Bridging the Gaps in India’s Maternal Care: Evidence to Action | India News

About 40 percent of maternal and neonatal deaths still occur during labor or within the first 24 hours after birth, a window in which timely and quality care is critical to survival. However, the gap, increasingly, is not only in access but also in terms of consistency, quality, and the extent to which evidence-based practices are adopted across different healthcare settings.This was the focus of a panel discussion at the Times Future of Maternity 2026, hosted by Times Internet and Pregatips, where clinicians looked at how evidence-based medical knowledge can improve real-world outcomes.“There is ample global and national evidence of what works. We know what interventions work,” said Prof (Dr) Aarti. mariaFormer Dean, ABVIMS and Dr. Ram Manohar Lohia Hospital. Decades of research have already established protocols across maternal and newborn care. The problem, he says, is that these protocols don’t always reach the patient in the form they were designed for.He pointed to a basic but telling example. Mothers and newborns are meant to stay together immediately after birth, yet this is not often practiced. “Mother and newborn are one food… They are inseparable, and zero separation should occur,” he said, adding that awareness within the family is equally important. That’s because when families finally look to question hospital care practices, the system has little choice but to respond.This concern about implementation directly connects to outcomes. India’s maternal mortality rate has improved faster than the global average, as highlighted by Prof. (Dr.) Jyotsna Suri, Consultant and Unit Head, In-charge Obstetric Critical Care, VMMC and Safdarjung Hospital. “India in particular has improved by over 75 per cent, while the global improvement is around 40 per cent.” While the benefits are real, risks also exist.For the uninitiated, the leading causes of maternal death today remain postpartum hemorrhage, infection, and hypertension, all of which are preventable. What has changed is the availability of structured procedures to manage them. In critical care, timing becomes key. “I have to be very careful and act during that golden period,” says Dr. Suri, noting that in severe cases of bleeding, deterioration can occur in just a few minutes.Along with emergency care, the conversation has shifted steadily toward prevention, especially as the nature of pregnancy itself has changed. About half of all pregnancies in India are now considered high-risk. “These days, pregnancy is not what it was 30-40 years ago… In India, about 49.5% of pregnancies are high-risk,” said Dr Madhu Goel, director, obstetrics and gynaecology, Fortis La Femme.This situation has brought about an evolving focus on early detection and intervention. Risk stratification, routine supplementation, and vaccination protocols as part of standard prenatal care. Results are visible in areas such as reduction of anemia and better management of complications. “The shift from a purely therapeutic thing to a preventative strategy… is the biggest game changer in high-risk pregnancies,” she said.Prevention, however, is only effective when it is systematic. Dr. Tripti Saran, Director – Obstetrics and Gynaecology; Head- High Risk Pregnancy, BLK MAX Hospital, in his remarks described how early risk detection is embedded in routine care through clinical assessment, screening and regular monitoring. From checking hemoglobin levels to tracking fetal growth and detecting infections, every step contributes to better outcomes. “Risk identification and preventative strategies are the single most impactful entry point,” he said.While these approaches, taken together, reflect a mature healthcare system, experts have repeatedly returned to the same limitation – change. Thus, what works in one hospital or region may not always be replicated in another hospital or region.When it comes to public hospitals, volume pressure remains a challenge as they handle dozens of deliveries per day, essentially requiring systems that one can rely on under pressure. To address this issue, experts point out that simulation-based training and drills, especially for emergencies like hemorrhage or eclampsia, are being adopted.On the other hand, the situation is different in private and urban settings as standardization in protocols across healthcare centers is not visible, while access to recent clinical evidence is uneven, especially for India-specific data. As a result, there are differences in treatment approaches even within the same facility.During the discussion, the conversation also touched on how caregiving is experienced. Dr. Maria emphasized that healthcare systems should look beyond a provider-driven approach. “It’s not about what the doctor thinks…it’s about what the patient wants,” he argued, noting that by directly involving parents in newborn care, especially in intensive care units, outcomes have improved on multiple indicators. For example, breastfeeding rates increased, hospital stays decreased, and parents were better prepared to care for their children after discharge.This change, he claims, requires a change in mindset rather than a new technology or infrastructure.Throughout the discussion, the underlying theme was that India already has a strong foundation for evidence-based maternal and newborn care. However, the next phase will be a bit more complicated, requiring aligned systems, standardized practices, and ensuring that quality care is not dependent on geography, institution or situation because in maternal and newborn care, experts say the difference between knowledge and execution is often the difference between life and death.