Maternal deaths in Uttar Pradesh – a silent emergency

Any maternal death is actually a silent emergency. A single digit maternal mortality (MM) rate and MM ratio is desirable as there will be circumstances that will be out of reach from the medical care like the case of Smita Patil, the famous Indian actress of Mumbai. She died while giving birth to her son on 13 December 1986. The recent sample registration system (SRS) shows that the MM rate of Uttar Pradesh has decreased but the MM ratio has increased. The denominator of MM rate is 100,000 women in the reproductive age group of 15-49 years. This denominator is unreliable as it includes women who are infertile, unmarried, spinsters and widow and are not related to fertility. The MM rate covers deaths from conception till birth of the child. Hence, the deaths due to complications during pregnancy and abortions are accounted here. Similarly, the MM ratio covers deaths during births till 42 days after delivery. Two-thirds of all maternal deaths take place during intra natal care (INC) and post-natal care (PNC) and especially during PNC. The denominator of MM ratio is 100,000 live births (LB). This is a reliable denominator as we can track the child as well as the mother. Hence in policy making MM ratio is used but not MM rate but both indicators have to be reduced. The article in its conclusion mentions the future steps that are or will be taken up by the Government of Uttar Pradesh.