More mothers are dying in Bengal compared to the national average.
A recent report by the Registrar General of India on maternal mortality puts Bengal at 104, far above the national average of 88 for the years 2021-23, which is in keeping with the trend that the state has witnessed over the last few years.
Maternal mortality rate or MMR refers to deaths of mothers per 100,000 live births, due to complications from pregnancy or childbirth.
Bengal is on par with Bihar but below states like Jharkhand, Rajasthan, Uttarakhand, Haryana and Punjab.
“It’s a shame that West Bengal is now far above the national average,” a retired bureaucrat, who had served in the state health department told The Telegraph Online. “In 2007-09, the MMR in Bengal was 145 while the national average was 212. In 2010-12 it was brought down to 117. Bengal started sliding down after the Covid pandemic.”
Till about seven years ago, the MMR in Bengal was better than the national average, though still far above Kerala that has consistently kept its MMR below 40 for about a decade.
In the latest survey, Kerala and Andhra Pradesh have shared the top spot with MMR at 30.
The upward surge in the MMR was observed in 2017-19, when Bengal recorded 109 while the national average came down to 103. Since then the MMR in Bengal has stayed above 100, while nationally it has come down.
The World Health Organization (WHO) has set a target of reducing global MMR to less than 70 per 100,000 births, “with no country having a maternal mortality rate of more than twice the global average.”
India is above the ideal mark set by the WHO, but fares better than the global MMR average which in 2023 was 197.
Direct causes like postpartum haemorrhage, pre-eclampsia and hypertensive disorders, pregnancy-related infections, complications arising from unsafe abortion are the major reasons behind deaths during pregnancy or at and immediately after childbirth.
Pre-existing medical conditions among pregnant women add to indirect factors.
“We have taken institutional deliveries to almost 99 per cent. There are still some grey areas which need to be worked upon,” said a senior official in the Bengal health department who requested anonymity.
Doctors say often in small towns and rural areas, women from the lower income groups ignore pre-existing conditions like hypertension and high blood sugar that lead to complications during pregnancy and childbirth.
Dilip Ghosh, former mission director of the National Rural Health Mission, said that after 2009 the Bengal government had introduced a system of maternal death audit involving officials from the departments of health, women and child development and panchayats.
“Teams were sent to the neighbourhoods to talk to the families, the neighbours to identify the factors behind the death other than medical ones. Maternal mortality is a social issue,” Ghosh told The Telegraph Online.
In 2007-09, the MMR in Bengal was 145, below the national average of 178.
“Though politically 2010 onwards was a tumultuous period but no effort was spared to bring down the maternal mortality rate further down. Quarterly meetings were held in all the districts. Regular conversations were held with the auxiliary nurse midwife to understand the situation on the ground,” said Ghosh.
From 2010-12, Bengal’s MMR showed a steady decline from 117 till the lowest 98 in 2016-18.
“I am unaware if the audits are still being held. Something is definitely wrong because in infant mortality rate Bengal has been doing well steadily,” Ghosh said.
In 2020, the infant mortality rate – number of deaths of children per 1,000 live births – in Bengal was 19 while the national average was 27.
Bengal health secretary Narayan Swarup Nigam did not respond to calls from The Telegraph Online for comment.