From wards to homes: Where India’s maternal care breaks down | India News

Access to maternity care in India has certainly expanded over the past decade, even as a mother’s experience during pregnancy and delivery remains uneven once she steps outside the delivery room. What shapes outcomes for mothers in the weeks and months after delivery are breastfeeding-related struggles, poor postpartum follow-up, and limited mental health support. At Times Future of Maternity 2026, organized by Times Internet and Pregatips, doctors and experts convened to discuss a part of the maternity care ecosystem in India that often doesn’t get much attention – what happens before birth and, more importantly, after birth.Beginning with discussions on how to strengthen antenatal, postnatal, breastfeeding and emotional support systems, the focus was on breastfeeding, an area where India is seeing gaps despite clear global guidelines. Rates of exclusive breastfeeding still vary widely across regions. Dr. Deepti Arora, founding member of Everbliss Maternity and Family Wellbeing Leader, points to a pattern she sees time and time again in practice. “Breastfeeding fails not because a mother doesn’t know it, but because the gaps in instruction are so wide that she thinks I don’t know how to do the simple thing.”Known challenges in the early days include pain due to improper latch, concerns about low milk supply, late initiation, and emotional overwhelm. However, what stands out in Dr. Arora’s comments is the lack of timely support and preparation rather than lack of awareness. “Breastfeeding doesn’t fail, but systems do,” she said, emphasizing the need for early and continuous guidance rather than reactive intervention.That idea of ​​continuity comes up again when the discussion turns to postpartum recovery. Dr Helai Gupta, Senior Consultant, Obstetrics and Gynaecology, Rosewalk Hospital, argued that the healthcare system often treats childbirth as the end point rather than the beginning of a long recovery phase. “Postpartum care is the most under-medicated phase of a woman’s life cycle,” she said.The consequences of that mentality are visible. Several aspects related to recovery do not receive much attention from medical teams, while the focus is on delivery and discharge-related protocols. For example, sleep, hydration, mobility and mental health are neglected. Highlighting how even basic practices can have unintended consequences, Dr. Gupta noted that limited water intake after delivery, in some communities, causes dehydration, which affects recovery and lactation.Mental health, in particular, is a weak link across the continuum of care. According to Dr. Juhi Rachel Baloza, Consultant Psychiatrist at St. Stephen’s Hospital, while awareness about mental health has improved, anxiety disorders remain a concern during pregnancy and post-partum. “In about 15-20% of cases… there will be some sort of underlying anxiety,” Dr. Baluza said, adding that such anxiety is not limited to first-time mothers.In more severe cases, symptoms may progress to depression or psychosis and go unnoticed before becoming severe. According to Dr. Baluza, many women do not see these changes, which make the role of the family fundamentally important. Some early indications that require immediate attention are low self-confidence, inability to care for the child, and sadness.During a panel discussion on preparedness, the conversation then turned to prenatal education, which experts said remains underutilized. Dr Rashmi Bawa, founder director of WellMom, a wellness platform for expectant mothers, describes structured prenatal sessions as a low-cost, high-impact intervention. “Formal prenatal education… is the least input but most productive resource we have,” she said.According to Dr. Bawa, when available information is not considered reliable enough, prenatal sessions help families understand what to expect and how to respond. Also, a shared space where parents can talk and learn from each other can help reduce anxiety and gain confidence before delivery. Here, timing is also important. For example, it is too late to provide guidance on breastfeeding after delivery, according to Dr. Arora, since the mother is already experiencing stress while physically recovering. Therefore, preparation during pregnancy allows mothers to know what is normal and what is not, and respond accordingly instead of panicking.This concept of continuity of care extends to how postpartum support systems are structured. According to Dr. Gupta, since current public health programs track mothers up to six weeks after delivery, follow-ups should be extended. Digital tools, periodic check-ins, and structured screening can help identify early risks and promote long-term outcomes.At the same time, experts point out that the systems themselves are not enough, because what remains central, especially in the Indian context, is the role of the family. As Dr. Arora points out, “If the mother is supported, breast milk flows, if she is doubted, it slows down.”Yet, current support structures focus too much on the newborn, often ignoring the needs of the mother and the entire family. Dr. Bawa noted that while postpartum care needs to move toward a more “parent-centered” approach, in many families it remains child-centered. Furthermore, communication gaps between partners, lack of practical support, and social expectations around caregiving can increase stress during this phase.Experts also discuss the importance of involving extended family members in care planning. This is because older family members often make decisions about nutrition, recovery and childcare. Therefore, engaging them in the process can help increase adherence and results.Throughout the panel, a theme of conversation was that maternity care spans preparation, delivery, recovery and adaptation to a new phase of life rather than beginning at delivery and ending at discharge. Therefore, coordination between health care providers, communities, and families is critical in addition to clinical protocols to strengthen antenatal, postpartum, breastfeeding, and mental health frameworks. Why? Because the most important period of care for many women begins after delivery.