Indian social media has been increasingly filled with desperate calls for help and heartbreaking announcements of deaths of pregnant women due to Covid-related complications. The rising number of these deaths is setting India back after decades of progress at reducing maternal mortality.
In 1946, a year before India’s independence, India reported that for every 100,000 births, about 2,000 mothers died. Ill-equipped and undertrained midwives, home births and poor transportation over long distances during emergencies contributed to the high number. Sustained efforts over the decades, expansion of maternal health services, childbirths in hospitals instead of homes, and improved prenatal and postnatal care helped India bring the maternal mortality rate down to 130 per 100,000 live births in 2016.
Covid-19 threatens to set back these hard-won gains. A study in the International Journal of Gynecology and Obstetrics noted the medical treatment of pregnant women from October 2019 to February 2020 and April to August 2020 fell by 45.1 percent in institutional deliveries; there was a 7.2 percent increase in high‐risk pregnancy and a two-and-a-half-times increase in admission to the intensive care units. Fear of contracting the virus also decreased postnatal visits by women to hospitals.
I spoke to over 50 nursing homes across the country, and every single one refused to admit pregnant women who had tested positive for the virus. Some were afraid of contracting the virus, some didn’t have the resources to handle both Covid-19 positive and negative patients; some felt they were not equipped to adequately treat high-risk patients. Most nursing homes do not have I.C.U. beds or specialist doctors.
During my travels across Maharashtra — one of the most affected Indian states — I stopped at dozens of rural health centers. Most reported a shortage of government-mandated doctors and specialists including surgeons, physicians, gynecologists and pediatricians. Most lacked any form of prenatal care despite the existence of a government program offering free prenatal checkups.
The virus is not sparing expectant mothers even among the upper and middle classes in India’s major cities, who always had the financial resources and better access to health care than people in impoverished villages.
In early April, as the second wave of the pandemic hit Delhi, several members of the Chauhan family in the Saket neighborhood in Delhi were infected. Anshuma Chauhan, their daughter-in-law, who was eight months pregnant, isolated in her bedroom. During the night of April 29, Ms. Chauhan couldn’t breathe. “Eventually the virus found her,” her sister-in-law told me.