 

3) Reducing the Risk of Preterm Birth

Monitoring the pregnancy closely during prenatal care visits helps identify factors that may contribute to preterm birth, such as cervical incompetence or infections.

4) Preparation for Labour and Delivery

Education and guidance provided during prenatal care visits equip expectant parents with the knowledge and skills needed for a smoother labour and delivery experience.

Importance of Postnatal Care

The postpartum period—fourth trimester—is a critical phase for both the new mother and the baby, and it underscores the importance of postnatal care. During this time, the mother undergoes significant physical, social, and psychological changes, including learning to care for and feed the baby, hormonal shifts, and recovery from the physical demands of childbirth.

Postnatal care is essential for several reasons:

1) Physical Recovery

Childbirth is a significant event that takes a toll on the mother's body. Postnatal care ensures that the mother is healing properly from the delivery, monitoring any complications or issues that may arise.

2) Breastfeeding Support

Postnatal care involves providing guidance and support to help establish successful breastfeeding practices, which are crucial for the baby's nutrition and the mother's well-being.

3) Mental Health Screening and Support

The postpartum period can be emotionally overwhelming, and some women may experience mental health issues like postpartum depression or anxiety. Postnatal care includes screening for these conditions and providing necessary support, counselling, or referrals to mental health professionals.

4) Monitoring Infant Health

Postnatal care also involves monitoring the baby's health and development, ensuring that the infant is thriving and receiving appropriate care, including immunizations and screenings for potential issues.

Challenges in Prenatal and Postnatal Care in India

Many rural areas in India lack proper healthcare infrastructure, making it difficult for pregnant women to access prenatal and postnatal care services. Long distances to healthcare facilities, poor transportation options, and the associated costs can deter women from seeking care.

A few more challenges that surround pre and postnatal care in India are:

1) Shortage of Healthcare Professionals

India faces a significant shortage of trained healthcare experts, particularly in rural areas, leading to an overburdened healthcare system. This shortage includes obstetricians, gynaecologists, midwives, and skilled birth attendants, all of whom provide quality prenatal and postnatal care.

2) Socio-Economic and Cultural Barriers

Poverty, lack of education, and deeply rooted cultural beliefs can hinder women from seeking prenatal and postnatal care services. Some traditional practices and misconceptions about pregnancy and childbirth may discourage women from seeking professional medical assistance. 

3) Limited Financial Resources

Many women in rural and underprivileged areas lack the financial means to afford prenatal and postnatal care services, including transportation costs and medical expenses. This financial barrier can lead to delays in seeking care or forgoing it altogether, putting both the mother and the child at risk.

4) Low Awareness and Health Literacy

Lack of education and information about the benefits of regular check-ups, immunizations, and proper care during pregnancy and after childbirth can lead to poor maternal and child health outcomes.

How Can Prenatal and Postnatal Care be Improved in Rural Areas?

Integrating telemedicine and technology can bridge geographical gaps and facilitate efficient healthcare delivery. Remote consultations and virtual prenatal care enable expectant mothers in remote areas to access healthcare professionals without extensive travel. Also, real-time monitoring devices allow healthcare providers to track vital maternal health indicators, enabling early detection of potential complications. 

A few more ways to improve pre and postnatal care in rural areas are:

1) Infrastructure and Resource Development

Upgrading hospital facilities by modernising medical equipment, expanding physical infrastructure, and ensuring emergency preparedness are crucial for providing quality maternal care. Recruiting and retaining skilled healthcare professionals can be achieved through incentive programs, professional development opportunities, fostering community engagement, and establishing mentorship programs.

2) Government Policies and Support

Funding initiatives, such as grant programs for rural hospitals, subsidies for telehealth services, and research and development grants, can provide the necessary resources for infrastructure development and service enhancement.

3) Community Education and Outreach

Promoting maternal healthcare awareness through workshops, seminars, and distribution of educational materials in local languages can empower communities and facilitate better engagement with healthcare services.

4) Collaborative Healthcare Models

Collaborations enable resource sharing, access to medical specialists, seamless referral systems, training and skill development programs, and holistic care approaches that address social determinants of health. Community awareness programs focused on maternal health education, prenatal care, and family planning contribute to the early detection of potential issues and promote healthier pregnancies.

Concept of the Power of First 1000 Days of a Child’s Life

The first 1000 days of a child's life, from conception to their second birthday, are a remarkable and influential period. During this time, the foundations for a child's health, growth, and neurodevelopment are established, shaping their lifelong trajectory. Proper nutrition, care, and a nurturing environment during this critical window profoundly impact a child's overall well-being and future potential.

