In 2010, maternal deaths in India accounted for 19% of overall maternal deaths worldwide. For every maternal death, 20 more suffer from lifelong impairments resulting from pregnancy complications. Most of these deaths occur among the 15-29 age group when the women are in the prime of health, reproductive and otherwise. Since more than 90% of these deaths are avoidable, the key is to educate and provide affordable medical care to women of all economic classes through the entirety of their pregnancy. Let’s have a look at some of the top risk factors:
Top 10 Pregnancy Risk Factors In India
- Inadequate nutrition: According to WHO, only one in five pregnant women, received iron and folic acid for at least 90 days. Apart from supplements, only 4% took medication for conditions such as de-worming
- Post-partum bleeding: Post-partum bleeding, due to lack of good medical care can lead to severe complications or even death. 70 percent of pregnant women, who faced an emergency situation, did not have a means of transportation readily available as they had not planned for it earlier since more than half of births in India are still happening at home
- Pre-partum bleeding: This bleeding can be caused by conditions such as placenta previa, uterine rupture or ectopic pregnancies. These usually occur when women and their families cannot recognize the signs and do not receive proper prenatal care or do not consult a doctor regularly. 37.2% of maternal deaths are attributed to pre or post-partum bleeding. Read in detail about ectopic pregnancy here
- Sepsis or severe infection: Infections account for 10.9% of deaths. Most of these happen at home because of delays in trying to find money or getting to a doctor on time. While sepsis is not necessarily fatal, it can lead to bacterial infections in the first month for the baby for serious diseases such as meningitis or pneumonia
- Miscarriage or spontaneous abortion: Miscarriages and abortions result in about 7.92% pregnancies in India. The fetus is genetically defective and so unable to survive. Unfortunately, the cause of these miscarriages is unknown
- Hypertensive disorders: Associated with increased risk of maternal and fetal morbidity and mortality (lead to 4.95% of maternal deaths). This refers to a group of complications including pre-eclampsia, eclampsia, gestational hypertension, and chronic hypertension. Women below 15 and older than 35 are at a higher risk of pre-eclampsia.
- The age, weight and height: These factors pose different risks. Girls aged 15 and younger are at increased risk of pre-eclampsia/eclampsia. Teen pregnancies are also at increased risk of resulting in low-birth-weight babies. The chances of pregnancy-induced hypertension or diabetes in the mother and risk of fetal abnormalities increase with the mother’s age. Older women are at an increased risk of problems such as high blood pressure, gestational diabetes, and complications during labour. Obese women are also at a higher risk of similar complications
- Gestational diabetes: Gestational diabetes, which results because of glucose intolerance during pregnancy resulting in high levels of blood sugar. Older women, obese women (2-8 times more likely depending on the extent of the obesity), those with a family history or history of gestational diabetes are at a higher risk. Women with PCOS ( Poly-cystic ovary syndrome) a condition due to genetic and environmental factors resulting in a hormonal imbalance in women, also have a higher risk of contracting gestational diabetes
- Obstructed labor: This causes 4.95% maternal deaths in India and is largely due to child or teen pregnancies, inadequate medical facilities and healthcare. For example, according to the National Family Health Survey II, less than 30 % rural facilities had an obstetrician available; less than 10 % had an anesthetist. Obstructed labor is usually caused by wrong positioning by the baby, a small pelvis and problems with the birth canal. As a result, the baby might not get enough oxygen and the mother is at an increased risk of infection, uterine rupture and long term complications
- Complications in a previous pregnancy: If you have had complications in a previous pregnancy, the same are likely to recur in subsequent ones. Premature, underweight babies, those with birth defects, a previous miscarriage post-term delivery, large new-borns(>4.5kgs) might point to various complications that can recur again such as hypertension, gestational diabetes, pre-eclampsia etc.
While the risk of these factors is high and the complications severe, a few precautions can help avoid them. The key is to provide adequate, continual medical care and education to pregnant women and their families for all sections of society devoid of class or other socio-economic factors.