Maternal mortality has been identified as a priority issue in health
policy and research in India. The country, with an annual decrease of
maternal mortality rate by 4.9% since 1990, now records 63,000 maternal
deaths a year. India tops the list of countries with high maternal
mortality. Based on a verbal autopsy study of 403 maternal deaths,
conducted in 2008, this paper explores the missed opportunities to save
maternal lives, besides probing into the socioeconomic factors
contributing to maternal deaths in Jharkhand, India. This
cross-sectional study was carried out in two phases, and a multistage
sampling design was used in selecting deaths for verbal autopsy.
Informed consent was taken into consideration before verbal autopsy.
The analytical approach includes bivariate analysis using SPSS 15,
besides triangulation of qualitative and quantitative findings. Most of
the deceased were poor (89%), non-literates (85%), and housewives
(74%). Again, 80% died in the community/at home, 28% died during
pregnancy while another 26% died during delivery. Any antenatal care
was received by merely 28% women, and only 20% of the deliveries were
conducted by skilled birth attendants (doctors and midwives). Delays in
decision-making, travel, and treatment compounded by ignorance of
obstetric complications, inadequate use of maternal healthcare
services, poor healthcare infrastructure, and harmful rituals are the
major contributing factors of maternal deaths in India