Maternal Health Awareness: Challenges And Mental Health Requirements Of Mothers

• Traditional beliefs

• Male dominance in decision making

• Lack of family support

• Stigma associated with youth, prior terminations

• Concern with cultural safety

• Negative attitude towards health care

• Lack of decision-making power of women

• Poor knowledge and awareness on pregnancy danger signs

• Fear of going to unfamiliar areas

• Mistreatment during pregnancy and delivery

• Insufficient interactions between women and healthcare provider

Dr Shanti Pantvaidya, Executive Director, SNEHA stressed that pregnant mothers as well as their families may lack sufficient knowledge about the antenatal care (care during pregnancy). “It is important for them to hence, access the available healthcare facilities to maintain her health. We have observed that several women and their families carry misconceptions and misinformation regarding pregnancy. This includes some related to their pregnancies only after it starts showing, which may be as late as 6 months. But medically, women should reach out to health services or doctor soon after they miss their periods, that is within the first 3 months," said Dr. Pantvaidya.

Dangers of infectious diseases

The doctors also highlighted that pregnant mothers need to be aware of the risk of contracting infectious diseases. Dr. Muppidi highlighted that during pregnancy, some common infections that may occur are the flu, vaginal yeast infections, uterine infections, group B streptococcus and bacterial vaginosis. “Changes in immune function may cause this increased risk of infection, and if left untreated, may lead to serious complications. Complications from severe infections during pregnancy may include preterm birth, low birth weight, birth defects, learning problems, and possibly pregnancy loss," said Dr. Muppidi. She added that Viruses and infections associated with pregnancy include herpes simplex virus (HSV); varicella zoster virus (also known as chickenpox); cytomegalovirus; rubella; human immunodeficiency virus (HIV); hepatitis; influenza; and Ebola.

Dr. Pantvaidya highlighted that pregnant women living in informal settlements also need to be aware about the environmental factors that can contribute to the spread of such diseases. “Based on the area that they live in, they need to be aware of preventing mosquito bites, and removing stagnant water in their localities. Any early signs of a diseases such as fever, feeling sick or malaise, body ache, headache, getting shivers, etc. needs to be reported immediately. Early reporting of such issues will help doctors to provide them with timely medication and treatment," shares Dr. Pantvaidya.

Ways to promote maternal health

Dr. Pantvaidya highlighted that public healthcare systems need to provide services adopting the WHO standards but at the same it needs to be tweaked appropriately to the context of the Indian healthcare demands. “In Mumbai and its peri urban areas, we have seen how municipal corporations are providing all the 9 core services to pregnant women. But we need to also include feedback meetings with pregnant women as that will help in improving these services to meet their requirements in the future. For example, we have observed that pregnant women say they have to wait for long when it comes to accessing such services. When this was mentioned, we did notice a change brought about in the waiting period for women to access such services. There are other feedbacks such as women requiring wash room facilities. Because of space constraints in the informal settlements, these require innovative solutions," opines Dr. Pantvaidya.

She also highlighted the importance of mental health and wellbeing during pregnancy. “For this, the family needs to be part of the process. As per our experience, we have noticed that domestic violence can begin during pregnancy. Societal pressure often leads to the newly married woman getting pregnant within 2-3 months of marriage. The just pregnant mother then starts facing restrictions to her mobility, her desired pursuits and leading soon to emotional or in some cases physical abuse onset. Thus, it is important to identify early onset of violence and take measures to address and prevent. This helps ensure health and wellbeing of both mother and her baby," adds Dr Pantvaidya.

Dr. Muppidi also highlighted that asymptomatic urinary tract infections may occur in 10% to15% of pregnant women and can lead to complications, including premature labor. “A urine culture is best to be completed as part of the screening process during early pregnancy to help treat the infection early and prevent complications, such as pyelonephritis. If a positive culture result exists, antibiotic therapy for 7 days is recommended to treat bacteriuria as shorter therapy is less effective," concluded Dr Muppidi.