Safe Motherhood delivers results

Ranjana Narayan/ Jodhpur

White Ribbon Alliance for Safe Motherhood campaign in 10 villages of Osian block of Jodhpur district has started showing results. MMR is very high in Rajasthan

Will the baby live? Will the mother survive childbirth? Not very long ago, it was left to fate to decide how a pregnant woman and her unborn child would fare, but a slow change towards birth preparedness is taking place in some villages of Rajasthan's Jodhpur district.
Now women like Mamta, Goga, Pushpa and Ganga care. Hiding their faces behind colourful, pink and red odhnis or veils, and laughing shyly over the discussion on pregnancy and birth, these women are becoming aware of the need to eat properly, check blood pressure and weight regularly and write down the phone number of the local jeep or van driver to call when birth pains begin or in case of any emergency.
Rajasthan has among the highest maternal mortality ratio in India at 335 per 100,000 live births.
But in a project coordinated by SUMA-Rajasthan White Ribbon Alliance for Safe Motherhood, in partnership with White Ribbon Alliance India and GRAVIS (Gramin Vikas Vigyan Samiti) in 10 villages of Osian block of Jodhpur district, the results have begun to show.
When Goga, in her mid 20s, had her first child, a son, nine years ago and her daughter, who is now two years old, she wasn't aware of the need to have iron tablets, or get herself weighed every month to ensure she and her baby were fine or get her BP checked. But when she was carrying her newest addition, a daughter who is now five and a half months old, she paid attention to her diet.
"I ate greens, bajra rotis, iron tablets, took tetanus injections. The jaapa (birth) went off well," said Goga, smiling shyly. Goga, whose husband is a carpenter in Surat, Gujarat, managed to save Rs.5,000 by putting aside some money for her delivery every month. But she didn't have to spend a paisa. In fact, under the Janani Suraksha Yojana of the National Rural Health Mission of the central government, Goga got a cheque for Rs.1,400 a fortnight after the birth and was also compensated for the Rs.300 she spent on the vehicle to reach the primary health centre at Osian, some 27 km away.
In between her first and second child, Goga had three miscarriages, which is a common story among the women here. She underwent medical treatment at Umaid Hospital in Jodhpur for nine months at a cost of Rs.10,000, she said.
"Attitudes (to birth preparedness) have begun to change, and that is a big thing," said Smita Bajpai, programme officer of Chetna, an NGO.
"In our initial phase of work here, we had to deal with a lot of hostility from family elders. The in-laws would tear up our posters and other material we would bring to educate women, and tell us to go away. It took us some persistence to break through."
Ganga, who has four daughters, gave birth to a little boy a few months ago. Her eldest daughter is 12. A resident of Khabada hamlet, set among the sand dunes, Ganga had three miscarriages before the birth of her fifth child. All her babies were born at home. In the case of the last child, Ganga registered with the primary health centre, took her injections on time, and wrote down the important numbers on the calendar.
One major change among the women now is that they go for birthing at hospitals, either the primary heath centre or the nearest facility that is equipped to handle births. Earlier, births would take place at home as a norm, assisted by the dais or midwives.
Have the Safe Motherhood measures helped reduce the maternal mortality rates in the villages?
Aparajita Gogoi, country director CEDPA (the Centre for Development and Population Activities), which helped form the White Ribbon Alliance India, says the measures may not lead to direct prevention of maternal mortality but are extremely important "in preventing delays which lead to maternal deaths".
"Women alone cannot take the key steps for birth preparedness, and they need their husband's support and families support in preparing for steps like locating the nearest health centre, arranging transportation and money and blood donors and having emergency numbers handy," said Gogoi.
As Ganga's mother-in-law said, "We followed all the instructions to see that nothing goes wrong for the jaapa this time."