Addressing Critical Knowledge Gaps in Newborn Health

Numbers Aside, India’s Newborns Face Challenges

Numbers Aside, India’s Newborns Face Challenges
S Gottipati
November 2, 2011
New York Times
Newborn News
India

Written by Sruthi Gottipati for the New York Times' India Ink.


A nurse tends to a newborn minutes after the baby was born in the labor ward of Kasturba Maternity Hospital in Delhi on Monday. Photo Lynsey Addario for The New York Times

Usha Kumar’s wails sounded like the cries of a wounded animal, guttural and wrenching, her screams seeping through the corridor of Kasturba Hospital in Delhi, until, finally, mercifully, Ms. Kumar pushed out her baby boy.

Dr. Tanvir Sharma, 29, rushed to the bleeding mother, snipped the newborn loose and whisked him off to a corner. She rubbed his back and slapped his toes and weighed him on a sheet of paper in a metal scale.

Born on Monday, the baby boy was a quivering mass of 3.47 kilograms, or 7.6 pounds. But the number truly attracting attention was 7 billion.

The United Nations Population Fund estimated that the earth’s milestone 7 billionth resident was born Monday, most likely somewhere in India. No one truly knows where or when that birth took place, but the occasion has focused attention on the conditions in which babies are born in India – and on the worrisome status of infant and child health in the world’s second-most populous, and still rapidly growing, country.

On Monday, I visited a half dozen maternity wards in Delhi, and Kasturba was the largest facility I saw. Dozens of pregnant women lay splayed, groaning on rusty beds with creaky wheels. Some clutched their heads and watched the filthy fans whirring above them. Blood and body fluids were everywhere. In dingy rooms with peeling walls and grimy peach tiles, these women knew little about the world’s 7 billionth person, nor really seemed to care.

“I don’t want to talk,” said Ms. Kumar, 32, of Chandni Chowk, saying she was still in pain.

Kasturba has 350 beds for gynecology and obstetrics, with 100 more for pediatrics. There are about 60 doctors, a dozen assigned to a given shift. They deliver about 30 to 40 babies a day – those of poor women, many of them Muslims, who believe the hospital’s proximity to the Jama Masjid, India’s largest mosque, makes it a somewhat holy place to birth their babies.

Any newborn from a poor family in India is confronted with difficult odds. India has one of the highest infant mortality rates in the world, with 50 deaths for every 1,000 births, according to World Bank figures.  Forty-four percent of children under 5 are malnourished. Only sixty-three percent of Indians aged 15 and above are literate.

But these odds seemed less immediate for some of the new mothers at Kasturba.

“It’s expensive to have a kid,” said Vidanti Mishra, 26, as she cradled the baby, her first, soon after she delivered. “We’re scared if we have children, how will we take care of them, how will we feed them? Of course I’m scared.”

One of three physicians on duty, Dr. Shuchi Lakhanpal, a second-year postgraduate student, briskly made her rounds, wearing a white lab coat and striped socks, as she doled out basic advice to mothers.

“You need to eat properly,” Dr. Lakhanpal sternly told a young woman in labor.

During a tea break, Dr. Lakhanpal said the birth of a child is often an economic decision for many of her patients, another pair of hands to eventually work and bring money for the family.

“They think more kids means more hands to help out,” she said. “They don’t realize there are more mouths to feed.”

Indeed, different Indian states and districts have been introducing different incentive programs for years to try to slow the national birth rate, even as government-mandated family planning remains a very controversial issue.

“For each individual family it’s a matter of celebration (to have children.) But natural resources are limited. If population keeps increasing, not everyone will have enough to eat and live,” said Dr. Asha Aggarwal, the head of gynecology and obstetrics at the hospital. “Have fewer children, but healthier children.”

For Dr. Aggarwal, there’s reason for hope. She says women are now more educated and more aware of the benefits of having fewer children than they were when she joined the hospital 30 years ago.

Dr. Aggarwal also pointed out that there are now more women approaching hospitals to deliver their babies as opposed to having them at home with little medical help. The scene inside Kasturba’s birthing rooms might be graphic, but Dr. Aggarwal proudly noted that her hospital is in the process of acquiring fetal monitors that would help high-risk women.

In the maternity ward, about an hour after birthing her daughter, Ms. Mishra was relieved, the pain having subsided. She cradled her first child, smiling, albeit tired.

“The choice whether to have a baby should be there for everyone,” she said.

See more of Lynsey Addario’s photos from a maternity ward in Delhi.