Nearly half of all pregnancies in India now carry high risks, according to a recent analysis of national data. Researchers from the Indian Council of Medical Research (ICMR) and the National Institute for Research in Reproductive and Child Health, Mumbai, found that 49.4 percent of pregnant women in India have at least one high-risk factor. This alarming figure comes as India records about 30 million pregnancies each year, resulting in 23 to 27 million live births, making it the country with the highest number of births globally.[indiatoday+2]
Rising Risks and Dire Consequences
This high prevalence of complicated pregnancies directly links to India's significant maternal mortality rate. In 2023, India accounted for the second-highest number of maternal deaths worldwide, with 19,000 women dying. This means approximately 52 mothers die every day due to pregnancy-related complications. Health experts state that severe bleeding, infections, high blood pressure disorders, and complications during or after delivery cause most of these deaths. High-risk pregnancies are also responsible for 75 percent of perinatal deaths in India.[indiatoday+4]
The ICMR analysis, based on data from the National Family Health Survey-5 (NFHS-5), shows that 33 percent of pregnant women have a single high-risk factor. Another 16.4 percent face multiple risk factors. Women with no education and those from the poorest wealth groups face significantly higher odds of having a high-risk pregnancy.[pmc+6]
Key Factors Driving High-Risk Pregnancies
Several factors contribute to the rising number of high-risk pregnancies across India. Short birth spacing, or a quick succession of pregnancies, affects 31.1 percent of women. Nearly one in five women, or 19.5 percent, reported adverse outcomes like miscarriage, abortion, or stillbirth in their previous pregnancies. Caesarean deliveries in recent births also contribute to high-risk profiles for 16.4 percent of women.[pmc+10]
Other significant risk factors include maternal age, with adolescents (15-17 years) and women over 35 facing higher risks. Women with short stature or a high Body Mass Index (BMI) also show increased vulnerability. Pre-existing health conditions such as diabetes and hypertension further complicate pregnancies. Lifestyle choices like alcohol consumption and smoking also contribute to these risks. Dr. Sumana Banerjee, unit head of obstetrics and gynecology at Aakash Healthcare, Delhi, said poor lifestyle choices significantly increase high-risk pregnancies.[pmc+8]
The burden of high-risk pregnancies is not uniform across India. Northeastern states show the highest prevalence. Meghalaya reports 67.8 percent of pregnant women with one or more high-risk factors, followed closely by Manipur at 66.7 percent.[pmc+3]
Government Efforts and Remaining Challenges
The Indian government has launched several initiatives to improve maternal health outcomes. The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), started in 2016, offers comprehensive and free antenatal care, especially for high-risk pregnancies. The Extended PMSMA (e-PMSMA), launched in January 2022, focuses on tracking high-risk pregnancies and provides financial incentives for monitoring until safe delivery. Schemes like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakram (JSSK) promote institutional deliveries and offer free services, including for C-sections.[pmc+8]
India has seen a decline in its Maternal Mortality Ratio (MMR), which measures maternal deaths per 100,000 live births. The MMR fell from 130 in 2014-16 to 97 in 2018-20, and further to 88 for 2020-22. The country aims to achieve the Sustainable Development Goal target of reducing MMR to below 70 by 2030. However, the ICMR analysis warns that India might still fall short of this target despite its progress.[unicef+7]
Investing adequately in maternal healthcare is crucial. Fully meeting the recommended healthcare needs for pregnant women and their newborns would cost an estimated $7.9 billion (₹582 billion) annually. High out-of-pocket spending on maternity care remains a significant barrier for many families, hindering access to quality care during pregnancy and childbirth. Overcrowded public health facilities, overworked staff, and inadequate infrastructure also pose ongoing challenges to improving maternal health. Addressing these issues requires sustained policy attention and increased investment in public health services.[guttmacher+3]
