Improve Primary Health Care for Pregnant Women and Fetuses

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India has the highest number of deaths among pregnant women, worldwide. India also has a significant number of babies dying during pregnancy, or soon after birth. The major causes for maternal and fetal deaths and illness during pregnancy include pregnancy induced hypertension (raised blood pressure during pregnancy), growth restriction of the baby (fetus) during pregnancy often related to hypertension and maternal nutrition, preterm delivery of the baby, congenital abnormalities of the  fetus, abnormalities of the placenta (that forms the link between the mother and fetus for transfer of nutrients and blood circulation during pregnancy) and cervical abnormalities that may predict preterm delivery and loss of pregnancy. A focus on the anatomical structure, functional integrity, environment and growth of the fetus during pregnancy is essential to improve safe deliveries in India. There are approximately  76,000 deliveries of live babies every day in India, we should aim to make all of them safe. It is not ideal, for our position as a nation and our values and culture that pregnant women and babies still are at risk for death!

Ultrasound exams and multimodality exams done sequentially can help predict and identify those at risk for pregnancy induced hypertension, fetal growth abnormalities, preterm deliveries and prematurity and congenital abnormalities.  We have cost effective ways to identify early those who are at risk for conditions that may affect maternal or fetal wellbeing. These approaches should not be limited only to those who can access advanced tertiary care Centers. Healthy babies and mothers are the future  of the country and we should aim to secure that for a bright, smart, future. 

I appeal to the IRIA to develop a plan to provide appropriate diagnostic and imaging support for every pregnant woman in India, especially through improved primary care integration.