Being a mother is one of the most phenomenal events in a woman's life. Nothing gives some more joy than holding a baby in her arms. But for some women, it is a challenge being a mother during all this for the ongoing outbreak of the coronavirus pandemic. Feeling anxious and feeling of uncertainty have crept in during the otherwise happy time and yet they have handled the situation quite gracefully. At Medicircle, we present to you the National Safe Motherhood Awareness Series, wherein we are featuring some successful Mompreneurs, Obstetricians and Gynecologists, other healthcare professionals, and entrepreneurs who are working on safe motherhood to raise awareness about adequate access to care during pregnancy and childbirth and postnatal services. 

Dr. Nupur Gupta is a Consultant Gynecologist and Obstetrician. She is the Director of the Obstetrics and Gynecology Department at Fortis healthcare Hospital.  She's also the founder of Dr.Nupur’s Well Women Clinic. She has published numerous journal articles, book chapters for continued medical education in newspapers and magazines.

Safe motherhood is quality care for all mothers 

Dr. Nupur Gupta says, “The term safe motherhood means quality care. Women need special care during pregnancy irrespective of being in rural and urban areas. High-quality care during pregnancy time is termed safe motherhood. Mothers have the right to have this safety, safe abortion, and motherhood care at this time with hospitals, doctors, and especially institutional delivery. So, all these components are very important to give adequate antenatal care. Safe motherhood is celebrated every year since 2003 to create awareness about the same. It should also encompass newborn care, breastfeeding, and psychological support which mothers need post-delivery. 

Obstetricians, healthcare workers from other departments, and the government must work hard to improve services for mothers. Now, we also have dedicated mother and child hospitals to give some quality care. We are also working on the institutional deliveries. So, any complication related to maternal and child health can be taken care of and detected at an early stage. "

Prenatal care and Preconception check-up is a must 

Dr. Gupta informs, “It is important to have preconception checkups. So, when any reproductive age female is planning to get married and have a baby,  she should visit the gynecologist in the preconception period for screening of non-communicable diseases like hypertension, diabetes, and other viral infections. Nowadays, we also do screening for thalassemia before your planned pregnancy to identify any problems, so that corrective measures can be adopted. During the nine months of pregnancy, for the first 28 weeks, a monthly check is a must. From 28 - 36 weeks, a weekly check-up is a must. From 36 weeks till delivery, weekly care and close monitoring is a must” 

The main focus is to reduce the maternal mortality and morbidity rate

During the last year, our main focus is to minimize and prevent infections to mothers during pregnancy. It is important to offer them protection and adequate accessible care which they need during this time. Preconception care, pregnancy care are very essential for every woman. Women can go for antenatal classes and teleconsultation to know better about signs and symptoms. They can make a birth plan for the mode of delivery with regular vaccinations which is a must during pregnancy. This will help to screen high-risk mothers who have a medical illnesses like kidney or liver disease or hypertension and diabetes. It is also important to educate them about the breastfeeding of the newborns as well.”

The major reason for Maternal Mortality Rate (MMR) in India 

Dr. Gupta states, “Indian accounts for the larger burden of Maternal Mortality Rate. The major reason for this is illiteracy. The rural population of India does not have access to antenatal care. Screening of high-risk disorders in mothers is very important. Some complications might occur like preeclampsia or pregnancy-induced diabetes especially in women who suffer from PCOS or with a family history.   

Sepsis: Infection takes place in cases of unsafe deliveries or abortions. It may also be due to a lack of proper facilities or home deliveries. It is important to do screening to reduce the mortality and morbidity rate.” 

Causes of complications in pregnancy

Dr. Gupta informs, “ The problems in pregnancy occurs due to two conditions :

- Delay in identifying high-risk factors 

- Delay in right care and facilities

A lot of Asha workers are being educated to identify high-risk factors in women. Technology is also advanced now. There are apps installed by government centers in small primary care centers. So, maternal and newborn mortality can be reduced with proper care. Blood loss due to antepartum hemorrhage is a leading cause of maternal death and can be avoidable.    

Advice from the expert for pregnant women 

Dr. Gupta states, “ Pregnancy is a beautiful experience but sometimes they also go through stress. So, I would like to advise every pregnant woman :

• It is important to work from home and stay at home    
• Go for teleconsultation instead of a visit to your doctor
• Avoid unnecessary gathering 
• Avoid travel in order to keep infections at bay
• Take vaccinations 
• Regular follow up with ultrasound and visits to doctors
• Identify high-risk warning signs 
• Monitor weight and blood pressure 
• Monitor blood sugar levels with a glucometer 
• Dietary management 
• Take your flu shot to avoid flu or pneumonia during pregnancy
• Do not ignore signs of cough fever, sore throat, loss of smell, and taste." 

Care for pregnant women during pregnancy 

Dr.Gupta informs, “It is a difficult time for expecting mothers, those who are planning pregnancy, and mothers who have conceived. It is a horror in their lives facing this tough challenge and no matter whether they move out or not. So, our advice to pregnant women is to stay at home as far as possible.”

Warning signs during pregnancy 

Dr. Gupta informs, “There are some warning signs every pregnant woman should know. 

• Bleeding during pregnancy
• Irregular bleeding after conceiving 
• Identifying ectopic pregnancy during the first trimester 
• Premature delivery 
• Threatened abortion 
• Placenta Praevia Preterm delivery 
• Cervical cancer during pregnancy   
• Fibroid polyp 
• Abdominal pain during pregnancy 
• Constipation or loose motions 
• Passage of water from the vagina during the second trimester
• Leaking membranes should not be ignored
• Hypertension during pregnancy 
• Headaches 
• Blurring of vision 
• Stress 
• Pre Existing illness 
• Complications." says Dr.Gupta 

(Edited by Dr.Rati Parwani)