Nearly five women die every hour in India due to causes related to childbirth showed World Health Organization (WHO) report.
Bhadrapura is a small village located in Dodballapur Taluk in rural Bangalore. A lady in her late 60s, wearing a white printed kurta, was sitting amidst a group of children. A green scarf covered her bald head. “You will find Nandini playing with these children for hours. They are closer to her than their own parents,” said 58-year-old Geeta, a resident of the village.
Nandini is a dai who has been helping pregnant women in the village deliver at home since 25 years now. She is fondly known as ‘dai ma’ among the villagers.
Explaining the poor economic conditions and transport facilities, Nandini said, “At times, pregnant women have to deliver at home. During night, we hardly get any ambulance facility here. The roads are not good, to avoid any birth complications, I help them to deliver at home by using natural methods.” Residents of this Hakki Pikki tribe continue to face obstacles in visiting the nearest hospital which is 20 kilometers from the slum. For a span of 25 years, Nandini has helped more than hundred pregnant women deliver at home.
Studies showed how marginalized groups in the state of Karnataka, remained to be among the top ten states in India with a high proportion of scheduled castes and scheduled tribes. This indicated how socio-economically vulnerable population show poor utilization of family planning and maternal health services.
Story of Shaheen
On a bright sunny afternoon, a mother of four young boys, Shaheen was waiting for her husband Imtiaz who went to offer namaz in a nearby mosque. Amidst attending customers in her tailor shop, some Asha workers paid an occasional visit to her. “Why don’t you get operated? Will you travel back to Bihar for home delivery?” they said. Owing to the traditional beliefs and poor medical facilities, Shaheen prefers giving birth at home. To promote institutional delivery, the Government of India, through the Janani Suraksha Yojana (JSY) program, gives monetary reward to all pregnant women who give birth at the government or private health center. Despite the committed provision of free transportation under the Janani Express Programme, several women in rural India experienced transport-related delays in reaching their homes.
Shaheen was often forced to get sterilized and adopt a child from an orphanage. The couple aspire to have a girl child and believe in having a big family.
Dr. Poornima Jayadev, a gynecologist mentioned 40 percent women belonging from rural areas do not opt for institutional deliveries. There’s a gap of education, proper medical facilities and economic instability which forces women to give birth at home in low-resource setting. In absence of skilled professionals, women become vulnerable to maternal complications which often leads to death. According to the doctors, 80 percent of Indian women are anemic due to the improper intake of food. Addressing the poor state of these women at their houses, Dr. Jayadev added, “In rural areas, women are still not allowed to make decisions, her family takes an upper hand in it. Most of the time due to the distance to nearest PHCs or negligence by families, pregnant women bleed to death.”
To prevent maternal deaths, ASHA workers under the National Rural Health Mission have been assigned for educating, assisting, escorting and registering pregnant women to access health care centers and promote intuitional delivery in the country. However, the road to educate each woman like Shaheen is long and tedious.