Birthing targets must go beyond maternal survival

One of India's greatest public health successes has been the dramatic fall in maternal and infant mortality throughout the 21st century.

- Janhavi Nilekani

The Maternal Mortality Ratio (MMR) in India—maternal deaths per 100,000 live births—that was 384 in 2000 had fallen to 103 by 2020. There is much more access to modern health care. In 2019-2021, 89% of babies were born in hospitals and other health care institutions, compared to just 41% in 2005-2006. The quality of care has improved within institutions as well, saving even more lives.

But is it enough that more women and infants survive?

As United States-based maternal health expert Neel Shah says, survival is just the floor of what people deserve during childbirth. We should be aiming for the ceiling—not only survival, but also good health and quality of life; dignified, respectful, and positive birthing experiences; and memories of fulfillment and joy at the arrival of a new family member.

To get to that aspirational ceiling, we have to understand the three key challenges in India's maternal health landscape.