Prosperity Without Protection: The Unfinished Battle Against Maternal Mortality in Punjab and Haryana
-Ramphal Kataria
India has made measurable progress in reducing maternal mortality over the past two decades. Yet in economically prosperous states like Punjab and Haryana, mothers continue to die during pregnancy and childbirth despite extensive pregnancy tracking systems and multiple welfare schemes. The persistence of these preventable deaths exposes the gap between policy ambition and the lived realities of India’s public health system.
“Maternal mortality is widely recognised as one of the most sensitive indicators of the strength of a health system and the status of women in society.”
— World Health Organization
A Death That Should Not Happen
Late one evening in a village in Haryana, a young woman went into labour. Her pregnancy had been registered months earlier by frontline health workers. Her name appeared on official registers under maternal health programmes. The system knew she was pregnant.
But when complications began, the system seemed to disappear.
The nearest primary health centre referred her to a community health centre several kilometres away. From there she was referred again to a district hospital after doctors suspected severe bleeding. Hours slipped away between referrals, ambulance delays and the search for available specialists.
By the time she reached a facility capable of treating her, the damage had already been done.
She died before sunrise.
Her newborn survived.
Her story, like many others, appears in official records only as a statistic.
“Every maternal death today is rarely a failure of medicine—it is almost always a failure of systems.”
Childbirth Without Fear: The Global Context
Across much of the developed world, maternal deaths are extremely rare.
Country | Maternal Mortality Ratio (per 1 lakh births) |
Norway | 2–3 |
Japan | 3–5 |
United Kingdom | ~8 |
United States | ~23 |
Sri Lanka | ~30 |
These countries have achieved such outcomes through strong primary healthcare systems, skilled midwives and efficient emergency obstetric care.
India’s Progress—And Its Limits
India has made significant progress in reducing maternal mortality.
Year | Maternal Mortality Ratio |
2004–06 | ~254 |
2014–16 | 130 |
2020–22 | ~88 |
This progress reflects expanded institutional deliveries and maternal welfare programmes implemented through the National Health Mission.
Yet the national average hides large regional differences.
Two Indias in Maternal Health
Southern states such as Kerala and Tamil Nadu have maternal mortality levels comparable to developed countries.
State | Maternal Mortality Ratio |
Kerala | ~19–30 |
Tamil Nadu | ~30–40 |
By contrast, several northern states continue to struggle.
State | Maternal Mortality Ratio |
Punjab | ~90 |
Haryana | ~89 |
Assam | ~195 |
“Economic prosperity alone does not guarantee maternal safety.”
The Paradox of Prosperity
Punjab and Haryana are among India’s richest states. Their governments regularly highlight achievements in agriculture, industrial growth and infrastructure development.
Yet maternal mortality in these states remains stubbornly close to the national average.
The paradox is striking: states that symbolise economic progress still struggle to protect mothers during childbirth.
“Maternal mortality is the clearest mirror of a health system’s strengths—and its failures.”
Counting Pregnancies, Missing Mothers
India’s maternal healthcare system increasingly relies on digital pregnancy tracking.
Frontline workers register pregnant women through platforms under the National Health Mission.
In states with historically skewed sex ratios, pregnancy monitoring is also linked to campaigns such as Beti Bachao Beti Padhao.
The campaign has played an important role in highlighting the problem of female foeticide.
Yet some public health experts argue that the emphasis on monitoring pregnancies sometimes overshadows the equally urgent need for comprehensive maternal healthcare.
Pregnancies may be tracked meticulously, but high-risk mothers can still slip through the cracks.
“Pregnancies are counted carefully. Mothers are not always saved.”
The Silent Burden of Anaemia
One of the most significant contributors to maternal mortality in India is severe anaemia.
According to the National Family Health Survey conducted by the International Institute for Population Sciences, a large proportion of pregnant women in northern India suffer from anaemia.
Severe anaemia greatly increases the risk of death during childbirth, particularly when complications such as postpartum haemorrhage occur.
Yet anaemia is one of the most preventable medical conditions through nutritional care and regular antenatal monitoring.
Schemes Without Systems
India has introduced numerous maternal health programmes, including:
• Janani Suraksha Yojana
• Janani Shishu Suraksha Karyakaram
• Pradhan Mantri Surakshit Matritva Abhiyan
These initiatives have dramatically increased institutional deliveries.
However, institutional delivery alone does not ensure safe childbirth. Many hospitals continue to struggle with shortages of obstetricians, anaesthetists and blood banks.
Women reach hospitals, yet life-saving treatment may still be delayed.
Lessons from Successful Countries
Countries such as Sri Lanka and Thailand dramatically reduced maternal mortality by building strong primary healthcare networks and efficient referral systems.
Their success demonstrates that maternal healthcare must function as a coordinated system rather than a collection of disconnected schemes.
The Ethical Question
Maternal mortality is not merely a statistic.
Each death leaves behind grieving families and children who must grow up without their mothers.
For states like Punjab and Haryana, maternal mortality represents a deeper moral challenge.
“A nation that celebrates its daughters must first ensure that its mothers survive childbirth.”
Conclusion: The Real Measure of Development
Maternal mortality remains one of the most preventable forms of death in modern medicine.
When women die during childbirth today, the cause is rarely a lack of medical knowledge. More often it is the failure of systems meant to protect them.
For states like Punjab and Haryana, reducing maternal mortality is not merely a public health objective. It is a test of governance, priorities and social responsibility.
Until childbirth becomes safe for every woman, development will remain incomplete.
“When women die during childbirth today, the cause is rarely a lack of medical knowledge—it is the failure of systems meant to protect them.”
Footnotes
1. World Health Organization, Trends in Maternal Mortality, Global Health Observatory.
2. Sample Registration System estimates under the National Health Mission.
3. International Institute for Population Sciences, National Family Health Survey.
4. Ministry of Health and Family Welfare guidelines for Janani Suraksha Yojana and Janani Shishu Suraksha Karyakaram.
5. Government of India framework for Pradhan Mantri Surakshit Matritva Abhiyan.
6. WHO research on the “Three Delays Model” in maternal mortality analysis.
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