Birth pangsWe can't afford to ignore the rights of pregnant women and newborns.
The Supreme Court's interim order in the name of the Nepal government to make special arrangements for regular check-ups and vaccination for pregnant women and their new-born babies during the nationwide lockdown is a wake-up call for all of us concerned about mother-child safety. Citing the constitution’s provision of ensuring safe motherhood and the right to reproduction, the order decreed that there can't be any hindrance for women to enjoy these rights.
No court order should have been necessary for us to act on these constitutionally mandated rights. Even the Right to Safe Motherhood and Reproductive Health Act, 2075 (2018) emphasises the need to make provisions relating to the care of pregnant women and newborns. Further, the federal and provincial governments are required to appropriate grants from their budgets for the local levels towards ensuring safe motherhood and reproductive health rights. The top court’s order is a timely reminder that we have failed to fulfil the duties that concern each household in the country.
According to the 2016 Nepal Demographic and Health Survey, only 57 percent of births were delivered at a health facility in 2016; it was only 8 percent in 1996. The maternal mortality ratio (MMR) was 239 deaths per 100,000 live births for the seven years before the 2016 survey; it was 539 in 1996. These data sets indicate a great leap forward in the past two decades and more, but we can’t tire out just yet. Nepal has already failed to act on its commitment to reducing MMR to 125 per 100,000 live births by 2020. Worse still, the Covid-19 pandemic has led to a 200 percent rise in MMR, with at least 24 women dying due to birth-related complications in the first two months of the lockdown against a total of 80 such deaths during the whole of the previous fiscal year.
The situation might actually be worse than is reported. We're looking at a greater morbidity rate this year if the country continues to reel under the indiscriminate lockdown, limiting pregnant women's access to health facilities. Women today hesitate to seek medicare for fear of Covid-19 transmission. Even those who need to visit emergency rooms are denied access as a large number of health facilities have stopped providing services owing to the pandemic. The lack of clarity on whether Covid-19 has a high chance of being transmitted to pregnant women due to negligence at health facilities—especially in regards to the death of a new mother in mid-May—has possibly discouraged expectant mothers from seeking medical help institutionally. Couple that with the alarming shortage of misoprostol, a medication used to treat postpartum haemorrhage and a trusted weapon against maternal morbidity, in 61 out of 77 districts across the country, what we know for certain is that this is no country for women.
Even as the government claims to be fighting tooth-and-nail against the pandemic—let's not even delve into how we’re losing the battle by the day—maternal morbidity continues to dwarf Covid-19 casualties. Talking big and doing nothing is not an option anymore. Pandemic or otherwise, the time to act on reproductive health rights is now.