This period is characterized by rapid growth and development, making it highly sensitive to environmental influences. Adequate nutrition during this time is crucial for supporting physical growth, brain development, and the maturation of various bodily systems. Malnutrition or inadequate care during this phase can lead to irreversible consequences, such as stunted growth, cognitive impairment, and an increased chance of chronic diseases later in life.

What Does This Program Aim To Solve & How Does CRY India Do Interventions?

The program, prenatal and postnatal care in India aims to reduce child and maternal deaths by promoting systematic and behavioral changes through home visits and awareness sessions. CRY India , a child health NGO interventions focus on several key areas:

1) Adolescent girls

The program targets adolescent girls, recognising their critical role as future mothers. It creates adolescent collectives to disseminate information about the benefits of the Iron and Folic Acid (IFA) tablet program and encourages them to take these supplements regularly to prevent anaemia. Life skills training is also provided, equipping them with the knowledge to make informed decisions about marriage and pregnancy.

2) Pregnant Women

All pregnant women are tracked and counselled to ensure they receive proper nutrition and care for the healthy growth of their pregnancy. They are encouraged to attend timely check-ups and receive vaccinations to address any potential complications. The program focuses on creating individual birth plans for high-risk pregnancies to ensure safe institutional deliveries.

3) New Mothers

Post-natal check-ups for new mothers are conducted to reduce the occurrences of haemorrhages and address any respiratory complications in infants, which are leading causes of maternal and infant deaths. The program also aims to ensure adequate care and nutritious food for new mothers during this critical period.

4) Infants

All infants are monitored for growth, identifying those who are severely (SUW) and moderately (MUW) underweight. SUW children are referred to nutrition and rehabilitation centres (NRCs) for recovery. The program ensures 100% immunisation of children by organising monthly village health and nutrition days with the help of local authorities and health workers.

5) Community Building

The program creates awareness among communities, especially families of pregnant women and new mothers, about the benefits of colostrum feeding, exclusive breastfeeding, the importance of institutional delivery, and addressing harmful practices that endanger infants and mothers. Special food demonstration sessions are conducted to identify and utilise nutritious foods readily available at home. 

Moreover, seed support and training are provided to establish kitchen gardens to incorporate fresh vegetables into diets. Sessions are held with new mothers and family members to provide adequate complementary nutrition after the child reaches six months of age.

CRY India's Work on the Health of Infants & Pregnant Women

Over the past five years, through rigorous community engagement, working with adolescents, and house-to-house tracking of pregnant women and newborn children, CRY India has achieved significant behavioural changes in the community's attitudes and practices, positively impacting the care of pregnant women and newborns.

Additionally, our efforts have led to system activations, working closely with frontline workers (FLWs) like ASHAs, Anganwadi workers, and ANMs, and the establishment and renovation of primary health centres.

In the last three years, our efforts have resulted in:

• Early identification of all high-risk pregnancy cases, with regular observations and care, leading to 100% birth recording during deliveries.
  
• An increase in institutional delivery rates from 83% to 91%.
  
• The percentage of women completing prenatal check-ups improved from 27% to 63%.
  
• A 50% reduction in the percentage of severely malnourished children in the project area, from 12% three years ago to 6% in 2023, while the percentage of normal children has grown from 65% to 77.5%.
  
• 100% age-appropriate vaccination of children.

Conclusion

Investing in prenatal and postnatal care isn't just about individual health; it's an investment in India's future. By ensuring mothers and babies receive the support they need during this crucial time, we can create a healthier generation of children ready to learn and contribute to the country's success. This is why prioritizing accessible and high-quality prenatal and postnatal care services across India is vital.

Frequently Asked Questions

What is the role of NGOs in maternal health?

NGOs collaborate with local communities, health workers, and government agencies to identify gaps in maternal healthcare delivery and implement interventions tailored to the region's specific needs. Their efforts include providing prenatal and postnatal care, facilitating access to skilled birth attendants, and educating women about proper nutrition and hygiene practices during pregnancy and childbirth.

What role do government programs play in enhancing maternal health care?

Government programs are designed to address the multifaceted challenges pregnant women and new mothers face, particularly in resource-constrained settings. Government initiatives also focus on establishing and strengthening healthcare infrastructure, training and deploying skilled health workers, ensuring the availability of essential medicines and equipment, and implementing policies and guidelines for maternal health services.