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Maternal Mortality Rate (MMR) - Important Facts & State-Specific Findings for UPSC!

Last Updated on Dec 26, 2023
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Maternal Mortality Rate (MMR) is defined as the number of maternal deaths due to pregnancy or termination during a specific time period per 100,000 live births during the same time period, regardless of the site or duration of the pregnancy. The risk that comes with pregnancy for women is represented by the maternal mortality ratio. The term “maternal mortality” refers to a woman dying while pregnant or within 42 days after having given birth.

Maternal Mortality Rate (MMR) is one of the important topics for the UPSC IAS Exam. It will help you to cover the Indian society notes for the GS Paper-1 Syllabus

In this article, we shall cover in detail definitions, determinants of maternal mortality in India, and various other concerns important for the UPSC exam!

Maternal Mortality Rate (MMR) UPSC Notes: Download PDF here!

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What is Maternal Mortality Rate?

The Maternal Mortality Rate (MMR) is a key indicator of the health and well-being of women during pregnancy and childbirth. It refers to the annual number of deaths from any cause related to or aggravated by pregnancy and childbirth, occurring within 42 days of termination of pregnancy, per 100,000 live births.

मातृ मृत्यु दर (एमएमआर) – यूपीएससी नोट्स के लिए हाल के तथ्य और राज्य विशिष्ट निष्कर्ष यहां जानें!

Maternal Mortality Rate Calculation

Maternal Mortality Rate is calculated by dividing the total number of resident live births in the same geographic area for a given time period, typically a calendar year, by the total number of resident maternal deaths within 42 days of pregnancy termination due to complications during pregnancy, childbirth, and the postpartum period.

The maternal mortality rate formula is given below:

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Maternal Mortality Rate in India

In 1990, India had an exceptionally high Maternal Mortality Ratio (MMR), with 556 women dying during giving birth for every 100,000 live births. Every year, over 1.38 lakh women pass away from pregnancy- and childbirth-related problems. At the time, the global MMR was substantially lower, at 385. However, MMR in India has been declining more quickly lately. MMR in the nation dropped to 167 (2011–2013) compared to a global MMR of 216. (2015). Maternal deaths have decreased by 68.7% overall. According to the UN-MMEIG (Maternal Mortality Estimation Inter-Agency Group) report, India’s percentage of maternal deaths worldwide has drastically decreased to roughly 15%.

India’s Falling MMR

  • The MMR in India has decreased by 68.7%, from 556 in 1990 to 174 in 2015 (25 years), a fall of 4.6% on average every year. In India, the Maternal Mortality Ratio (MMR) dropped from 130 in 2014-2016 and 122 in 2015-17 to 113 in 2016–18.
  • India also agreed to adhere to the most recent Sustainable Development Goals (SDG) objective for the MMR, which is 70 per 100,000 live births by 2030. SDG Target 3.1 states to reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
  • Most of India’s neighbours — Nepal (186), Bangladesh (173) and Pakistan (140) — have a higher MMR. However, China and Sri Lanka are way ahead with MMRs of 18.3 and 36, respectively.
  • Many developed countries have successfully brought down MMR to single digits. Italy, Norway, Poland and Belarus have the lowest MMR of two, while it is seven in both Germany and the UK, 10 in Canada and 19 in the US.

NRHM’s Role in Falling MMR

Institutional births nearly doubled with the implementation of Janani Suraksha Yojana (JSY) under National Rural Health Mission. Between the National Family Health Survey III (2005–2006) and NFHS IV, it rose from about 38% to 78%. Since 2010, every pregnancy in the nation has been tracked by the online Mother and Tracking System. Additionally, NRHM permitted the support of nurse midwives. Under supervision, they provide medications, intravenous fluids, and antibiotics during crises. Women who did not deliver in hospitals were attended to by Accredited Social Health Activists (ASHA). NRHM made an attempt to increase the number of ASHA visits. The Janani Shishu Suraksha Karyakram (JSSK) was also put into practice in addition to these.

State Specific Findings on MMR

  • Maternal mortality is quite high in seven Indian states. They are Assam, Madhya Pradesh, Bihar, Odisha, Uttar Pradesh, Madhya Pradesh, and Chhattisgarh. To have a “very high” MMR, there must be 130 maternal deaths for every 100,000 live births.
  • Punjab, Uttarakhand, and West Bengal all have “high” MMRs. Per 100,000 live births, this translates to 100–130 maternal fatalities. In Haryana and Karnataka, it is “low” (71-100 maternal deaths per 100,000 live births).
  • The states with the largest reductions in MMR are Uttar Pradesh, Rajasthan, and Bihar. MMR has increased in West Bengal, Haryana, Uttarakhand, and Chhattisgarh from the previous survey.
  • In comparison to the MMRs of 201 in 2014–16, 216 in 2015–17, and 197 in 2016–18, Uttar Pradesh’s MMR for 2017–19 was 167. The MMR for Bihar in 2017–19 was 130, falling from 165 in 2014–16, 165 in 2015–17, and 149 in 2016–18.
  • In comparison to 199 in 2014–16, 186 in 2015–17, and 164 in 2016–18, Bihar’s MMR was 141 in 2017–19.

Image Credit: Office of the Registrar General of India

Image Credit: Office of the Registrar General of India

Learn more about Maternal and Neonatal Tetanus!

