The scene is familiar in many Indian households: a new mother, recovering from a caesarean section, with a newborn, a painful surgical wound, and a folder of papers listing the baby's feeding schedule and immunisation dates. But what about her own care?
Key Takeaways
- India's maternal mortality ratio has fallen, but post-delivery care for new mothers remains a concern.
- Only 82.8% of mothers received postnatal care within two days of delivery, according to the NFHS-6.
- A systematic review of 26 studies identified 6,142 maternal deaths, with nearly one-quarter occurring between postpartum days 8 and 42.
What Happens to New Mothers After Birth?
India has made remarkable progress in maternal health, with the maternal mortality ratio falling from 254 deaths per 100,000 live births in 2004-2006 to 87 in 2022-2024. However, the National Family Health Survey-6 (NFHS-6) reveals that only 82.8% of mothers received postnatal care within two days of delivery, and the postnatal care recorded within 48 hours of an institutional delivery may not be a check that occurs before the mother leaves the hospital.
Why Post-Delivery Care Matters
A systematic review of 26 studies involving 8.7 million women globally identified 6,142 maternal deaths, with nearly one-quarter occurring between postpartum days 8 and 42. This is precisely when an Indian mother is at home, and what is happening to her is least visible to the system.
Traditional Postpartum Practices
A qualitative systematic review of 51 studies of traditional postpartum practices across more than 20 countries found that organised support for the mother, a prescribed period of rest, particular foods, and additional help with the baby were common elements. These practices can be read as a structured plan for recovery, feeding the mother at a time when she is depleted and breastfeeding.
What's Missing in India's Postnatal Care Schedule
India's postnatal care schedule focuses on danger signs, feeding, and breast problems rather than on recovery. The ASHA's checklist does not include blood-pressure measurement, a systematic mental health screening, or a follow-up glucose test. The arithmetic of the schedule tells its own story: six visits for the baby, three of which are hers as well.
Why Social Support Matters
A study among 403 women in Gujarat found that those with low social support had about two-and-a-half times the odds of postnatal depression compared with women who had strong support. However, attention can still gravitate toward the baby, and customs and practices cannot detect persistently high blood pressure or determine whether anaemia is contributing to the exhaustion everyone is calling normal.
What Would It Take to Consider the Mother's Condition?
A structured review can begin in minutes, asking about bleeding, pain, and her surgical wound, measuring her blood pressure, testing for anaemia, and asking about feeding difficulty, urinary leakage, prolapse, and whether she's experiencing pain during sex. It should also arrange a follow-up glucose test for the woman who had gestational diabetes.
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By the Numbers
- Maternal mortality ratio in India: 87 deaths per 100,000 live births (2022-2024)
- Percentage of mothers receiving postnatal care within two days of delivery: 82.8% (NFHS-6)
- Number of maternal deaths identified in a systematic review of 26 studies: 6,142
- Percentage of women with low social support who experienced postnatal depression: 2.5 times higher than those with strong support (Gujarat study)
Primary care also belongs here, not in place of the obstetrician or the ASHA but as part of the system that holds on to what the pregnancy revealed. It is often during pregnancy that high blood pressure or high blood sugar first appears. When the delivery record closes, that knowledge should not close with it.
We measure delivery and newborn outcomes in detail. We should give equal attention to maternal recovery after discharge. Until maternal recovery is counted, too much of it will continue to unfold privately at home, with symptoms described as 'normal' by everyone, including the mother herself, until enough time passes that she stops mentioning them and lives with ill health instead.
Frequently Asked Questions
What is the current state of post-delivery care in India?
The current post-delivery care in India focuses on danger signs, feeding, and breast problems rather than on recovery, and does not include blood-pressure measurement, a systematic mental health screening, or a follow-up glucose test.
Why is social support important for new mothers?
Social support is important for new mothers as it can reduce the risk of postnatal depression and other complications. However, attention can still gravitate toward the baby, and customs and practices cannot detect persistently high blood pressure or determine whether anaemia is contributing to the exhaustion everyone is calling normal.
What would it take to consider the mother's condition as well as the baby's?
A structured review can begin in minutes, asking about bleeding, pain, and her surgical wound, measuring her blood pressure, testing for anaemia, and asking about feeding difficulty, urinary leakage, prolapse, and whether she's experiencing pain during sex. It should also arrange a follow-up glucose test for the woman who had gestational diabetes.
