Childbirth

Maternity benefits of at least `6,000 per child are a legal right of all Indian women under the National Food Security Act, 2013. In practice, a large majority are still deprived of maternity benefits. A recent survey, conducted in six states of North India, reveals that pregnant women’s basic needs for nutritious food, proper rest, and healthcare are rarely satisfied. Among the women who had recently delivered a child, about half had eaten less than the usual during pregnancy and nearly 40% complained of a lack of rest at that time. The average weight gain during pregnancy was just 7 kg. There is, thus, an urgent need for better recognition of the special needs of pregnancy, provision of maternity benefits in accordance with the law, and better support for pregnant women, including quality healthcare.

Using data from the household surveys on health conducted by the National Sample Survey Office between 2004 and 2014, the utilisation patterns of health facilities for childbirth and the associated
out-of-pocket expenditure are analysed. The findings reveal that the utilisation of public facilities for childbirth increased three times in rural areas and almost one and a half times in urban areas between 2004 and 2014, but that most deliveries took place in district hospitals. Also, the average medical expenditure on childbirth in government health facilities declined by 36% in rural areas and by 5% in urban areas. Considerable interstate variations in regard to oop expenditure on drugs, diagnostics and transportation were also witnessed. Though government policies to promote institutional births have improved the utilisation of public facilities and reduced the overall oop expenditure, more needs to be done for the benefits to reach the vulnerable sections, especially in urban areas.