Causes of High Maternal Mortality Rate

Several factors contribute to a high Maternal Mortality Rate (MMR). They can be broadly categorized into direct and indirect causes:

Direct causes

  • Hemorrhage
  • Pre-eclampsia and eclampsia
  • Puerperal sepsis
  • Complications from delivery
  • Unsafe abortions

Indirect causes

  • Pre-existing medical conditions
  • Malnutrition
  • Early marriage and childbearing
  • Limited access to quality healthcare
  • Gender inequality and social factors

Learn more about the Infant Mortality Replacement Rate!

Government Initiatives for Improving Maternal Mortality Rate (MMR)

The Ministry of Health and Family Welfare (MoHFW) is assisting all States and Union Territories in implementing the Reproductive, Maternal, New-born, Child, Adolescent Health and Nutrition (RMNCAH+N) strategy under the National Health Mission (NHM) based on the Annual Program Implementation Plan (APIP) submitted by States and UTs in order to reduce the Maternal Mortality Rate (MMR). 

  • Comprehensive Abortion Care Services- The provision of medications, equipment, information education and communication (IEC), among other things, as well as training of healthcare professionals, increase the services for comprehensive abortion care.
  • Midwifery programme- The goal of the Midwifery Program is to develop a cadre of Nurse Practitioners in Midwifery who are competent in accordance with International Confederation of Midwives (ICM) competencies and able to provide compassionate services for women-centred, maternal, and newborn health care.
  • Delivery Points- The nation’s more than 25,000 “Delivery Points” have improved infrastructure, tools, and educated staff to provide full RMNCAH+N services.
  • Janani Suraksha Yojana (JSY) 2005- It is a demand promotion and conditional cash transfer program. It intends to lower maternal and infant mortality by encouraging institutional delivery among expectant mothers.
  • Janani Shishu Suraksha Karyakram (JSSK) 2011- It gives pregnant women and unwell babies access to free transportation, cesarean deliveries, diagnostics, medications, other consumables, diets, and blood in public health facilities in an effort to minimize out-of-pocket costs for these individuals.
  • Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) 2016- On the ninth day of every month, MatritvaAbhiyan (PMSMA) offers pregnant women a set day of quality antenatal care that is guaranteed to be free of charge.
  • LaQshya 2017- LaQshya wants to raise the standard of care provided to expectant mothers and their babies in operating rooms and labor rooms so that they can have a healthy delivery and early postpartum period.
  • SurakshitMatratvaAshwasan (SUMAN) 2019- Aspires to provide every mother and a newborn who visits a public health institution with guaranteed, dignified, respectful, and high-quality healthcare at no cost.
  • Functionalization of First Referral Units (FRUs)- Ensure the First Referral Units (FRUs) are functional by providing staff, blood storage facilities, referral connections, etc.
  • Setting up of Maternal and Child Health (MCH)- The establishment of Maternal and Child Health (MCH) Wings in facilities with a large caseload to enhance the standard of care given to mothers and children.
  • Maternal Death Surveillance Review (MDSR)- The goal is to enhance the standard of obstetric treatment and take remedial action at the proper levels.
  • Monthly Village Health, Sanitation and Nutrition Day (VHSND)- Community outreach initiative for the provision of nutrition-based maternal and child care.

Maternal Mortality Rate vs Ratio

The Maternal Mortality Ratio is the number of maternal deaths per 100,000 live births each year from any cause connected to or aggravated by the pregnancy or its management (apart from accidental or incidental causes) during pregnancy, childbirth, or within 42 days of termination of pregnancy.

The Maternal Mortality Rate is the number of maternal fatalities in a population divided by the number of women of childbearing age. It includes the probabilities of getting pregnant and dying while pregnant (including deaths up to six weeks after delivery).

Conclusion

Maternal health is a crucial component of any nation’s growth in terms of boosting fairness & lowering poverty. Mothers’ survival and well-being are crucial for addressing major issues in the economy, society, and child development, in addition to being significant in and of themselves. One of the key metrics for assessing the effectiveness of the nation’s healthcare system is the maternal mortality ratio. India has already been commended by the WHO for its efforts to lower the rate of maternal mortality. India has made impressive strides in lowering maternal death over the past 20 years, but it still needs to pay particular attention to the states with higher MMR.

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Maternal Mortality Rate (MMR) FAQs

The Maternal Mortality Rate is the number of maternal fatalities in a population divided by the number of women of childbearing age. It includes the probabilities of getting pregnant and dying while pregnant (including deaths up to six weeks after delivery).

The formula for calculating maternal mortality rate is (Number of maternal deaths / Number of live births) X 100,000.

Although there are several factors that contribute to maternal deaths worldwide, haemorrhage continues to be the leading one, responsible for about 25% of deaths.

According to data from 2020, India's infant mortality rate during the period of 2016–18 decreased by 7.4% to 113 from the MMR in 2015–17, which was at 122, a decrease of 6.2 percent. The current infant mortality rate for India in 2022 is 27.695 deaths per 1000 live births, a decrease of 3.74% from 2021.

The United Nations Children's Fund (UNICEF) lists severe bleeding, infections, high blood pressure throughout pregnancy, anaemia, problems following delivery, and unsafe abortions as the main causes of maternal mortality. The majority of these problems can be resolved with appropriate medical care, which is occasionally difficult to obtain.

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