Fact: Maternal mortality
Maternal mortality means that one dies in connection with pregnancy or childbirth. For example, there could be complications after childbirth or an unsafe abortion. The majority of deaths occur in low- and middle-income countries.
Maternal mortality in Sweden is low, and has long been around 4 deaths per 100,000 births.
In India the maternal mortality rate is much higher, in 2021 the figure was 125 deaths per 100,000 births. In recent years, however, a strong improvement has taken place. Just over 30 years ago, in 1990, the figure was 491 per 100,000 births.
One of the global goals in Agenda 2030 is that the average maternal mortality rate in the world should be no more than 70 per 100,000 births. Today, that figure is 159, a decrease from 271 in 1990.
Source: Bill & Melinda Gates Foundation, RFSU
In northern India is the state of Chhattisgarh. One of the most sparsely populated parts of the country, and also one of the states with the highest maternal mortality. Last year the figure was 137 deaths per 100,000 births. Approximately 50 percent more than in the country as a whole. Nevertheless, it is the lowest figure ever – ten years ago it was 244.
The fact that the mortality rate is so high right here is due, among other things, to the fact that many people give birth at home. Partly because they live in remote villages with long distances to the nearest hospital, and partly because they have low trust in the authorities.
The motorcycle ambulance is on its way on a mission. Sidecar as a hospital bed
In Kodoli, a remote village in the state, lives Phagni Poyam. She is 23 years old and nine months pregnant with her second child. She gave birth to Dilesh, her first child who is now one year old, at home. But this time she wants to give birth in a hospital. After seeing several women and children die in childbirth, she doesn’t want to take any chances.
“My baby will be safer,” she says.
The ambulatory healthcare staff rushes to her aid. She and her son will be allowed to go to a center for pregnant women which is connected to the hospital two kilometers away, in Orchha.
With a motorcycle and an attached sidecar that functions as a hospital bed, the healthcare staff can also go to villages that lack functioning roads. For Phagni Poyam and the other residents of Kodoli, the nearest road is a mile and a half away.
Phagni Poyam prepares her son for departure to the center for pregnant women. Twice as many hospital births
Chhattisgarh has had itinerant motorcycles since 2014. First was the district of Naryanpur, to which Kodoli belongs. There, the number of hospital births has more than doubled, from 76 to 162 hospital births per year. A total of 3,000 mothers have been helped by the motorcycle ambulances in Naryanpur. But neither authorities nor healthcare professionals think it is a long-term solution.
The authorities want to build functioning road networks instead, but their attempts are often sabotaged by armed rebel groups that attack road works. The groups have operated in the area for over 40 years and say they are fighting for the tribal people of Chhattisgarh, who make up 80 percent of the state’s population.
The roads are barely passable even for a motorcycle. On the way back to the maternity center, two miles from Kodoli, Phagni Poyam and her son have to get off the motorbike several times where the road is too difficult to pass. The paramedics have to put the vehicle on steep river slopes, dig out the wheels when they are stuck in mud or lift large rocks out of the way so they don’t get stuck in the sidecar.
Should feel like home
When they arrive at the hospital, it is already dark. Lata Netam is in charge of the center and also one of the paramedics who have gone out to collect Poyam.
— We are from here, we know these villages. We want the mothers to feel at home here, says Netam.
The local population’s trust in hospitals and modern healthcare has increased recently, and in the villages several mothers speak warmly of the hospital. These days, health workers stand at the local market every week and test people for diseases such as diabetes and malaria.
At the center samples of Phagni Poyam are taken. It turns out she has dangerously low iron levels. If it is not treated, it poses serious risks if she loses a lot of blood during childbirth.
Poyam receives nutritional supplements and regular meals. Just over a month later, she has recovered her iron values and gained four kilos. Soon after, she gives birth to a healthy boy.
Phagni Poyam and her son sit on a bed at the center for pregnant women. The two other women work at the centre.