India is falling behind other countries in meeting international commitments to improve obstetric care because it does not adequately monitor deaths and injuries in the critical period following childbirth, Human Rights Watch has said.
Public health experts say the key to progress in maternal health is ensuring that women with pregnancy complications are able to get appropriate care during childbirth. But Human Rights Watch research shows this is not happening in India even though it has started healthcare programs that guarantee free obstetric care to rural women.
"India should be a leader in protecting and monitoring women's sexual and reproductive health," said Aruna Kashyap, researcher for the Women's Rights Division of Human Rights Watch. "Yet women continue to die entirely preventable deaths, and health authorities do not track down the reasons or do what is needed to rectify the health system."
The government counts the number of births in health clinics and hospitals, but these are often woefully under-resourced and under-staffed. Many women die or suffer serious injury after giving birth under these circumstances. India does not monitor what happens to women after childbirth, especially in the following 24 to 72 critical hours, when the chances of dying are the highest. Without this information, it cannot save women who go back home and die or develop long-lasting complications, the report said.
India should change its approach to examine whether women with pregnancy-related complications are in fact getting the kind of treatment they need and whether they are surviving childbirth in the postpartum period, it said.