Reflections on safe motherhood

I didn’t know there was such a thing, but apparently April 11 is National Safe Motherhood Day. It has been observed since 2013 when the government decided to commemorate the anniversary of Kasturba Gandhi. In states like Uttar Pradesh, which have traditionally had some of the highest maternal mortality rates in the country, a lot has been done to make deliveries safer. Local hospitals have been upgraded, pregnant women are monitored and given iron and folic acid supplements and in rural areas, women are being incentivised to have institutional deliveries instead of giving birth at home. Yet, field experiences in the state have led me to believe that not much will change unless people’s (especially men’s) attitude towards childbirth undergoes a change. The story of Ved Shukla illustrates this.

Shukla is a driver, originally from a village on the eastern UP-Nepal border in Maharajganj district. He is 27 but his eyes still well up when he talks about growing up as an orphan. His mother died while giving birth to him at home. “She was barely 16 when she became pregnant with me,” he recalls. “No one really knows why she died — I’m told she simply slipped into a coma from which she never awakened.” His father remarried months after her death and Shukla grew up neglected as his stepmother, also 16, soon became pregnant too. “Growing up, nobody cared to find out if I had eaten or how I was doing at school,” he says. “There was no one to guide me when I decided to drop out of school after class 10.” He soon migrated to Delhi because, as he says, he had no ties to bind him to his home. 

Cut to the present. Shukla is excited because he is about to become a father for the first time. “My wife has gone to her brother’s house in her village to have the child,” he says. “I’m waiting for the good news any day now.” I congratulate him and say I hope there are good medical facilities for institutional births in the village. Had his wife chosen to have the baby in Delhi, he says, of course they’d have registered in a hospital. “In the village, however, childbirth is considered a natural process,” he adds. “There’s a midwife and plenty of experienced women to help her.” When I press for details, he says, these are women’s matters about which he doesn’t know much. 

It amazes me that after having grown up a posthumous child, Shukla remains so nonchalant about childbirth. Does he think, I ask, that his mother’s death was preventable? He smiles and shakes his head. “It was her fate and my greatest misfortune,” he says. “Whatever we do, we are powerless in the face of death.” Perhaps, I say, treading gently, if she had been in a hospital, she could have had better treatment. “I’m a man who knows nothing about women’s matters so I really can’t say,” he says. 

Which is why I feel rather than making posters and distributing pamphlets, a more appropriate way to observe National Safe Motherhood Day could be to initiate discussions with adolescent boys and girls about safe childbirth. Perhaps then they would grow up to espouse better practices than their parents ever did.